Processes of health care delivery, education, and provider satisfaction in acute care surgery: A systematic review

Kristin Degirolamo, Patrick B. Murphy, Karan D'Souza, Jacques X. Zhang, Neil Parry, Elliott Haut, W. Robert Leeper, Ken Leslie, Kelly N. Vogt, S. Morad Hameed

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


In recent years, significant workload, high acuity, and complexity of emergency general surgery conditions have led hospitals to replace the traditional on-call model with dedicated acute care surgery (ACS) service models. A systematic search of Ovid, EMBASE, and MEDLINE was undertaken to examine the impact of ACS services on health-care delivery processes and cost, education, and provider satisfaction. From 1827 papers, reviewers identified 22 studies that met inclusion criteria and subsequently used The Evidence-Based Practice for Improving Quality method and Newcastle-Ottawa Scale to score quality and level of evidence. Most studies found an increase in daytime operating, improved patient transit from emergency department to operating room to home, and decreased length of stay. Higher and more diverse case volumes improved resident education and operative experience. ACS services enhanced the educational experience of residents on subspecialty services by offloading emergency work from those services. Finally, surgeons generally felt that ACS services improved job satisfaction, productivity, and billing. The ACS model has demonstrated improvement in timeliness of care, diversified case mix, decreased costs, improved trainee learning, and increased surgeon job satisfaction.

Original languageEnglish (US)
Pages (from-to)1438-1446
Number of pages9
JournalAmerican Surgeon
Issue number12
StatePublished - Dec 2017

ASJC Scopus subject areas

  • Surgery


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