Author Archive

Surgical Affiliates – a national leader in establishing high-quality trauma and acute care surgical hospitalist programs – offers our hospital partners unequaled knowledge and expertise in acquiring and maintaining ACS trauma center verification. This distinctive, enhanced level of verification extends beyond state verification requirements in providing hospitals with evidence-based protocols that significantly elevate the standard of trauma care. Our surgeon-led corporate leadership team has extensive experience as both the American College of Surgeons and state-specific site reviewers, giving our hospital partners an effective depth of leadership and experience during every phase of the ACS verification process. Established by the American College of Surgeons in 1987, the Committee on Trauma (COT) Consultation/Verification Program for Hospitals promotes the development of trauma centers that provide the hospital resources necessary for trauma care as well as the entire spectrum of care to address the needs of all injured patients.

The Considerable Benefits of an ACS-Verified Trauma Center

Leveraging our extensive experience in site verifications, Surgical Affiliates works hand-in-hand with our hospital partners in helping their trauma programs achieve and maintain ACS verification standards – opening the door to an array of meaningful benefits that make the process worthwhile.

Patients receive the highest level of trauma care.

For massively injured patients, hospitals with ACS-verified trauma programs are able to mobilize quickly and respond immediately – such as supplying blood to a patient within 90 seconds of arrival. When hospitals are prepared and equipped according to these standards, patients benefit from receiving the highest level of trauma care.

ACS verification status leads to better patient outcomes.

Of course, patients receiving care for a trauma-related injury aren’t in a position to choose their healthcare team due to the urgency of the situation. ACS verification status ensures that healthcare providers adhere to the highest standards for trauma care, reducing the risk of complications and leading to better outcomes for patients. In fact, several studies have shown a relationship between ACS-verified trauma centers and patient complication rates, including a 2017 study published in the Journal of the American College of Surgeons that found an association between the lack of ACS verification and an increased complication rate for patients of any age who sustain major injuries.

It’s a financially sound decision for hospitals.

While the ACS verification process requires a significant financial commitment, our hospital partners who acquire the designation derive the financial benefits of a well-managed trauma program, such as markedly improved performance and efficiencies that impact the entire organization.

It has a significant “halo effect.”

Trauma center verification provides a structure of trauma care that produces a “halo effect” throughout the hospital organization, resulting in improved performance and efficiencies across multiple departments. Due to these wide-ranging effects, an ACS-verified trauma center can serve as a process improvement program that tends to raise the level of performance throughout a hospital.

It serves the community and keeps care locally.

The heart of a hospital’s mission is to serve the community. Establishing an ACS-verified trauma center provides an invaluable service to communities and patients by keeping care local, helping to reduce or eliminate the need to transfer patients to distant facilities to receive trauma care.

ACS verification status brings prestige.

Verification by the American College of Surgeons brings a level of credibility and respect regarding a hospital’s resources and capabilities in providing trauma care. In an era when hospital differentiation is important, an ACS-verified trauma center can help to establish a hospital’s reputation as a well-known provider of exceptional, specialized care within the community and the region.

With hospitals across the nation struggling to keep pace with the growing demand for trauma and acute care surgery, local community surgeons are often forced to perform in multiple spheres of rigorous emergency call schedules and demanding elective practices – leading to high rates of stress and professional dissatisfaction. The Surgical Affiliates acute care surgery model, providing hospitals with 24/7 emergency general surgery care, gives local community surgeons the opportunity to rebalance their surgical careers based on their own individual needs with options to focus exclusively on acute care surgery, elective cases, or a combination of both.

The advantage lies in the division of labor inherent in the Surgical Affiliates acute care surgery model, which provides hospitals with a dedicated, fully staffed trauma and acute care surgery program. An experienced team of board-certified surgical partners providing 24/7 emergency general surgery care creates significant career options for local community surgeons that often lead to reduced stress, a more rewarding professional life, and greater opportunities to lead a more balanced and fulfilling lifestyle.

