The impact of a dedicated Acute Care Surgical Service on the delivery of care for patients with general surgical emergencies

dc.contributor.authorMetcalfe, Jennifer
dc.contributor.examiningcommitteeKeijzer, Richard (Surgery) Park, Jason (Surgery) Snider, Carolyn (Emergency Medicine)en_US
dc.contributor.supervisorHardy, Krista (Surgery)en_US
dc.date.accessioned2015-08-10T19:41:09Z
dc.date.available2015-08-10T19:41:09Z
dc.date.issued2015
dc.degree.disciplineSurgeryen_US
dc.degree.levelMaster of Science (M.Sc.)en_US
dc.description.abstractIntroduction: Acute Care Surgery (ACS) is a new model of emergency general surgery care developed to provide prompt, comprehensive, and evidence-based care to acutely ill non-trauma surgical patients. Our objective was to determine the impact of implementing ACS on efficiency of care (EOC) and patient outcomes. Methods: A retrospective review was performed for patients with acute appendicitis (AA) and biliary tract disease (BTD). EOC measures and patient outcomes were compared over two time periods: pre-ACS (2007) and ACS (2011). Results: n=1,229 patients were included in this study; n=507 (pre-ACS), and n=722 (ACS). Surgical response times and acquisition of imaging were significantly faster with ACS. Time to OR and total LOS were similar between cohorts. Similar rates of daytime operating were present. With ACS and AA, there were more perforations, more ORs were performed at night and patients were readmitted more frequently. Conclusions: Increased volumes of patients were seen with ACS, but surgical assessments and imaging were significantly faster. Inpatient EOC measures were unchanged with ACS; outcomes for AA were worse.en_US
dc.description.noteOctober 2015en_US
dc.identifier.urihttp://hdl.handle.net/1993/30660
dc.language.isoengen_US
dc.rightsopen accessen_US
dc.subjectSurgery, Acute Care Surgery, Efficiency of care, Patient outcomesen_US
dc.titleThe impact of a dedicated Acute Care Surgical Service on the delivery of care for patients with general surgical emergenciesen_US
dc.typemaster thesisen_US
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