The evolution of emergency general surgery: its time for a dedicated program manager
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ORIGINAL ARTICLE
The evolution of emergency general surgery: its time for a dedicated program manager Barbara Eaton1 · Lindsay O’Meara1 · Carla Aresco1 · Thomas Scalea1,2 · Jose Diaz1,2 · Brandon Bruns1,2 Received: 4 June 2020 / Accepted: 21 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Emergency general surgery (EGS) is emerging as a distinct sub-specialty of acute care surgery but continues to exist without essential processes that drive modern trauma programs. An EGS-specific quality program was created with service-based Advanced Practice Provider (SB APP) administrative oversight, thus validating the need for a dedicated EGS program manager. Methods In 2017, a quality structure was formalized with primary focus on scheduled quality meetings, peer review and outcomes review. All admission, service-specific dashboards, and readmission data were manually audited by SB APPs to confirm accuracy and identify opportunities for process improvement. Results Surgical quality metrics including patient volume, mortality, complications, readmission and infection prevention indicators, were reviewed by SBAPPs. Annual EMR data for all EGS patients was compared to data collected via manual review with a novel registry logic. Comparison of EMR generated data versus EGS registry data identified under-representation of total admissions: in 2016, the EMR identified 130 admissions with registry logic identifying 625 actual EGS admissions. The EMR identified 515 admissions in 2017 and 485 admission in 2018 with registry logic identifying 777 and 712, respectively. Review of readmission data revealed an error of 14 patients in 2017 and 11 patients in 2018. Conclusions The quest to improve quality of care for the EGS patient requires timely review of high-quality, accurate data by dedicated and trained personnel. Our process revealed the vital functions of an EGS PM are crucial in the evolution of the EGS specialty. Level of evidence Level IV economic and value-based evaluations Keywords Emergency general surgery · Program manager · Advanced practice provider
Background
This study was presented at the annual scientific meeting of the Southeastern Surgical Congress, February 8–11, 2020 in New Orleans, LA.
The field of Acute Care Surgery (ACS) encompasses the specialties of trauma, surgical critical care and emergency general surgery (EGS). In 2003 the American Association for the Surgery of Trauma (AAST) and the American
* Barbara Eaton [email protected]
Brandon Bruns [email protected]
Lindsay O’Meara [email protected]
1
Division of Acute Care Surgery, University of Maryland, R Adams Cowley Shock Trauma Center, 22 South Greene St, Baltimore, MD 21201, USA
2
Department of Surgery, University of Maryland School of Medicine, 22 South Greene St, Baltimore, MD 21201, USA
Carla Aresco [email protected] Thomas Scalea [email protected] Jose Diaz [email protected]
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Vol.:(0123456789)
College of Surgeons Committee on Trauma (ACS-COT) proposed this
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