Time to surgical review: an assessment of the traditional model of emergency surgical care

Hdl Handle:
http://hdl.handle.net/10147/321606
Title:
Time to surgical review: an assessment of the traditional model of emergency surgical care
Authors:
Kelly, M. E.; Conlon, C.; Le, G. N.; Nason, G. J.; Mansour, E.; Conlon, K. C.; Ridgway, P. F.
Citation:
Kelly ME et al. Time to surgical review: an assessment of the traditional model of emergency surgical care 2014 Apr Irish Journal of Medical Science. Epub ahead of print.
Publisher:
Irish Journal of Medical Science
Journal:
Irish Journal of Medical Science
Issue Date:
Apr-2014
URI:
http://hdl.handle.net/10147/321606
DOI:
10.1007/s11845-014-1113-4
Additional Links:
http://link.springer.com/10.1007/s11845-014-1113-4
Item Type:
Article
Language:
en
Description:
The traditional model for emergency surgical care consists of an on-call team providing service to the emergency department, while simultaneously balancing the demands of elective work. Various newer models, such as the “surgeon of the week” aim to reduce the conflict between elective and emergency duties. Despite the recent focus on newer models, there remains no data on the effectiveness of the traditional model. We aim to assess the efficacy of the traditional model in a large regional hospital. Methods A retrospective study between July 2009 and March 2010 was performed. Primarily, we assessed the initial time to surgical consultation after emergency department referral. Secondarily, we evaluated the impact of time periods, days of week, and case-mix etiology on this consultation time. Results The overall median time to surgical consultation after emergency department referral was 30 min (N = 860, P = 0.709). However, the median time to consultation was 60, 30, and 20 min for daytime, evening and night time, respectively (*P < 0.001). Trauma cases had a median time of 15 min, vascular had 45 min, neoplasm had 120 min, while other categories (upper and lower gastroenterology, and skin related) were 30 min (*P = 0.025). Discussion Newer models of acute surgical care have desirable outcomes in consultation times. However, regional and economical implications have a substantial impact on which model is feasible at local levels. We demonstrated that the traditional model still remains effective in a large sized tertiary referral unit.
Keywords:
SURGERY; EMERGENCY MEDICAL CARE
Local subject classification:
MEDICAL STAFFING
ISSN:
0021-1265; 1863-4362

Full metadata record

DC FieldValue Language
dc.contributor.authorKelly, M. E.en_GB
dc.contributor.authorConlon, C.en_GB
dc.contributor.authorLe, G. N.en_GB
dc.contributor.authorNason, G. J.en_GB
dc.contributor.authorMansour, E.en_GB
dc.contributor.authorConlon, K. C.en_GB
dc.contributor.authorRidgway, P. F.en_GB
dc.date.accessioned2014-06-13T14:38:42Z-
dc.date.available2014-06-13T14:38:42Z-
dc.date.issued2014-04-
dc.identifier.citationKelly ME et al. Time to surgical review: an assessment of the traditional model of emergency surgical care 2014 Apr Irish Journal of Medical Science. Epub ahead of print.en_GB
dc.identifier.issn0021-1265-
dc.identifier.issn1863-4362-
dc.identifier.doi10.1007/s11845-014-1113-4-
dc.identifier.urihttp://hdl.handle.net/10147/321606-
dc.descriptionThe traditional model for emergency surgical care consists of an on-call team providing service to the emergency department, while simultaneously balancing the demands of elective work. Various newer models, such as the “surgeon of the week” aim to reduce the conflict between elective and emergency duties. Despite the recent focus on newer models, there remains no data on the effectiveness of the traditional model. We aim to assess the efficacy of the traditional model in a large regional hospital. Methods A retrospective study between July 2009 and March 2010 was performed. Primarily, we assessed the initial time to surgical consultation after emergency department referral. Secondarily, we evaluated the impact of time periods, days of week, and case-mix etiology on this consultation time. Results The overall median time to surgical consultation after emergency department referral was 30 min (N = 860, P = 0.709). However, the median time to consultation was 60, 30, and 20 min for daytime, evening and night time, respectively (*P < 0.001). Trauma cases had a median time of 15 min, vascular had 45 min, neoplasm had 120 min, while other categories (upper and lower gastroenterology, and skin related) were 30 min (*P = 0.025). Discussion Newer models of acute surgical care have desirable outcomes in consultation times. However, regional and economical implications have a substantial impact on which model is feasible at local levels. We demonstrated that the traditional model still remains effective in a large sized tertiary referral unit.en_GB
dc.language.isoenen
dc.publisherIrish Journal of Medical Scienceen_GB
dc.relation.urlhttp://link.springer.com/10.1007/s11845-014-1113-4en_GB
dc.rightsArchived with thanks to Irish Journal of Medical Scienceen_GB
dc.subjectSURGERYen_GB
dc.subjectEMERGENCY MEDICAL CAREen_GB
dc.subject.otherMEDICAL STAFFINGen_GB
dc.titleTime to surgical review: an assessment of the traditional model of emergency surgical careen_GB
dc.typeArticleen
dc.identifier.journalIrish Journal of Medical Scienceen_GB
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