Archive for the
‘Articles’ Category

A growing body of evidence has shown that delays in emergency surgery are linked to a host of adverse outcomes for patients and providers. A recent study published in the Canadian medical journal CMAJ is further exposing the realities of the problem – finding that 19% of the patients studied experienced surgical delays as well as post-operative hospitalizations that were 1.1 days longer and cost the hospital $1,409 more than patients who did not have to wait for surgery.

Surgical Affiliates surgical hospitalist programs address the growing and serious problem of surgical delays by providing hospitals with the resources and expertise that allow emergency operations to be performed more quickly – leading to improved outcomes for patients and hospitals.

Round-the-Clock Availability of Surgicalists Improves Patient Outcomes

In providing our hospital partners with a dedicated, in-house team of board-certified trauma and acute care surgeons delivering round-the-clock care in accordance with evidence-based guidelines, operations are performed more quickly – eliminating the need to locate an on-call surgeon that may result in delays in care and increased risk of complications for patients. And because our surgicalists provide acute care surgery within designated, on-duty shifts, emergency patients at surgical-staffed hospitals receive focused, dedicated surgical care without delays or interruptions, supporting better outcomes for patients and improved performance for hospitals.  To further enhance surgeon availability, each of our surgicalist programs is supported and led by a local medical director focused on maintaining high-quality standards and efficient clinic operations – alleviating administrative duties from the surgical team and allowing surgeons to focus more of their time on patient care.

Our Surgicalist Programs Are Associated with Decreased 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. Also 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). Over the five-year period, the JACS study showed that length of stay declined 12%, from an average of 6.5 days at the start of the program to a low of 5.7 days.

Further Insights from the CMAJ Study

In 86% of the cases in the CMAJ study with documented reasons for surgical delay, researchers found that most delays were due to system issues, such as physician, nurse, and operating room unavailability.  Our surgicalist programs help to fill these critical medical personnel gaps in providing hospitals with a team of highly qualified surgeons, nurse practitioners, and physician assistants delivering 24/7 services according to evidence-based medical protocols – eliminating emergency surgical delays, reducing patient complications and length of stay, and improving hospital performance.

Dr. Jodi Coates chose Surgical Affiliates because, “to be able to have work satisfaction, career satisfaction but family as well” is key for her. This is one of the reasons why the Surgical Affiliates’ Surgical Care Program was built and continues to grow momentum with surgical teams across the country.

Our goal is to provide a real work-life balance for all our employees with a program that enables surgeons and medical staff to enjoy doing what they love, surgeries, on their schedule. With a set schedule and no on-call shifts, our team members enjoy the benefits of quality family time and true off the clockwork schedules.

See why Dr. Jodi Coates has found her home with the Surgical Affiliates team.

You go to medical school to learn to be a surgeon. But learning how to be a good surgeon requires having a mentor who truly cares. Dr. Amir Amiri explains what he feels to be the most important aspect of a mentor, “A mentor can help you learn new techniques, skills and how to be safe as a surgeon”– both imperative to having a successful career, “but having a heart is more important than anything else. You have a lot of doctors that are just doctors.”

Dr. Lynette Scherer is the definition of a great mentor and is the reason why many of our employees choose to expand their careers by working with Surgical Affiliates under her leadership.

See why Dr. Amir Amiri is proud to be a part of the Surgical Affiliates team below.

Surgical Affiliates surgicalist programs are meeting a significant need in hospitals across the nation with an advanced acute care surgical model. Our model delivers the highest level of 24/7 trauma and emergency general surgical care to patients.  The core focus of our surgicalist programs is to help hospitals close critical gaps in emergency surgical care. In addition, the comprehensive practice management support we provide to our hospital partners is an intrinsic part of our acute care surgical model that continuously drives quality improvements and operational efficiency – impacting the entire organization.

