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. 2019 Aug 1;62(4):281-288.
doi: 10.1503/cjs.010718.

Impact of acute care surgery on timeliness of care and patient outcomes: a systematic review of the literature

Ashley Vergis  1 , Jennifer Metcalfe  1 , Shannon E. Stogryn  1 , Kathleen Clouston  1 , Krista Hardy  1
Affiliations

Impact of acute care surgery on timeliness of care and patient outcomes: a systematic review of the literature

Ashley Vergis et al. Can J Surg. .

Abstract
in English, French

Background: Dedicated emergency general surgery (EGS) service models were developed to improve efficiency of care and patient outcomes. The degree to which the EGS model delivers these benefits is debated. We performed a systematic review of the literature to identify whether the EGS service model is associated with greater efficiency and improved outcomes compared to the traditional model.

Methods: We searched MEDLINE, Embase, Scopus and Web of Science (Core Collection) databases from their earliest date of coverage through March 2017. Primary outcomes for efficiency of care were surgical response time, time to operation and total length of stay in hospital. The primary outcome for evaluating patient outcomes was total complication rate.

Results: The EGS service model generally improved efficiency of care and patient outcomes, but the outcome variables reported in the literature varied.

Conclusion: Development of standardized metrics and comprehensive EGS databases would support quality control and performance improvement in EGS systems.

Contexte: Des modèles dédiés de services de chirurgie générale d’urgence (CGU) ont été développés pour améliorer l’efficience des soins et les résultats chez les patients. On ne s’entend toutefois pas sur l’ampleur des bénéfices conférés par le modèle CGU. Nous avons procédé à une revue systématique de la littérature afin de vérifier si le modèle CGU est associé à une plus grande efficience et à de meilleurs résultats comparativement au modèle classique.

Méthodes: Nous avons interrogé les bases de données MEDLINE, Embase, Scopus et Web of Science (collection centrale) depuis la plus ancienne couverture du sujet et jusqu’à mars 2017. Les paramètres principaux pour l’efficience des soins étaient le temps de réponse, le délai avant l’intervention et la durée totale du séjour hospitalier. Le paramètre principal pour l’évaluation des résultats chez les patients était le taux de complications total.

Résultats: Le modèle de service CGU améliore généralement l’efficience des soins et les résultats chez les patients, mais dans la littérature, les paramètres mesurés varient.

Conclusion: Le développement de paramètres standardisés et de bases de données globales sur la CGU appuierait le contrôle de la qualité et l’amélioration du rendement des systèmes CGU.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Flow chart showing study selection. EGS = emergency general surgery.
See this image and copyright information in PMC

References

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