Emergency General Surgery Quality Improvement: A Review of Recommended Structure and Key Issues
Samuel W. Ross, Caroline E. