The impact of an acute care surgery model on general surgery service productivity

Abstract Background The Acute Care Surgery (ACS) model has been widely adopted by hospitals across the United States, with ACS services managing emergency general surgery (EGS) patients previously treated by general surgery (GS) services. We evaluated the operational and financial impact of an ACS service model on general surgeons at an academic medical center. Methods Using WiseOR® (Palo Alto, CA), we compared surgical case volumes for the GS service two years before (October, 2013–September, 2015) and two years after (October, 2015–September, 2017) implementation of an ACS service at the University of Vermont Medical Center. From financial reports, we obtained monthly wRVUs, clinical FTEs, net patient revenue, and payer mix for the GS service and compared the two years before and after ACS model implementation. Results There was a significant reduction in the average number of cases performed by the GS service following ACS service implementation (monthly mean ± SD, 139.1 ± 16.0 vs. 116.7 ± 14.0, p p  = 0.08). There was a significant increase in average monthly clinic-derived wRVU/FTE for the GS service (106.3 ± 13.5 vs. 120.5 ± 16.4, p  = 0.007). Conclusions Shifting EGS patient management from the GS to ACS service did not negatively impact the productivity of the GS service.