Providing Appealing Career Choices for Local Surgeons

Many community-based surgeons have become weary of the old surgical model of maintaining an elective practice while taking emergency calls, yet they’re uncertain about the unknown implications of a dedicated trauma and acute care surgery program. Because our focus is to establish community-based practices in the hospitals we serve, Surgical Affiliates welcomes surgeons who are a part of the local community to participate in our trauma and acute care surgery programs either as full-time surgical hospitalists or as part-time acute care surgeons while maintaining their own elective practices.

When a surgical hospitalist program is established, a primary concern for some local surgeons is that their operative volume and compensation will be reduced due to the elimination of all operations and the accompanying stipends. In reality, the data indicates that our surgical hospitalist programs allow local surgeons to maintain or increase their surgical case volume. The flexibility allows surgeons to either focus exclusively on their elective practice or they can combine their elective practice with part-time acute care shifts with the Surgical Affiliates surgical hospitalist program. These options represent the best of all worlds for most surgeons by giving them an opportunity to rebalance their surgical careers according to their individual needs and interests.

Improving Quality Standards and Patient Care – A Priority for Surgeons

At the heart of every surgeon’s professional mission is the desire to provide the highest level of care for patients. Our local surgical partners appreciate and value the high-quality standards on which our surgical hospitalist programs are built, leading to significant, improved outcomes for patients such as reduced complication rates and length of stay (LOS). And because we handle the details of managing the practice, our surgical partners have more time to focus on patient care.

What’s more – whether serving as full-time surgicalists or part-time acute care surgeons – our surgical partners are supported by a team of experienced healthcare professionals who comply with evidence-based medical protocols and treatment algorithms to improve standardization of care and accurate handoff. To further facilitate improved patient care and increased hospital efficiencies, a dedicated medical director serves as an engaged “boots on the ground” surgeon in each of our community-based practices.

Improving Professional Satisfaction and Opening Opportunities for Engagement

Many surgeons adhering to the old surgical model of balancing on-call and elective cases are chronically exhausted from the strain of performing in several different areas with unpredictable schedules, hindering their ability to focus their time and efforts in any one area for an extended time. In providing hospitals with a 24/7, fully staffed trauma and acute care surgery program, Surgical Affiliates support a division of labor that allows surgeons to focus their efforts where they choose and helps to optimize the efficiencies of both the elective and acute care surgical teams.

Surgeons who choose to continue caring for trauma and acute care patients while maintaining elective practices can do so within predictable, manageable part-time shifts supported by a team of board-certified surgeons and other healthcare professionals. And because trauma and acute care surgery patients are managed by the surgeon on duty, surgeons who maintain elective practices no longer worry that the needs of their elective and acute care surgery patients will conflict. The end result for local surgeons who partner with us – the chance to rebalance their surgical careers with reduced stress and more manageable schedules, opening new avenues for a more rewarding professional life and engagement within the hospital and community.

As hospitals nationwide face the ongoing challenge of managing costs while achieving improved quality outcomes, those best positioned for success in this competitive healthcare environment will give increased focus to patient safety, quality, and cost in providing value-based care. The Surgical Affiliates Surgical Hospitalist Program provides hospitals with a powerful acute care surgery model with published, peer-reviewed quality outcomes that raises the level of hospital performance and achieves cost savings that are proven and sustained.

Generating a Program of Savings Based on Documented, Peer-Reviewed Quality Outcomes

Although hospitals make an initial investment when implementing a surgical hospitalist program, the return on investment (ROI) can be substantial and typically offsets the cost of the program. We’re pleased to offer the Acute Care Surgery Program Impact Calculator, an easy-to-use tool designed to allow hospitals to quickly determine the potential ROI impact that can be achieved by implementing our acute care or trauma surgical hospitalist programs. Based on a few specific data points entered by the user, the Acute Care Surgery (ACS) Program Impact Calculator utilizes documented, peer-reviewed quality outcome data to immediately generate an estimated program of savings in three key metrics – emergency surgical case volume, length of stay (LOS), and case mix index (CMI).

