scholarly journals A special acute care surgery model for dealing with dilemmas involved in emergency department in China

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dequan Xu ◽  
Yue Yin ◽  
Limin Hou ◽  
Haoxin Zhou
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Emergency Surgery ◽  
Medical Model ◽  
Lessons Learned ◽  
First Century ◽  
Acute Care Surgery ◽  
Ed Overcrowding ◽  
Ed Visits ◽  
Care Surgery

AbstractThere was a fast growth in the number and the formation of emergency department (ED) visits in China during the twenty-first century. As a result, engaging special medical model will be essential to decompressing the ED visits. To do this, it will be important to understand which specific aspects to focus interventions on for the greatest impact. To characterize the emergency surgery patients who were seen and discharged from ED. Retrospective cohort study of hospitalized emergency surgery patients currently under the care from specialists presenting to an urban, university affiliated hospital between 01 January 2018 and 1 January 2019. This study will highlight some of the controversies and challenges and key lessons learned. During the study period there were 231,229 ED visits; 4100 of these patients were admitted for Acute care surgery (ACS) service. Multivariate analysis identified age ≧ 65 (p = 0.023; odds ratio, OR = 2.66), ACS model (p = 0.000, OR = 0.18), ICU stay (p = 0.000, OR = 118.73) as factors associated with in-hospital mortality. There was a increase in length of stay between young and elderly postoperative patients when stratifying patients by age (11.67 ± 9.48 vs 13.95 ± 9.11 p < 0.05). ED overcrowding is not just an ED problem. ED overcrowding is a systems problem requiring a systematic facility-wide multidisciplinary response. Continuous and high-quality surveillance data across China are needed to estimate the acute care surgery model which used to deal with ED overcrowding.

scholarly journals A special acute care surgery model in China: How to improve the efficiency of emergency clinical diagnosis and treatment.

2020 ◽  
Author(s):  
Dequan Xu ◽  
Yue Yin ◽  
Limin Hou ◽  
Haoxin Zhou
Keyword(s):  
Acute Care ◽  
Emergency Surgery ◽  
Medical Model ◽  
Lessons Learned ◽  
First Century ◽  
Acute Care Surgery ◽  
Urban University ◽  
Ed Overcrowding ◽  
Ed Visits ◽  
Care Surgery

Abstract Background There was a fast growth in the number and the formation of ED visits in China during the twenty-first century. As a result, engaging special medical model will be essential to decompressing the ED visits. To do this, it will be important to understand which specific aspects to focus interventions on for the greatest impact. Methods To characterize the emergency surgery patients who were seen and discharged from ED. Retrospective cohort study of hospitalized emergency surgery patients currently under the care from specialists presenting to an urban, university affiliated hospital between 01 January 2018 and 1 January 2019. This study will highlight some of the controversies and challenges and key lessons learned. Results During the study period there were 231,229 ED visits; 4,100 of these patients were admitted for ACS service. Multivariate analysis identified age ≧ 65 (p = 0.023; odds ratio, OR = 2.66), ACS model (p = 0.000, OR = 0.18), ICU stay (p = 0.000, OR = 118.73) as factors associated with in-hospital mortality. There was a increase in LOS between young and elderly postoperative patients when stratifying patients by age(11.67 ± 9.48 vs 13.95 ± 9.11 p < 0.05). we first came up with this concept of Fast Track Acute Care Surgery. Conclusions ED overcrowding is not just an ED problem. ED overcrowding is a systems problem requiring a systematic facility-wide multidisciplinary response. Continuous and high-quality surveillance data across China are needed to estimate the emerging FTACS model which used to deal with ED overcrowding. Trial registration: retrospectively registered

Evaluation of Frailty Assessment Compliance in Acute Care Surgery: Changing Trends, Lessons Learned

2022 ◽  
Vol 270 ◽  
pp. 236-244
Author(s):  
Meera Kapadia ◽  
Omar Obaid ◽  
Adam Nelson ◽  
Ahmad Hammad ◽  
Daniel James Kitts ◽  
...  
Keyword(s):  
Acute Care ◽  
Lessons Learned ◽  
Acute Care Surgery ◽  
Changing Trends ◽  
Frailty Assessment ◽  
Care Surgery

Acute care surgery: the impact of an acute care surgery service on assessment, flow, and disposition in the emergency department

2012 ◽  
Vol 203 (5) ◽  
pp. 578-583 ◽  
Author(s):  
Chad G. Ball ◽  
Anthony R. MacLean ◽  
Elijah Dixon ◽  
May Lynn Quan ◽  
Lynn Nicholson ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Acute Care Surgery ◽  
Care Surgery ◽  
The Impact

