The Effects of Additional Surgeon Coverage on Trauma Patient Outcomes

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-8-2026

Abstract

In order to improve access to care and timely treatment of critically ill surgical patients, the acute care surgery (ACS) model has been adopted by numerous hospitals across the United States. At Butterworth Hospital, the ACS surgeons cover Trauma, General Surgery, Burn, and Surgical Critical Care services. However, due to concerns regarding patient census and significant operative volumes, an additional surgeon, the "7th Surgeon," was employed in November of 2023 to be present during the day shift and assist with each service as needed. On the Trauma service, this includes rounding in the ICU, evaluating post-trauma patients at outpatient follow up visits, and providing procedural sedation as needed. The purpose of this study was to determine if the addition of the 7th Surgeon has improved timeliness of care and overall outcomes for Trauma patients.

This retrospective cohort study assessed trauma patients who were admitted to Butterworth Hospital in the years before and after initiation of the 7th Surgeon in November of 2023. The pre-intervention cohort included patients from 10/1/22 to the morning of 11/1/23. The post-intervention cohort began the next month to allow for an adjustment period, and so this cohort included patients from 12/1/23 to 12/31/24. The trauma registry was queried to identify all qualifying adult patients and provide initial data points. The study team accessed patient charts via EPIC to supplement data from the registry. Primary outcomes were to identify differences in timeliness of ED consult evaluation, as defined by the time from attending notification to admission order placement, as well as rates of adverse events. The secondary objective was to assess differences in time to surgery. Numeric outcomes were expressed as mean ± standard deviation, and categorical outcomes were expressed as percentages.

3,214 trauma patients were included in this study, with 1,591 admitted before the 7th Surgeon was initiated and 1,623 patients coming after. Time from consult order to admission order was decreased in the post-intervention cohort, with average times dropping from 1.96 hr (SD ± 2.21) to 1.79 hr (SD ± 1.79). With regard to adverse patient events, the pre-intervention cohort had higher rates of VTEs (1.13% vs. 0.99%) and unplanned ICU admissions (2.77% vs. 2.22%). The rate of sepsis development was greater in the post-intervention cohort (0.43% vs. 0.31%). There were no notable changes in the rates of CAUTIs, CLABSIs, or patients discharged as deceased or home with hospice care. Among patients who required operative intervention, the time from Trauma attending notification to first surgery was lower in the post-intervention cohort (26.62 hr, SD ± 35.48) than in the pre-intervention cohort (27.81 hr, SD ± 49.41).

Here, we demonstrate that, in addition to outpatient clinic duties, employing an additional ACS surgeon at Butterworth Hospital has been associated with multiple inpatient benefits. Time to evaluation and admission, which are paramount in the care of trauma patients, improved by approximately 10 minutes on average. Additionally, on the inpatient floors, the rates of sepsis development and VTEs also improved, as did time to first surgery. Future studies should identify methods to optimize the role of the 7th Surgeon and further improve the efficiency of care.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 2135

This document is currently not available here.

Share

COinS