Specifically, the ACS Program Impact Calculator generates a concise, one-page summary that provides an overall projection of the cost savings your hospital could achieve by implementing our surgical hospitalist programs. Also, the report provides a comparison of current and expected data points for emergency surgical case volume, length of stay (LOS), and case mix index (CMI) as well as a projected ROI impact figure for each of the three metrics. The projected savings generated with the implementation of our surgical hospitalist programs are achieved while maintaining superior quality metrics, including Center for Medicare and Medicaid Services (CMS) performance in the 92^nd percentile for quality of care at a mean cost. The data and calculations utilized on the ACS Program Impact Calculator are based on industry standards, past Surgical Affiliates case study results, and published information.

Achieving a Robust ROI with Improvements in Key Metrics

The robust ROI achieved with our surgical hospitalist programs is derived from improvements in three key cost-related metrics, namely emergency surgical case volume, length of stay (LOS), and case mix index (CMI). While the expected improvements in these areas are well documented and significant, the financial impact often extends far beyond these in providing hospitals a competitive advantage in improved performance and efficiencies throughout the organization.

Emergency Surgical Case Volume

In providing hospitals with a dedicated team of board-certified surgical partners providing 24/7 emergency general surgery care, our surgical hospitalist programs experienced an increase in surgical volume. With a highly qualified team in place to provide emergency surgical support, operations are performed more quickly and are no longer deferred until elective cases or clinic patients are completed. Also, the accessible, high quality trauma and acute care surgery programs we establish enable hospitals to create a culture of “yes,” typically increasing the number of patients transferred into the hospital for emergency surgeries and reducing the need for local patients to be transferred to other facilities to receive treatment for serious conditions requiring prompt surgery.

Length of Stay

Decreased length of stay is a key improvement directly related to the availability of 24/7 acute surgical care that is the cornerstone of our surgical hospitalist programs. Because emergency patients undergo surgery without delays, throughput within the hospital is typically improved and the availability of beds increases. Inherent in the improved length of stay metric is increased quality of care, as eliminating surgical delays reduces complication rates and improves outcomes for patients.  Improvement in the length of stay metric is well documented in peer-reviewed data from a five-year study of a Surgical Affiliates Surgical Hospitalist program with Sutter Memorial Medical Center published in the Journal of the American College of Surgeons (JACS).

Case Mix Index (CMI)

A core benefit of our surgical hospitalist programs is that we provide highly qualified surgeons who manage patients as a team in accordance with evidence-based guidelines, reducing variations in care and helping to standardize best practices across our programs. This standardization of care, in concert with the requirement that our surgeons provide documentation that supports the resources patients require, typically leads to significant improvement in CMI. Most of our programs achieve an improved CMI to 2.09, which is demonstrated in the peer-reviewed JACS study and also represents the average CMI of our current surgical hospitalist programs.

If you have questions about the results generated by the Acute Care Surgery Program Impact Calculator, or you’d like to learn more about our acute care surgery model and how it can help your hospital achieve improved quality outcomes and sustained cost savings, contact us today for a free program analysis consultation.

Learn about how today’s leading hospitals are working with Surgical Affiliates to implement 24/7 emergency surgical care. As well as how these hospitals address the fears many local surgeons have about the program’s impact on the surgical volume and team structure.

To overcome the challenges inherent in standard surgical care models, hospitals require systematic approaches that offer effective solutions to reduce transfers out of the hospital, improve current standards of care, and increase the number of surgery cases performed without sacrificing care quality.

While a surgical hospitalist program is designed to address these issues, there are several legitimate fears and misconceptions regarding these programs that are often raised by hospital medical staff. When unaddressed, these fears may perpetuate the repetitive care cycle that’s inefficient, costly, and associated with a higher risk of post-surgical complications.

The issue is, how do hospitals keep local surgeons happy under a surgical hospitalist program like the one offered from Surgical Affiliates? Also, how do hospitals prevent surgeons from threatening to take their services elsewhere when another group of acute care and emergency/trauma surgeons comes in?

Addressing the Fears of a Surgical Program

Despite the benefits of the Surgical Affiliates approach, there are some legitimate fears associated with this type of program that often prevents adoption.

When a third-party surgical team comes in to cover acute care and emergency surgery services, many hospitals fear that local on-call surgeons will find their position within the center threatened, resulting in surgeons taking their services to another hospital. The local on-call surgeons often own private practices and typically receive a stipend for emergency coverage, which helps to supplement their income. The fear of losing this stipend can provoke anxiety among local surgeons. Of course, one of the main goals is to ensure these professionals are satisfied, as they are typically prime sources of revenue for the hospital.

It’s appropriate to be concerned that an outside program will produce resentment among medical staff and result in a loss of business from the current cadre of local providers. However, the data does not support the notion that surgicalist programs decrease business — in fact, these programs help satisfy local surgeons and increase surgery caseload.

Keep reading to learn how Surgical Affiliates accomplishes this in hospitals across the nation.

How a Surgical Program Increases Business for Local Surgeons

One of the issues many hospitals have concerning a program like Surgical Affiliates is that surgeons may feel their position will become minimized following adoption. Fortunately, this surgical solution works with local surgeons and provides them options related to how and when they wish to practice, essentially resulting in zero loss in the number of cases they can perform in any given shift.

In general, hospitals participating in a surgicalist model feature an equal mix of surgeons – some surgeons want to focus on elective cases, some want the option of elective and/or emergency cases, and some want to focus purely on emergency care. Under the program, these options are available for all currently employed surgeons at the facility. And, if surgeons don’t want to take a call, they don’t have to. This can help them focus more on the elective cases that they enjoy — however, emergency cases are still theirs for the taking if they require or want the extra income.

A Surgical Program Provides Cost-Effective Care Despite Initial Investment

Another barrier to program engagement includes the initial costs associated with implementing a “‘round-the-clock acute emergency care surgical program.” Despite these fears, all hospitals under the program see a return on investment (ROI), due to Surgical Affiliate’s expertise in creating efficiencies and the program’s ability to manage surgical opportunities that may have otherwise been transferred to outside centers.

Additionally, with a greater number of on-site surgeons available for emergency surgical services, even rural hospitals become a reliable source of care in the community. This improved community-wide trust increases the number of cases that come into the hospital, thereby affecting the hospital’s bottom line.

Surgical Affiliates: Case Studies

In a retrospective 5-year study of the Surgical Affiliates strategy implemented in Sutter General Hospital in Sacramento, California, none of the surgeons in the hospital experienced a loss of business and all performed just as many operations during the 5-year period as they performed prior to program adoption. During these 5 years, complications, length of hospital stay, readmissions, and hospital costs significantly decreased for emergency cases, following the implementation of the acute care surgical model.¹

In fact, in every hospital that adopts the Surgical Affiliates program, emergency surgical volume steadily increases and the operative volume for local surgeons does not decline, despite all emergency operations being performed by the Surgical Affiliates team. NorthBay Medical Center in Fairfield, California, for instance, observed a 3.2% increase in the number of operations performed during a 2-year period. The center also observed an improvement in operating margins from a 3-year period of -2.1% in 2011 to .2% in 2012, and 6.3% in 2013.²

Learn More About Surgical Affiliates’ Surgical Program

Hospitals should present these findings to surgeons or other hospital personnel who may feel nervous about potential program adoption. Knowing the real-world data regarding how the program works and understanding how to communicate these findings to hospital staff may prevent surgeons from taking their elective surgical services elsewhere.

To learn more about the program offered by Surgical Affiliates and how it’s been successful for driving down hospital costs, reducing transfers and complication rates, and retaining and satisfying local surgeons, read through our case studies and take a look at our recent media stories demonstrating its effectiveness in today’s clinical setting.

References:

1. O’Mara MS, Scherer L, Wisner D, Owens LJ. Sustainability and success of the acute care surgery model in the nontrauma setting. J Am Coll Surg. 2014;219(1):90-98.

2. NorthBay Medical Center: Case Study. Surgical Affiliates data on file.

In this interview of the Behind the Knife Podcast, Lynette Scherer MD, FACS, Chief Medical Officer (CMO) of Surgical Affiliates, provides her take on important considerations for trauma surgeons, including early intervention, medication management, and communication among the surgical team. This podcast interview was conducted following Dr. Scherer’s talk, titled “Broken Bones – What the Trauma Surgeon Needs to Know,” presented at the 2018 Trauma, Critical Care & Acute Care Surgery (TCCACS) event held April 9-11, in Las Vegas, NV. Listen to the full interview at Behind the Knife.

“I love making a difference.” These 5 simple words are what Lynette Scherer MD, FACS, uses when asked about what makes her excited when it comes to trauma and acute care surgery.

Patients presenting the emergency room with traumatic injuries are often extremely sick and have a high mortality risk. Surgeons possessing many years of experience in trauma and general surgery substantially improve the chance of survival. This experience and skill set has driven the success of Dr. Scherer’s own practice as well as her contribution as Chief Medical Officer of Surgical Affiliates. “I think the breadth of what we do is great,” Dr. Scherer added, “and I feel like I make a difference when I go to work every day.”

Orthopedic Injury Management: Key Considerations from Dr. Scherer

Orthopedic injuries require a management approach that focuses on early intervention while maintaining quality care. Medication management is an important consideration in this setting, particularly among those with open fractures. According to Dr. Scherer, trauma surgeons need to pay close attention to delivering antibiotic treatment to patients with open fractures within a 60-minute window of hospital admission. “I realize that in some rural settings, the patient might not get to the hospital within 60 minutes, but the focus is on delivering antibiotics as soon as possible,” said Dr. Scherer. “In fact, doing this is just as important as your secondary survey.” Additionally, Dr. Scherer recommends having a goal of early termination of antibiotic therapy to ensure a positive outcome. “The other thing we have in our control is how long the patient is receiving antibiotics,” added Dr. Scherer. “The focus should be on getting these antibiotics turned off within 24-72 hours.”

The Importance of Early Intervention

Similar to most emergency surgeries, early intervention is key for improving prognosis in trauma patients, regardless of injury type. For femur fractures, however, certain challenges exist in many hospital settings that prevent timely surgical management. “I think it’s pretty well accepted on getting femur fractures fixed early,” Dr. Scherer explained, “but as we see fewer and fewer orthopedic surgeons who are willing or able to cover trauma surgeries, we’re starting to see a little bit of a push back on how quickly those femur fractures can be stabilized.” Early stabilization, according to Dr. Scherer, is key for favorable outcomes in these patients. Hospitals with a specialized 24-hour surgery team may be in a better position to ensure early intervention in these patients.

Timely Delivery to the OR

For individuals presenting to the hospital with an orthopedic injury, conventional wisdom states that these patients must be delivered to the operating room (OR) early, or at least within 6 hours of arrival. However, this isn’t always the case, particularly for low-risk injuries. “We now have pretty solid evidence, especially for the lower grade injuries, that these surgeries can be performed within 24 hours,” Dr. Scherer commented, “except for patients with grossly contaminated wounds. In that case, these wounds should be washed out as soon as possible.” Most often, a washout for contaminated wounds that count for the trauma registry “is the one that happens in the OR where devitalized tissue is debrided and the wound is completely washed out.”

Other Considerations for the Trauma Surgeon

In cases where a trauma patient has a head injury and has also developed venous thromboembolism (VTE), Dr. Scherer again advocates for early management, specifically in regard to VTE prophylaxis. “We like to start [VTE prophylaxis] within 24-48 hours after stable CT,” commented Dr. Scherer, “depending upon what kind of bleeding they had.” Communication within a neurosurgery team is also critical for appropriate management of these and other trauma patients. “I think communication with the neurosurgeons is critical, and sometimes it has to be over and over and over to get a group consensus,” Dr. Scherer explained, “and invariably there’s a discussion about patients with more complicated wounds.”

The emphasis on early presentation and treatment highlights the importance of having a robust, fully capable team of experienced and specialized trauma surgeons available to take on cases, regardless of the time of day. Surgical Affiliates works with existing hospital systems to support current surgical teams and improve standards of care by offering a 24-hour trauma and acute care service, facilitating earlier intervention and reduced transfers. To learn more about the program read through our real-world case studies here.

The pain associated with shattered bone, a sports injury, or a fractured hip can be frightening. Especially for those patients who find that treatment at their local hospital means waiting until an orthopedic surgeon can arrive. This delayed treatment is all too common across America and can substantially impact community trust while adversely impacting the overall financial status of the hospital system.

