In the U.S., the quality of acute surgical care is threatened by a shortage of surgeons performing emergency procedures. This is due to the rising costs of uncompensated care, liability concerns, declining reimbursement, and lifestyle considerations. We hypothesized that a surgical hospitalist program could improve timeliness of care, emergency department (ED) efficiency and physician satisfaction, resident supervision, continuity of care, and revenue generation.
Our preliminary benchmarks seem to validate this approach. Future research will assess the effect of surgical hospitalists on average length of hospital stay for several complex conditions and determine whether morbidity and mortality are reduced (which will require adequate sample sizes and a possible multicenter study). Patient satisfaction, and the satisfaction of the other non-hospitalist surgical faculty members, will be assessed through survey instruments.
Benchmarking the Acute Care Model
In July 2005, the Division of General Surgery restructured its service at the UCSF Medical Center into a hospitalist model to improve patient access to surgical care. Our research focuses on benchmarking the surgical hospitalist program to determine its effect on timeliness of care, emergency department (ED) efficiency, physician satisfaction, resident supervision, continuity of care, and revenue generation.
The program was evaluated after 1 year, focusing on patient demographics, diagnosis, and time to consult. The data suggested that the surgical hospitalist model provides a cost-effective way for general surgeons to provide timely and high-quality emergency surgical care and enhance patient and referring provider satisfaction. Our research continues to validate these metrics.