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Impact of an Acute Care Surgery Model with a Dedicated Daytime Operating Room on Outcomes and Timeliness of Care in Patients with Biliary Tract Disease

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Abstract

Background

Although many acute care surgery (ACS) formats exist, the model established in 2006 at our academic, level 1 trauma center includes a dedicated daytime operating room. The goal of the present study was to evaluate the effect that an ACS model with a dedicated daytime operating suite would have on outcomes and timeliness of care in patients with biliary tract disease.

Methods

A retrospective cohort study was performed on all patients with biliary tract disease admitted to the University of Alberta Hospital pre- and post-ACS. Data collected included demographic information, medical diagnoses, procedures performed, and complications. Time points included the time from admission to operation, operative time, and length of hospital stay. Pre- and post-ACS groups were compared with the Pearson Chi square test and Student’s t test (α = 0.05).

Results

There were 72 patients pre-ACS and 172 post-ACS. The two groups had similar demographics and co-morbidities. The post-ACS group had a shorter time from admission to operation (34.1 vs 24.8 h; p < 0.05). There was a decrease in the number of patients awaiting daytime operating room availability (95.8 vs 60.7 %; p < 0.05), with most surgeries being done within a 24 h period versus patients waiting upwards of 3 days pre-ACS.

Conclusions

We observed a significant decrease in preoperative time by 10 h with increased access to a readily available operating room. Having a dedicated ACS team is important, but it is equally important to have a dedicated operating room with disposable time to care for unpredictable, emergent cases to realize the full potential benefit of the ACS model.

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Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, University of Alberta, 2D Walter C. Mackenzie Health Sciences Centre, 8440-112th Street, Edmonton, AB, T6G 2B7, Canada

    David W. Lim, Rachel G. Khadaroo & Sandy Widder

  2. Alberta Centre for Injury Control & Research, School of Public Health, University of Alberta, 4075 Research Transition Facility, 8308-114th Street, Edmonton, AB, T6G 2E1, Canada

    Dejan Ozegovic

Authors
  1. David W. Lim
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  2. Dejan Ozegovic
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  3. Rachel G. Khadaroo
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  4. Sandy Widder
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Correspondence to Sandy Widder.

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Lim, D.W., Ozegovic, D., Khadaroo, R.G. et al. Impact of an Acute Care Surgery Model with a Dedicated Daytime Operating Room on Outcomes and Timeliness of Care in Patients with Biliary Tract Disease. World J Surg 37, 2266–2272 (2013). https://doi.org/10.1007/s00268-013-2118-2

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  • DOI: https://doi.org/10.1007/s00268-013-2118-2

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