The Successful Implementation of a Trauma and Acute Care Surgery Model in Ecuador.
The Successful Implementation of a Trauma and Acute Care Surgery Model in Ecuador.
- 2020
Available online from MWHC library: 1997 - present, Available in print through MWHC library: 1999 - 2006
BACKGROUND: For years, surgical emergencies in Ecuador were managed on a case-by-case basis without significant standardization. To address these issues, the Regional Hospital Vicente Corral Moscoso adapted and implemented a model of "trauma and acute care surgery" (TACS) to the reality of Cuenca, Ecuador. CONCLUSIONS: The implementation of TACS model in a resource-restrained hospital in Latin America had a positive impact by decreasing surgical waiting time in trauma and emergency surgery patients and length of stay in trauma patients. We also noted a statistically significant decrease in mortality. Savings to the overall system and patients can be inferred by decreased mortality, length of stay and surgical wait times. To our knowledge, this is the first implementation of a TACS model described in Latin America. METHODS: A cohort study was carried out, comparing patients exposed to the traditional model and patients exposed to the TACS model. Variables assessed included number of surgical patients attended to in the emergency department, number of surgical interventions, number of surgeries performed per surgeon, surgical wait time, length of stay and in-hospital mortality. RESULTS: The total number of surgical interventions increased (3919.6-5745.8, p <= 0.05); by extension, the total number of surgeries performed per surgeon also increased (5.37-223.68, p <= 0.05). We observed a statistically significant decrease in surgical wait time (10.6-3.2 h for emergency general surgery, 6.3-1.6 h for trauma, p <= 0.05). Length of stay decreased in trauma patients (9-6 days, p <= 0.05). Higher mortality was found in the traditional model (p <= 0.05) compared to the TACS model.
English
0364-2313
10.1007/s00268-020-05435-z [doi] 10.1007/s00268-020-05435-z [pii]
*Critical Care
*Wounds and Injuries/su [Surgery]
Cohort Studies
Ecuador
Emergency Service, Hospital
Hospital Mortality
Humans
Length of Stay
Wounds and Injuries/mo [Mortality]
MedStar Washington Hospital Center
Surgery/General Surgery
Journal Article
Available online from MWHC library: 1997 - present, Available in print through MWHC library: 1999 - 2006
BACKGROUND: For years, surgical emergencies in Ecuador were managed on a case-by-case basis without significant standardization. To address these issues, the Regional Hospital Vicente Corral Moscoso adapted and implemented a model of "trauma and acute care surgery" (TACS) to the reality of Cuenca, Ecuador. CONCLUSIONS: The implementation of TACS model in a resource-restrained hospital in Latin America had a positive impact by decreasing surgical waiting time in trauma and emergency surgery patients and length of stay in trauma patients. We also noted a statistically significant decrease in mortality. Savings to the overall system and patients can be inferred by decreased mortality, length of stay and surgical wait times. To our knowledge, this is the first implementation of a TACS model described in Latin America. METHODS: A cohort study was carried out, comparing patients exposed to the traditional model and patients exposed to the TACS model. Variables assessed included number of surgical patients attended to in the emergency department, number of surgical interventions, number of surgeries performed per surgeon, surgical wait time, length of stay and in-hospital mortality. RESULTS: The total number of surgical interventions increased (3919.6-5745.8, p <= 0.05); by extension, the total number of surgeries performed per surgeon also increased (5.37-223.68, p <= 0.05). We observed a statistically significant decrease in surgical wait time (10.6-3.2 h for emergency general surgery, 6.3-1.6 h for trauma, p <= 0.05). Length of stay decreased in trauma patients (9-6 days, p <= 0.05). Higher mortality was found in the traditional model (p <= 0.05) compared to the TACS model.
English
0364-2313
10.1007/s00268-020-05435-z [doi] 10.1007/s00268-020-05435-z [pii]
*Critical Care
*Wounds and Injuries/su [Surgery]
Cohort Studies
Ecuador
Emergency Service, Hospital
Hospital Mortality
Humans
Length of Stay
Wounds and Injuries/mo [Mortality]
MedStar Washington Hospital Center
Surgery/General Surgery
Journal Article