The association between self-declared acute care surgery services and critical care resources: Results from a national survey.

Published on Jul 5, 2020in Journal of Critical Care3.425
路 DOI :10.1016/J.JCRC.2020.04.002
Ashley M. Tameron (OSU: Ohio State University), Kevin B. Ricci5
Estimated H-index: 5
(OSU: Ohio State University)
+ 10 AuthorsHeena P. Santry9
Estimated H-index: 9
(OSU: Ohio State University)
Sources
Abstract
Abstract Purpose We examined differences in critical care structures and processes between hospitals with Acute Care Surgery (ACS) versus general surgeon on call (GSOC) models for emergency general surgery (EGS) care. Methods 2811 EGS-capable hospitals were surveyed to examine structures and processes including critical care domains and ACS implementation. Differences between ACS and GSOC hospitals were compared using appropriate tests of association and logistic regression models. Results 272/1497 hospitals eligible for analysis (18.2%) reported they use an ACS model. EGS patients at ACS hospitals were more likely to be admitted to a combined trauma/surgical ICU or a dedicated surgical ICU. GSOC hospitals had lower adjusted odds of having 24-h ICU coverage, in-house intensivists or respiratory therapists, and 4/6 critical-care protocols. Conclusions Critical care delivery is a key component of EGS care. While harnessing of critical care structures and processes varies across hospitals that have implemented ACS, overall ACS models of care appear to have more robust critical care practices.
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Objective: To examine national adherence to emergency general surgery (EGS) best practices. Background: There is a national crisis in access to high-quality care for general surgery emergencies. Acute care surgery (ACS), a specialty leveraging strengths of trauma systems, may ameliorate this crisis. A critical component of trauma care is adherence to clinical guidelines. We previously established best practices for EGS using RAND Appropriateness Methodology and pilot data. Method: A hybrid (post...
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#1Kathleen B. To (UM: University of Michigan)H-Index: 9
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Importance Hospital readmission rates following surgery are increasingly being used as a marker of quality of care and are used in pay-for-performance metrics. To our knowledge, comprehensive data on readmissions to the initial hospital or a different hospital after emergency general surgery (EGS) procedures do not exist. Objective To define readmission rates and identify risk factors for readmission after common EGS procedures. Design, Setting, and Participants Patients undergoing EGS, as defin...
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