Acute-Care Surgery Hospitalists: Coming to a Medical Center Near You?
A surgical hospitalist program that’s been shown to improve clinical outcomes and reduce inpatient length of stay (LOS) in a non-trauma setting is replicable across the country, says the author of a recent study.
Published in the Journal of the American College of Surgeons, the study reports that a team of surgeons dedicated solely to acute-care surgeries at Sutter Medical Center in Sacramento, Calif., decreased patients’ LOS (6.5 days to 5.7 days, P<0.0016), hospital costs ($12,009 to $8306, P<0.0001), and overall complications (21% to 12%, P<0.0001).
Readmissions also “showed a downward trend” but not enough to be statistically significant. The retrospective review looked at the five-year period from 2007 to 2011, which represented the year before the service was initiated and the subsequent four years in which it was practiced.
“By decreasing variation, we improved outcomes and we improved efficiencies,” says study author Leon Owens, MD, FACS, president and chief executive officer of the Sacramento-based Surgical Affiliates Management Group, which provided the surgical coverage for Sutter Medical Center. “So we wound up saving money and taking better care of patients. We succeeded because of the uniformity of how we approached the problems and because our team of surgeons is dedicated to doing these surgeries. They do not additionally need to do an elective surgery or deal with other distractions at their office.”
Dr. Owens says he believes a well-managed team of acute-care surgeons can improve patient care at any institution that chooses to institute a similar program. “It’s not only the brilliance of our doctors but the methodology,” he adds. “Our doctors are bright and good, but if you get group-oriented, team-willing, competent surgeons, I believe this is reproducible. We believe this is going to be a common practice across the country. It’s just a matter of time to get there.” TH
