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. 2024 Feb;50(1):259-268.
doi: 10.1007/s00068-023-02272-2. Epub 2023 Jul 20.

Characteristics of emergency general surgery services in Switzerland: a nationwide survey

Oliver Quaile  1 , Stéphanie Fabienne Perrodin  1 , Amedeo Trippel  1 , Beat Schnüriger  2 ; “SwissACS”
Affiliations

Characteristics of emergency general surgery services in Switzerland: a nationwide survey

Oliver Quaile et al. Eur J Trauma Emerg Surg. 2024 Feb.

Abstract

Objective: Running an emergency general surgery (EGS) service is challenging and requires significant personnel and institutional resources. The aim of this study was to achieve a nationwide overview of the individual EGS service organizations in public hospitals in Switzerland.

Methods: All Swiss public hospitals with a surgical and emergency department were included and contacted by telephone. General surgeons were interviewed between December 2021 and January 2022 using a standardized questionnaire.

Results: Seventy-two out of 79 public hospitals in Switzerland (91.1%) agreed to the survey. They employed 1,581 surgeons in 19 (26.4%) hospitals with < 100 beds, 39 (54.2%) hospitals with 100-300 beds, 7 (9.7%) with 300-600 beds, and 7 (9.7%) with > 600 beds. The median number of surgeons per hospital was 20.5 (IQR 13.0-29.0). Higher level of care (intermediate or intensive care unit) was significantly less available in small hospitals (< 100 beds). The median hour of designated emergency operating room capacity per day was 14 h (IQR 14-24) for all hospitals with < 600 beds and 24 h (IQR 14-24) for the largest hospitals (> 600 beds). With increasing hospital size, there was a significant increase in the number of surgical units where EGS and orthopedic trauma surgery were covered by two separate teams (21.1% vs. 43.6% vs. 85.7% vs. 100%, p = 0.035). The median number of surgeons on-call per hospital and per 24 h was 5.0 (IQR 3.3-6.0).

Conclusion: Lack of higher level of care in small hospitals, limited emergency OR capacity and short rotations of on-call teams are major drawbacks of many current EGS systems in Switzerland. Centralization of critically ill EGS patients and reorganization of surgical on-call systems to designated acute care surgery teams should be considered.

Keywords: Acute care surgery; Emergency general surgery; Service models; Surgeons on-call.

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Conflict of interest statement

Oliver Quaile, Stéphanie Perrodin, Amedeo Trippel and Beat Schnüriger have no conflicts of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
Interdisciplinary use of emergency operating room capacity stratified according the hospital size
Fig. 2
Fig. 2
Specific responsibilities of the surgical on-call team
See this image and copyright information in PMC

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