Top

Published in:

Open Access 01-12-2017 | Research article

Proceedings of resources for optimal care of acute care and emergency surgery consensus summit Donegal Ireland

Authors: M. Sugrue, R. Maier, E. E. Moore, M. Boermeester, F. Catena, F. Coccolini, A. Leppaniemi, A. Peitzman, G. Velmahos, L. Ansaloni, F. Abu-Zidan, P. Balfe, C. Bendinelli, W. Biffl, M. Bowyer, M. DeMoya, J. De Waele, S. Di Saverio, A. Drake, G. P. Fraga, A. Hallal, C. Henry, T. Hodgetts, L. Hsee, S. Huddart, A. W. Kirkpatrick, Y. Kluger, L. Lawler, M. A. Malangoni, M. Malbrain, P. MacMahon, K. Mealy, M. O’Kane, P. Loughlin, M. Paduraru, L. Pearce, B. M. Pereira, A. Priyantha, M. Sartelli, K. Soreide, C. Steele, S. Thomas, J. L. Vincent, L. Woods

Published in: World Journal of Emergency Surgery | Issue 1/2017

Abstract

Background

Opportunities to improve emergency surgery outcomes exist through guided better practice and reduced variability. Few attempts have been made to define optimal care in emergency surgery, and few clinically derived key performance indicators (KPIs) have been published. A summit was therefore convened to look at resources for optimal care of emergency surgery. The aim of the Donegal Summit was to set a platform in place to develop guidelines and KPIs in emergency surgery.

Methods

The project had multidisciplinary global involvement in producing consensus statements regarding emergency surgery care in key areas, and to assess feasibility of producing KPIs that could be used to monitor process and outcome of care in the future.

Results

Forty-four key opinion leaders in emergency surgery, across 7 disciplines from 17 countries, composed evidence-based position papers on 14 key areas of emergency surgery and 112 KPIs in 20 acute conditions or emergency systems.

Conclusions

The summit was successful in achieving position papers and KPIs in emergency surgery. While position papers were limited by non-graded evidence and non-validated KPIs, the process set a foundation for the future advancement of emergency surgery.

Tan BH, Mytton J, Al-Khyatt W, Aquina CT, Evison F, Fleming FJ, Griffiths E, Vohra RS. A comparison of mortality following emergency laparotomy between populations from New York state and England. Annals Surgery. 2017;266(2):280–6.CrossRef

The Second Patient Report of the National Emergency Laparotomy Audit (NELA) December 2014 to November 2015 July 2016 http://www.nela.org.uk/reports accessed 23 Feb 2017.

Santry HP, Madore JC, Collins CE, Ayturk MD, Velmahos GC, Britt LD, et al. Variations in implementation of acute care surgery: results from a national survey of university-affiliated hospitals. J Trauma Acute Care Surg. 2015;78(1):60–7.CrossRefPubMedPubMedCentral

Tolstrup MB, Watt SK, Gögenur I. Morbidity and mortality rates after emergency abdominal surgery: an analysis of 4346 patients scheduled for emergency laparotomy or laparoscopy. Langenbeck's Arch Surgery. 2016;9:1–9.

Scott JW, Olufajo OA, Brat GA, Rose JA, Zogg CK, Haider AH, SalimA HJM. Use of national burden to defineoperative emergency general surgery. JAMA Surg. 2016;151(6):e160480.CrossRefPubMed

Royal College of Surgeons in Ireland. Model of care for acute surgery: National Clinical Programme in Surgery [Internet]. RCSI; 2013. Available at http://www.rcsi.ie/files/surgery/20131216021838_Model%20of%20Care%20for%20Acute%20Surger.pdf. Accessed 12 Apr 2017.

Hsee L, Devaud M, Middleberg L, Jones W, Civil I. Acute surgical unit at Auckland City Hospital: a descriptive analysis. ANZ J Surg. 2012;82(9):588–91.CrossRefPubMed

Association of Surgeons of Great Britain and Ireland. Emergency general surgery: the future a consensus statement [Internet]. ASGBI. Available at http://www.asgbi.org.uk/consensus-statements/ accessed 12 Apr 2017.

Sorelli PG, El-Masry NS, Dawson PM, Theodorou NA. The dedicated emergency surgeon: towards consultant-based acute surgical admissions. Ann R Coll Surg Engl. 2008;90:104–8.CrossRefPubMedPubMedCentral

10.

Hameed SM, Brenneman FD, Ball CG, Pagliarello J, Razek T, Parry N, et al. General surgery 2.0: the emergence of acute care surgery in Canada. Can J Surg. 2010;53(2):79–83.PubMedPubMedCentral

11.

Royal Australasian College of Surgeons. The case for the separation of elective and emergency surgery [Internet]. RACS; 2011. Available at http://www.surgeons.org/media/college-advocacy/submission-to-the-council-of-australian-government's-expert-panel-on-the-case-for-the-separation-of-elective-and-emergency-surgery/ accessed 12 Apr 2017.

12.

The Royal College of Surgeons of England. Separating emergency and elective surgical care: recommendations for practice [Internet]. RCSENG Professional Standards and Regulation; 2007. Available https://www.rcseng.ac.uk/library-and-publications/college-publications/year/accessed 12 Apr 2017.

13.