The Benefits of an Orthopedic Surgery Program

An orthopedic emergency that requires immediate surgical attention is usually the result of some type of trauma, either related to physical activity and recreation, violence, or an accident that occurs during normal activity. Types of injuries that require an orthopedic surgeon include:

• Hip fractures
• Dislocated bones
• Open (compound) fractures
• Acute compartment syndrome (extremity trauma)

Some of these injuries can be life threatening if not managed immediately. Unfortunately, some hospitals have few resources and orthopedic services on hand, resulting in delayed treatment and complications in these emergency situations.

Today, the demand for Orthopedic surgeons to provide hospital services is growing, yet issues to ensure continuity of care has proven challenging. The utilization of surgery programs, such as an Acute Orthopedic Surgery program, may provide a direct solution to this issue by introducing surgeons who are devoted to 24/7 orthopedic care.

An orthopedic surgery program means relying less on locum tenens and on-call physicians and more on reliable, stable surgeons who are available to handle patients at any time of the day or night. “I guarantee you we wouldn’t have orthopedic services if it wasn’t for Surgical Affiliates–there’s not a doubt in my mind,” said Doug Archer, Sutter Health Memorial Hospital administrator in Los Banos, California. In fact, approximately 60,000 people in the area would be without orthopedic services “and they would still be driving to Salinas” if it wasn’t for implementing an emergency orthopedic surgical team at Sutter Health Memorial.

In an orthopedic surgical program, also known as a surgicalist program, surgeons become embedded in the hospital culture and are essential for ensuring efficient patient management while reducing transfers out of the facility. Adding a specialized surgical program adds new dimensions to the hospital setting by increasing the number of patients treated in-house, reducing costs, increasing revenue, and building community value and trust.

Better Care and More Patients Treated In-House

Having an orthopedic surgery program in place reduces transfers out of the facility and provides a dedicated team of orthopedic surgeons that are able to treat patients in-house as opposed to sending to a neighboring hospital that is better equipped to handle orthopedic emergencies. Specialized services also help facilitate lower average length of stay for patients, which supports the value-based care model resulting in more efficient patient management.

Growth of Hospital Staff

According to Doug Archer, many physicians who would come to work in the surgery setting at Los Banos would be gone within 2 years of hiring, in part due to the rural setting. “Continuity of care became an issue,” said Archer. Since adding a specialized team of 24/7 emergency surgeons, Memorial Hospital has been able to secure a specialty program with surgeons that stay. “They [orthopedic surgeons] have been able to develop relationships with the other hospital staff,” added Archer, “and they’ve been able to establish themselves even though they don’t live in the community. Primary care physicians are a lot more comfortable referring to someone they know rather than the orthopedist on call, which helps the community a ton. It gives us the ability to really provide a robust and complete specialty service versus piecing it together with locum tenens.”

Surgical Affiliates Acute Orthopedic Surgery Program

With the Surgical Affiliates orthopedic surgery program, hospitals can rely on a long-term approach to achieving its orthopedic surgical goals, regardless of the community setting. For rural hospitals, the program may also be helpful when recruitment and retention become challenging.

Contact Surgical Affiliates today to learn more and start improving the quality of healthcare at both the patient and practitioner level.

In the United States, approximately 1.7 million patients per year sustain a traumatic brain injury.^1,2 Estimates from the CDC suggest that roughly 52,000 deaths are attributable to traumatic brain injury nationwide.³ Some of these patients require immediate neurosurgical intervention to survive, such as when a patient requires removal of an enlarging hematoma from around the brain.

In 2013, approximately 2.8 million visits to the emergency department were associated with brain injury.⁴ Today, experienced neurosurgeons who are willing to provide emergency care are in limited supply. It is particularly hard to find those who meet and fulfill the stringent requirements for the American College of Surgeons trauma verification. Many neurosurgeons find professional satisfaction by delivering care in an elective setting, further limiting the number of available neurosurgeons to care for emergencies. Subsequently, there is a growing need for surgeons who will readily take on emergency neurosurgical cases. A surgical hospitalist program may provide the optimal solution when neurosurgeons don’t heed the emergency call.