Certified acute care surgery programs improve outcomes in patients undergoing emergency surgery

2015 ◽  
Vol 79 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Mazhar Khalil ◽  
Viraj Pandit ◽  
Peter Rhee ◽  
Narong Kulvatunyou ◽  
Tahereh Orouji ◽  
...  
Keyword(s):  
Acute Care ◽  
Emergency Surgery ◽  
Acute Care Surgery ◽  
Care Surgery

scholarly journals Acute Care Surgery Billing, Coding and Documentation Series Part 1: Basic Evaluation and Management (E/M), Emergency Department E/M, Prolonged Services, Adult Critical Care Documentation and Coding

2020 ◽  
Vol 5 (1) ◽  
pp. e000578
Author(s):  
Thomas Esposito ◽  
Robert Reed ◽  
Raeanna C Adams ◽  
Samir Fakhry ◽  
Dolores Carey ◽  
...  
Keyword(s):  
Complex System ◽  
Emergency Department ◽  
Critical Care ◽  
Acute Care ◽  
Acute Care Surgery ◽  
Formal Training ◽  
Experienced Surgeon ◽  
Care Surgery ◽  
Basic Evaluation

This series of reviews has been produced to assist both the experienced surgeon and coder, as well as those just starting practice that may have little formal training in this area. Understanding this complex system will allow the provider to work ‘smarter, not harder’ and garner the maximum compensation for their work. We hope we have been successful in achieving that goal and that this series will provide useful information and be worth the time invested in reading it by bringing tangible benefits to the efficiency of practice and its reimbursement.

scholarly journals P074: Improving urology care in the emergency department through implementation of an Acute Care Urology model

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S90
Author(s):  
A. Kirubarajan ◽  
R. Buckley ◽  
S. Khan ◽  
R. Richard ◽  
V. Stefanova ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Outpatient Care ◽  
Renal Colic ◽  
Interdisciplinary Collaboration ◽  
Wait Time ◽  
Acute Care Surgery ◽  
Post Intervention ◽  
Care Surgery

Introduction: Renal colic is one of the most common presentations to the emergency department (ED), and often requires complex interdisciplinary collaboration between emergency physicians and urology surgeons. Previous literature has shown that adoption of interdisciplinary rapid referral clinics can improve both timeliness of care and patient outcomes. However, these Acute Care Surgery models have not yet been commonly adopted for urology care in the ED. Methods: In July 2016, we adopted the intervention of an Acute Care Urology (ACU) model through the creation of a rapid referral clinic dedicated to ED patient referrals, the addition of an ACU surgeon, and enhanced use of daytime OR blocks. We conducted a manual chart review of 579 patients presenting to the ED with a complaint of renal colic. Patient data was collected in two separate time periods to analyze trends before implementation of the ACU model (pre-intervention, September - November 2015), to examine the model's impact (post-intervention, September - November 2016). Secondary methods of evaluation included a survey of 20 ED physicians to capture subjective feedback through Likert scale data. Results: Of the evaluated 579 patients with a complaint of renal colic,194 patients were discharged from ED with an diagnosis of obstructing kidney stone and were referred to urology for outpatient care. The ED-to-clinic time was significantly lower for those in the ACU model (p &lt;0.001). The mean time to clinic was 15.76 days (SD = 15.47, range 1-93) pre-intervention versus 4.17 days (SD = 2.33, range = 1-12) post-intervention. Furthermore, the ACU clinic allowed significantly more patients to be referred for outpatient care (p = 0.0004). There was also higher likelihood that patients would successfully obtain an appointment following referral (p = 0.0055). Decreasing trends were shown in mean ED wait time, in addition to time from assessment to procedure. Results of the qualitative survey were overwhelmingly positive. All 20 surveyed ED physicians were more confident that outpatients would be seen in a timely manner (85% strongly agree, 15% agree). Qualitative feedback included the belief that follow-up is more accessible, that ED physicians are less likely to page the on-call urologist, and that they are able to discharge patients sooner. Conclusion: The ACU model for patients with renal colic may be beneficial in reducing ED-to-clinic time, ensuring proper follow-up after ED diagnosis, and improving patient care within the ED.

scholarly journals World society of emergency surgery study group initiative on Timing of Acute Care Surgery classification (TACS)

2013 ◽  
Vol 8 (1) ◽  
Author(s):  
Yoram Kluger ◽  
Offir Ben-Ishay ◽  
Massimo Sartelli ◽  
Luca Ansaloni ◽  
Ashraf E Abbas ◽  
...  
Keyword(s):  
Acute Care ◽  
Emergency Surgery ◽  
World Society ◽  
Acute Care Surgery ◽  
Study Group ◽  
Care Surgery
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