Professional Standards and Regulation Directorate: Royal College of Surgeons of England. Standards for Unscheduled Surgical Care: Guidance for providers, commissioners and service planners [Internet]. Publications Department, The Royal College of Surgeons of England; 2011. Available at: https://www.rcseng.ac.uk/library-and-publications/college-publications/year/accessed 12 Apr 2017.

14.

Resources for optimal care of emergency surgery Letterkenny 2016 978–0–09926109–9-9 Available http://dcra.ie/images/Resources_2016_Emergency_Surgery.pdf accessed 12 Apr 2017.

15.

Royal Australasian College of Surgeon (2015) Position paper of emergency surgery. Available at: https://www.surgeons.org/media/311630/2015-05-20_pos_fes-pst-050_emergency_surgery.pdf accessed 5 Oct 2017.

16.

General Surgeon Association of Australia (2010) 12-Point plan on emergency surgery. Available at: https://www.generalsurgeons.com.au/media/files/Publications/PLN%202010-09-19%20GSA%2012%20Point%20Plan.pdf. Accessed 5 Oct 2017.

17.

Ministry of Health New Zealand (2011) Targeting emergencies: shorter stays in emergency departments. Available at: https://www.health.govt.nz/search/results/Targeting%20emergencies%3A%20shorter%20stays%20in%20emergency%20department. Accessed 5 Oct 2017.

18.

Stewart B, Khanduri P, McCord C, Ohene-Yeboah M, Uranues S, Vega Rivera F, Mock C. Global disease burden of conditions requiring emergency surgery. BJS. 2014;101:e9–e22.CrossRef

19.

20.

Scott JW, Olufajo OA, Brat GA, Rose JA, Zogg CK, Haider AH, Salim A, Havens JM. Use of national burden to define operative emergency general surgery. JAMA surgery. 2016;151(6):e160480.CrossRefPubMed

21.

Ogola GO, Haider A, Shafi S. Hospitals with higher volumes of emergency general surgery patients achieve lower mortality rates: a case for establishing designated centers for emergency general surgery. J Trauma Acute Care Surg. 2017;82(3):497–504.CrossRefPubMed

22.

Becher RD, Hoth JJ, Miller PR, Mowery NT, Chang MC, Meredith JW. A critical assessment of outcomes in emergency versus nonemergency general surgery using the American College of Surgeons National Surgical Quality Improvement Program database. Am Surg. 2011;77:951–9.PubMed

23.

Ingraham A, Nathens A, Peitzman A, Bode A, Dorlac G, Dorlac W, Miller P, Sadeghi M, Wasserman DD, Bilimoria K. Assessment of emergency general surgery care based on formally developed quality indicators. Surgery. 2017;162:397–407.CrossRefPubMed

24.

Clavien PA, Puhan MA. Measuring and achieving the best possible outcomes in surgery. Br J Surg. 2017;104:1121–2.CrossRefPubMed

25.

Scarborough JE, Schumacher J, Pappas TN, McCoy CC, Englum BR, Agarwal SK, Greenberg CC. Which complications matter most? Prioritizing quality improvement in emergency general surgery. J Am Coll Surg. 2016;222(4):515–24.CrossRefPubMedPubMedCentral

26.

Nathan H, Dimick JB. Quality accounting: understanding the impact of multiple surgical complications. Ann Surgery. 2017;265(6):1051–2.CrossRef

27.

Quiney N, Aggarwal G, Scott M, Dickinson M. Survival after emergency general surgery: what can we learn from enhanced recovery programmes? World J Surg. 2016;40(6):1283–7.CrossRefPubMed

Title: Proceedings of resources for optimal care of acute care and emergency surgery consensus summit Donegal Ireland
Authors: M. Sugrue
R. Maier
E. E. Moore
M. Boermeester
F. Catena
F. Coccolini
A. Leppaniemi
A. Peitzman
G. Velmahos
L. Ansaloni
F. Abu-Zidan
P. Balfe
C. Bendinelli
W. Biffl
M. Bowyer
M. DeMoya
J. De Waele
S. Di Saverio
A. Drake
G. P. Fraga
A. Hallal
C. Henry
T. Hodgetts
L. Hsee
S. Huddart
A. W. Kirkpatrick
Y. Kluger
L. Lawler
M. A. Malangoni
M. Malbrain
P. MacMahon
K. Mealy
M. O’Kane
P. Loughlin
M. Paduraru
L. Pearce
B. M. Pereira
A. Priyantha
M. Sartelli
K. Soreide
C. Steele
S. Thomas
J. L. Vincent
L. Woods
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: World Journal of Emergency Surgery / Issue 1/2017
Electronic ISSN: 1749-7922
DOI: https://doi.org/10.1186/s13017-017-0158-x

At a glance: The STEP trials

Springer Medicine

Proceedings of resources for optimal care of acute care and emergency surgery consensus summit Donegal Ireland

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2017

Combined totally mini-invasive approach in necrotizing pancreatitis: a case report and systematic literature review

Splenic trauma: WSES classification and guidelines for adult and pediatric patients

Resuscitative Endovascular Balloon Occlusion of the Aorta in trauma: a systematic review of the literature

The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections

2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias

Performance of imaging studies in patients with suspected appendicitis after stratification with adult appendicitis score