Acute Care Surgery Models and Outcomes
Summary
The Acute Care Surgery (ACS) paradigm unites emergency general surgery, trauma management and critical care into a single, dedicated service line available 24 hours a day. Initially conceived to address delays and fragmentation in urgent surgical care, ACS models typically feature attending surgeons relieved of elective duties, continuous in-house resident coverage and reserved operating‐room capacity. Implementation has been highly variable across regions, with some centres embedding critical care within the ACS unit while others maintain separate intensive care structures. Evaluations of ACS services consistently demonstrate reductions in time to theatre, fewer after-hours procedures, improved surgeon work–life balance and stable elective schedules. Outcome measures extend beyond timeliness to encompass length of stay, complication rates and patient throughput. Concurrently, the formal recognition of ACS as a subspecialty has spurred the development of consensus guidelines, quality metrics and tiered regional networks. These advances underscore the global relevance of ACS models in optimising resource use, standardising emergency surgical care and enhancing both patient and provider experience.
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Acute Care Surgery Models and Outcomes publication trend
The graph below shows the total number of articles in acute care surgery models and outcomes across all publications each year (not limited to Nature Index journals).
Technical terms
Acute Care Surgery (ACS): A service model that integrates emergency general surgery, trauma care and critical care into a dedicated, round-the-clock platform.
Emergency General Surgery (EGS): Surgical interventions for non-traumatic acute abdominal and soft-tissue conditions requiring immediate hospital admission.
Donabedian framework: A quality assessment approach that evaluates healthcare services through the domains of structure, process and outcome.
References
- Acute Care Surgery Models Worldwide: A Systematic Review. World Journal of Surgery (2020).
- Impact of an acute care surgery service on timeliness of care and surgeon satisfaction at a Canadian academic hospital: a retrospective study. World Journal of Emergency Surgery (2014).
- Identifying the fundamental structures and processes of care contributing to emergency general surgery quality using a mixed-methods Donabedian approach. BMC Medical Research Methodology (2020).
- Impact of an Acute Care Surgery Model on the Management of Acute Appendicitis in South Korea: A Retrospective Cohort Study. Emergency Medicine International (2021).
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