Abstract
BackgroundMultiple acute care surgery (ACS) working models have been implemented. To optimize resources and on-call rosters, knowledge about work characteristics is required. Therefore, this study aimed to investigate the daily work characteristics of ACS surgeons at a Swiss tertiary care hospital.MethodsSingle-center prospective snapshot study. In February 2020, ACS fellows prospectively recorded their work characteristics, case volume and surgical case mix for 20 day shifts and 16 night shifts. Work characteristics were categorized in 11 different activities and documented in intervals of 30 min. Descriptive statistics were applied.ResultsA total of 432.5 working hours (h) were documented and characterized. The three main activities ‘surgery,’ ‘patient consultations’ and ‘administrative work’ ranged from 30.8 to 35.9% of the documented working time. A total of 46 surgical interventions were performed. In total, during day shifts, there were 16 elective and 15 emergency interventions, during night shifts 15 emergency interventions. For surgery, two peaks between 10:00 a.m.–02:00 p.m. and 08:00 p.m.–11:00 p.m. were observed. A total of 225 patient were consulted, with a first peak between 08:00 a.m. and 11:00 a.m. and a second, wider peak between 02:00 p.m. and 02:00 a.m.ConclusionThe three main activities ‘surgery,’ ‘patient consultations’ and ‘administrative work’ were comparable with approximately one third of the working time each. There was a bimodal temporal distribution for both surgery and patient consultations. These results may help to improve hospital resources and on-call rosters of ACS services.
Highlights
Conceived in 2003 in Northern America, the concept of acute care surgery (ACS) is globally evolving
A total of 46 surgical interventions were performed by the three ACS fellows during the documented study period of 20 days and 16 nights
At the investigated Swiss tertiary care center, the workload of ACS surgeons includes mainly emergency general surgery (EGS) interventions, preand postoperative patient consultations, non-operative patient management and administrative work. Both broad general surgical and cognitive skills should be implemented into adapted training programs to meet the unique and challenging requirements of acute care surgery
Summary
Conceived in 2003 in Northern America, the concept of acute care surgery (ACS) is globally evolving. This study aimed to investigate the daily work characteristics of ACS surgeons at a Swiss tertiary care hospital. In February 2020, ACS fellows prospectively recorded their work characteristics, case volume and surgical case mix for 20 day shifts and 16 night shifts. The three main activities ‘surgery,’ ‘patient consultations’ and ‘administrative work’ ranged from 30.8 to 35.9% of the documented working time. A total of 225 patient were consulted, with a first peak between 08:00 a.m. and 11:00 a.m. and a second, wider peak between 02:00 p.m. and 02:00 a.m. Conclusion The three main activities ‘surgery,’ ‘patient consultations’ and ‘administrative work’ were comparable with approximately one third of the working time each. There was a bimodal temporal distribution for both surgery and patient consultations These results may help to improve hospital resources and on-call rosters of ACS services
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