Role of interprofessional teams in emergency general surgery patient outcomes.

Autor: Oslock WM; Ohio State University College of Medicine, Columbus, OH; Center for Surgical Health Assessment, Research and Policy (SHARP), Ohio State Wexner Medical Center, Columbus, OH. Electronic address: wendelyn.oslock@osumc.edu., Ricci KB; Center for Surgical Health Assessment, Research and Policy (SHARP), Ohio State Wexner Medical Center, Columbus, OH; Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH., Ingraham AM; Department of Surgery, University of Wisconsin, Madison, WI., Rushing AP; Center for Surgical Health Assessment, Research and Policy (SHARP), Ohio State Wexner Medical Center, Columbus, OH; Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH., Baselice HE; Center for Surgical Health Assessment, Research and Policy (SHARP), Ohio State Wexner Medical Center, Columbus, OH; Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH., Paredes AZ; Center for Surgical Health Assessment, Research and Policy (SHARP), Ohio State Wexner Medical Center, Columbus, OH; Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH., Heh VK; Center for Surgical Health Assessment, Research and Policy (SHARP), Ohio State Wexner Medical Center, Columbus, OH; Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH., Byrd CA; Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH., Strassels SA; Center for Surgical Health Assessment, Research and Policy (SHARP), Ohio State Wexner Medical Center, Columbus, OH; Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH., Santry HP; Center for Surgical Health Assessment, Research and Policy (SHARP), Ohio State Wexner Medical Center, Columbus, OH; Department of Surgery, Ohio State University Wexner Medical Center, Columbus, OH.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2020 Aug; Vol. 168 (2), pp. 347-353. Date of Electronic Publication: 2020 May 12.
DOI: 10.1016/j.surg.2020.04.046
Abstrakt: Background: In response to duty hour restrictions, hospitals expanded residency programs and added advanced practice providers. We sought to determine if type of clinical support was associated with emergency general surgery outcomes.
Methods: As part of our 2015 survey of acute care hospitals, we asked hospitals whether residents and advanced practice providers participate in emergency general surgery care. Data from responding hospitals were linked to patient data (≥18 years old admitted with an emergency general surgery diagnosis) from 17 State Inpatient Databases using American Hospital Association identifiers. Analyses compared emergency general surgery patient and hospital characteristics based on type of providers assisting emergency general surgery surgeons (none, only advanced practice providers, only residents, or both). Multivariable analysis determined if presence of advanced practice providers and/or residents was associated with type of management, mortality, or complications.
Results: Eighty-three hospitals and 49,271 unique emergency general surgery admissions were included. Hospitals without residents and advanced practice providers were most likely to manage patients operatively. However, hospitals with residents (alone or with advanced practice providers) had reduced odds of systemic complication compared with hospitals without clinical support (adjusted odds ratio 0.77 [95% confidence interval 0.60-0.98] and adjusted odds ratio 0.77 [95% confidence interval 0.62-0.95], respectively), while hospitals with only residents had the lowest odds of operative complication.
Conclusion: Our findings highlight the positive effect residents (alone or partnering with advanced practice providers) can have on emergency general surgery patient outcomes.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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