Evidence map›Paper›PMID 31131335›Full record

ArticlePerioperative care and operating room management2018

The Impact of an Acute Care Surgery Model on General Surgery Service Productivity.

Adam N Paine, Bradley L Krompf, Edward C Borrazzo, Thomas P Ahern, Ajai K Malhotra, Mitchell C Norotsky, Mitchell H Tsai

Abstract read
In one paragraph

Article in Perioperative care and operating room management, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. The Power Law in Operating Room Management.Journal of medical systems · 2021
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Adam N PaineDepartment of Surgery, The University of Vermont Larner College of Medicine, Burlington, VT.
Bradley L KrompfDepartment of Surgery, The University of Vermont Medical Center, Burlington, VT.
Edward C BorrazzoDepartment of Surgery, The University of Vermont Larner College of Medicine, Burlington, VT.
Thomas P AhernDepartment of Surgery, The University of Vermont Larner College of Medicine, Burlington, VT.
Ajai K MalhotraDepartment of Surgery, The University of Vermont Larner College of Medicine, Burlington, VT.
Mitchell C NorotskyDepartment of Surgery, The University of Vermont Larner College of Medicine, Burlington, VT.
Mitchell H TsaiDepartment of Anesthesiology and Department of Orthopaedics and Rehabilitation (by courtesy), The University of Vermont Larner College of Medicine, Burlington, VT.

Funding

Vermont Center on Behavior and HealthP20GM103644 · NIGMS · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI KHADANGA, SHERRIE · 2013 to 2022
$21.3M
NIGMS NIH HHS P20 GM103644
6 · The paper itself

Abstract

backgroundThe Acute Care Surgery (ACS) model has been widely adopted by hospitals across the United States, with ACS services managing emergency general surgery (EGS) patients previously treated by general surgery (GS) services. We evaluated the operational and financial impact of an ACS service model on general surgeons at an academic medical center.

methodsUsing WiseOR® (Palo Alto, CA), we compared surgical case volumes for the GS service two years before (October, 2013 - September, 2015) and two years after (October, 2015 - September, 2017) implementation of an ACS service at the University of Vermont Medical Center. From financial reports, we obtained monthly wRVUs, clinical FTEs, net patient revenue, and payer mix for the GS service and compared the two years before and after ACS model implementation.

resultsThere was a significant reduction in the average number of cases performed by the GS service following ACS service implementation (monthly mean ± SD, 139.1 ± 16.0 vs. 116.7 ± 14.0, p < 0.001). The normal-hours caseload remained stable, while a significant decrease in after-hours cases accounted for the reduction in overall volume. Despite the reduction in operative volume, the decrease in mean monthly wRVU/FTE for the GS service when comparing the pre- and post- ACS periods did not reach statistical significance (614.9 ± 82.9 vs. 576.3 ± 62.1, p = 0.08).There was a significant increase in average monthly clinic-derived wRVU/FTE for the GS service (106.3 ± 13.5 vs. 120.5 ± 16.4, p = 0.007).

conclusionsShifting EGS patient management from the GS to ACS service did not negatively impact the productivity of the GS service.

background

Indexed as

Acute Care SurgeryEmergency General SurgeryGeneral Surgeryproductivitywork Relative Value Units

Identifiers

PMID31131335
PMCPMC6532993

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.