A lay of the land: a description of academic acute care surgery models in Canada.

Autor:	Rosenzveig A; From the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Alberta, Edmonton, Alta. (Rosenzveig); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Jarrar, Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Ottawa Hospital, Ottawa, Ont. (Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Division of Trauma/Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)., Jarrar A; From the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Alberta, Edmonton, Alta. (Rosenzveig); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Jarrar, Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Ottawa Hospital, Ottawa, Ont. (Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Division of Trauma/Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)., Stuleanu T; From the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Alberta, Edmonton, Alta. (Rosenzveig); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Jarrar, Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Ottawa Hospital, Ottawa, Ont. (Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Division of Trauma/Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)., Mamazza J; From the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Alberta, Edmonton, Alta. (Rosenzveig); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Jarrar, Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Ottawa Hospital, Ottawa, Ont. (Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Division of Trauma/Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)., Neville A; From the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Alberta, Edmonton, Alta. (Rosenzveig); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Jarrar, Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Ottawa Hospital, Ottawa, Ont. (Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Division of Trauma/Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)., Walsh C; From the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Alberta, Edmonton, Alta. (Rosenzveig); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Jarrar, Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Ottawa Hospital, Ottawa, Ont. (Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Division of Trauma/Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)., Murphy PB; From the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Alberta, Edmonton, Alta. (Rosenzveig); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Jarrar, Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Ottawa Hospital, Ottawa, Ont. (Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Division of Trauma/Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy)., Kolozsvari N; From the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Alberta, Edmonton, Alta. (Rosenzveig); the Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Jarrar, Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Ottawa Hospital, Ottawa, Ont. (Stuleanu, Mamazza, Neville, Walsh, Kolozsvari); the Division of Trauma/Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis. (Murphy) nkolozsvari@toh.ca.
Jazyk:	angličtina
Zdroj:	Canadian journal of surgery. Journal canadien de chirurgie [Can J Surg] 2024 Aug 01; Vol. 67 (4), pp. E307-E312. Date of Electronic Publication: 2024 Aug 01 (Print Publication: 2024).
DOI:	10.1503/cjs.000724
Abstrakt:	Background: Patients who require emergency general surgery (EGS) are at a substantially higher risk for perioperative morbidity and mortality than patients undergoing elective general surgery. The acute care surgery (ACS) model has been shown to improve EGS patient outcomes and cost-effectiveness. A recent systematic review has shown extensive heterogeneity in the structure of ACS models worldwide. The objective of this study was to describe the current landscape of ACS models in academic centres across Canada. Methods: We sent an online questionnaire to the 18 academic centres in Canada. The lead ACS physicians from each institution completed the questionnaire, describing the structure of their ACS models. Results: In total, 16 institutions responded, all of which reported having ACS models, with a total of 29 ACS services described. All services had resident coverage. Of the 29, 18 (62%) had dedicated allied health care staff. The staff surgeon was free from elective duties while covering ACS in 17/29 (59%) services. More than half (15/29; 52%) of the services described protected ACS operating room time, but only 7/15 (47%) had a dedicated ACS room all 5 weekdays. Four of 29 services (14%) had no protected ACS operating room time. Only 1/16 (6%) institutions reported a mandate to conduct ACS research, while 12/16 (75%) found ACS research difficult, owing to lack of resources. Conclusion: We saw large variations in the structure of ACS models in academic centres in Canada. The components of ACS models that are most important to patient outcomes remain poorly defined. Future research will focus on defining the necessary cornerstones of ACS models. Competing Interests: Competing interests:: Amy Neville reports receiving honoraria for teaching from Ethicon. Caolan Walsh reports consulting fees from Ethicon, for bariatric surgery and sleeve gastrectomies. No other competing interests were declared. (© 2024 CMA Impact Inc. or its licensors.)
Databáze:	MEDLINE
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