Local Medical Director
Each of our surgicalist programs is supported and led by a local medical director focused on maintaining high-quality standards and efficient clinic operations – alleviating administrative duties from the surgical team and allowing surgeons to focus more of their time on patient care.  Highly credentialed surgeons with strong leadership experience, our local medical directors play an important role in facilitating quality improvements at every level of the program.  Surgical Affiliates medical directors also receive administrative and management support from our practice management team, comprised of experienced trauma and critical care nurse managers, nationally recognized surgeon leaders, and healthcare executives.

Our local medical directors and practice management team continuously work to identify opportunities to enhance program performance and improve patient care. Local medical directors are actively engaged in ensuring the highest level of operational efficiency and quality through ongoing activities such as:

• Working closely with the Surgical Affiliates Chief Medical Officer (CMO) to develop ongoing quality improvement projects and quality review
• Regularly interfacing with local providers
• Representing our surgical programs while serving on hospital committees
• Ensuring standardization of care with development of practice management guidelines
• Providing practice updates to ensure surgeon practices are meeting current standards through monthly meetings, literature and case reviews

Quality Management
Our hospital partners benefit from our unrelenting focus on quality management – leading to improved outcomes for patients and a “halo effect” that often results in elevated performance in multiple departments throughout the organization.  Because providing the highest quality of patient care is central to our mission, Surgical Affiliates leverages our expertise in developing and managing trauma center performance improvement programs as required by the American College of Surgeons.

• With the leadership of the local medical director and Surgical Affiliates CMO, the quality improvement programs we establish are focused on reducing variability in surgical outcomes and identifying best practices to improve our care. We utilize fundamental principles to reinforce quality that includes recognizing variabilities and inefficiencies in order to establish corrective action plans.
• Also, our robust analytic infrastructure supports our programs with the tools to benchmark performance, establish performance targets in conjunction with hospital metric development, and drive improvement initiatives in an effort to standardize best practices across our programs, such as utilizing the latest evidence-based practices to ensure accurate handoff and provide the highest quality of surgical care. As a growing body of evidence in healthcare shows, standardizing processes and functions reduces mistakes and improves efficiency – leading to better patient outcomes and improved hospital performance.

The hospitalist model of care, introduced more than 20 years ago, has helped to reshape patient care within the hospital setting while enabling hospitals to better achieve key quality outcomes. Today, the Surgical Affiliates Surgical Hospitalist Program is helping to transform the delivery of trauma and emergency general surgery care, allowing for a seamless integration within the hospital setting that also serves to complement and support a hospital’s existing hospitalist program. The end result of this integration – a productive, synergistic partnership between surgicalists and hospitalists that yields significant benefits for patients, providers, and hospitals.

Our Surgicalists Work Closely with Hospitalists in Support of Common Goals
Hospitalists – dedicated in-house physicians providing care to acutely ill hospitalized patients – are typically board-certified internal medicine physicians or general practitioners who are members of the core group of physicians delivering dedicated on-site services within the hospital setting. One important duty for hospitalists is coordinating patient care, which involves delineating a comprehensive plan of care, organizing the communication among specialists caring for a patient, and serving as the point of contact with other healthcare providers and family members for questions and updates.

In providing our hospital partners with a dedicated, in-house team of experienced board-certified trauma and acute care surgeons delivering round-the-clock care to patients, we work closely with hospitalists to provide the highest level of care to patients while seamlessly integrating with all existing hospital departments. Our surgicalists, dedicated members of our hospital partners’ in-house physician teams, closely collaborate with hospitalists in support of institutional goals such as improving patient outcomes, increasing operational efficiency, and enhancing continuity of care.