Why Neurosurgeons Don’t Answer an Emergency Call

The workload of most surgeons has become increasingly difficult to maintain. On-call burdens and the pressure to produce more elective volume have contributed to the declining availability of surgeons for emergency care, and this is especially true for neurosurgeons. Many of today’s neurosurgeons have chosen to focus on providing high-level elective care that focuses on specialty cases. Emergency care is disruptive to this sort of an elective practice and often times emergency patients don’t have the means to provide payment for such services. The disruption of the elective practice and the inability to be paid for services to reduce the likelihood that neurosurgeons will happily embrace the emergency call burden.

According to Lynette Scherer, MD, FACS, Chief Medical Officer of Surgical Affiliates, the need in helping emergency neurosurgery patients has quadrupled in recent years because there has been a significant shortage of neurosurgeons who are willing to take emergency cases. Additionally, since many neurosurgeons perform elective cases, hospitals aren’t pressuring these highly specialized physicians to take cases they don’t want. “Neurosurgeons can really command a presence at the hospital because their cases are so valuable to the hospital and the care they provide is so critical,” said Dr. Scherer, “and the hospital often won’t force them to take the emergency call as long as they are doing their elective cases.”

Impact on Patients Requiring Emergency Neurosurgery

The lack of hospital neurosurgeons to provide care for emergency cases can result in delayed patient care and the worsening of patient outcomes. Additionally, when a neurosurgeon doesn’t answer an emergency call, hospital efficiency will subsequently be impacted since staff will need to take the time to find someone that will help the patient.

Hospitals in rural communities are especially affected by neurosurgeons who refuse to take on emergency neurosurgical cases. “If a patient shows up in a small rural center looking for help,” commented Dr. Scherer, “that hospital may be calling for hours trying to locate a neurosurgeon.” Hospitals in major metropolitan areas, although better connected and more likely to find a surgeon to help in an emergency case, are also impacted by the shortage of willing emergency neurosurgeons. Many patients have to be transferred to a center that will take them, which delays treatment for potentially life-threatening issues.

The Surgicalist Approach for Emergency Neurosurgery Cases

The surgicalist program with Surgical Affiliates offers a one-of-a-kind initiative for the field of neurosurgery. This program provides neurosurgeons who are willing and ready to take on an emergency neurosurgical procedure. At Surgical Affiliates, there is a 24/7 neurosurgery team available for emergency cases, such as cases involving epidural hematomas, traumatic brain injury, acute or infectious spinal cord processes, or stroke-related care. Hospitals who can’t find a neurosurgeon to answer an emergency case can simply partner with Surgical Affiliates who will provide a team of neurosurgeons available for immediate care.

Learn How a Surgicalist Program Can Improve Neurosurgical Care

Currently, Surgical Affiliates is the first organization to offer a surgicalist program for neurosurgery and is seen as the leader in facilitating greater and more immediate care for patients presenting with life-threatening neurosurgical problems.  If you wish to learn more about the surgicalist approach and how you can use it to improve the level of care your emergency neurosurgery patients can receive, contact us today for a free program analysis consultation.

References

1. Faul M, Xu L, Wald MM, et al. Traumatic brain injury in the United States: national estimates of prevalence and incidence, 2002–2006. Injury Prevention. 2010;16: A268.
2. Annual Number of TBIs. Centers for Disease Control and Prevention. https://www.cdc.gov/traumaticbraininjury/pdf/tbi_blue_book_annualnumber.pdf. Accessed December 8, 2017.
3. Get the Stats on Traumatic Brain Injury in the United States. Centers for Disease Control and Prevention. https://www.cdc.gov/traumaticbraininjury/pdf/bluebook_factsheet-a.pdf. Accessed November 8, 2017.
4. Taylor CA, Bell JM, Breiding MJ, Xu L. Traumatic Brain Injury-Related Emergency Department Visits, Hospitalizations, and Deaths — the United States, 2007 and 2013. MMWR Surveill Summ. 2017;66(No. SS-9):1–16.