• Round-the-clock availability of surgicalists supports hospitalists in improving patient outcomes. In hospitals without surgicalist programs, hospitalists sometimes must wait for responses from on-call surgeons for patients in need of emergency surgery – resulting in possible delays in care and an increased risk of complications. Surgical Affiliates establishes experienced, highly qualified teams to provide 24/7, in-house emergency surgical support, allowing operations to be performed more quickly and leading to improved outcomes for patients and hospitals. Also, eliminating the need for hospitalists to locate an on-call surgeon for a patient in need allows them to focus more of their valuable time on patient care, further contributing to improved outcomes for patients. Additionally, we provide our hospital partners with a standardized admission grid in the Emergency Department, which allows for a streamlined admission process that facilitates improved patient flow.
• A dedicated medical director helps to increase operational efficiency and ensure seamless integration with other hospital departments, including hospitalist programs. Our experienced surgical teams are supported and led by a dedicated, local medical director focused on maintaining high-quality standards and efficient clinic operations. Also, this dedicated professional is available to serve on any hospital committee as a means of ensuring optimal integration with other hospital departments.
• Our surgicalists support hospitalists in coordinating and enhancing continuity of care.A the well-managed surgicalist program creates an improved working relationship between hospitalists and surgeons that enhances continuity of care. For example, the advantage of a dedicated in-house surgical team is that together, surgeons and hospitalists can create treatment algorithms that allow for better coordination of care – perhaps not feeding a patient who may need timely surgery or not administering blood thinners when an operation is imminent. Also, hospitalists appreciate the immediate availability of an engaged and professional surgeon who serves as a willing consultant for complicated patients and potential transfers into the facility. What’s more, our surgicalist programs provide standardized care based on evidence-based best practices, ensuring that our experienced teams of acute care surgeons reduce variations in care and create an environment in which hospitalists can come to rely on a standard approach to various clinical scenarios, reducing unnecessary tests or delays in care.

Improving the quality of care remains a priority for most hospitals, and delivering standardized care based on evidence-based protocols is a vital step in ensuring key quality measures such as increased efficiency, reduced complications, and improved patient outcomes. Surgical Affiliates assists our hospital partners in improving standardization of surgical care by providing high-quality trauma and acute care surgical hospitalist programs designed according to evidence-based best practices that are patient-centered. By decreasing variability in the delivery of surgical care, standardization of care helps to ensure that every patient receives the highest standard of care available and leads to a series of meaningful benefits for both patients and providers.

Improving Efficiency and Protecting Patients

Standardization has long been a staple ingredient in industries from power and automobile manufacturing to banking and telecommunications. In providing formal guidelines for specific procedures, standardization supports effective management and improves operational efficiency – especially in complex industries with multi-step processes. In healthcare, a growing body of evidence has shown that – as in any other industry with great complexity – standardizing processes and functions reduces mistakes and improves efficiency, leading to better patient outcomes. Our acute care surgical hospitalist programs utilize evidence-based protocols as the building blocks of procedure-specific guidelines and treatment algorithms, ensuring that experienced Surgical Affiliates healthcare professionals deliver the highest, most consistent level of quality care to every patient based on evidence-based best practices.

Providing standardized care according to evidence-based protocols decreases variability in surgical care and helps to protect patients during surgery, ensuring that no step is missed that could jeopardize patient safety. A key example of how a standardized protocol is important for protecting patients in the process of handoffs, the method of transferring the responsibility of patient care from one healthcare provider to another. This real-time process involves transferring specific information to ensure continuity of care for a patient. Time pressure and a lack of standardization may result in handoffs that are incomplete or inconsistent, undermining continuity of care and increasing the risk of patient complications. However, our teams of experienced acute care surgeons and healthcare providers comply with a standardized handoff protocol that ensures accuracy, continuity of care, and better outcomes for patients.

Enhancing Personalization of Care

Standardized and personalized care approaches can work hand in hand in delivering the highest level of care to patients. Standardization often enhances personalization by streamlining work for physicians, giving them more time to spend with patients. What’s more, standardization can help to reduce complications and the resulting time expenditure of not adhering to best practices. Because physicians make treatment decisions based in part on their unique clinical experience, standardization balances this variation in experience by revealing the outcome-specific treatments that have proven effective for thousands of patients. In this way, standardization supplements physician experience and reduces guesswork – serving as the foundation of personalized patient care for our acute care surgeons and healthcare teams.

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.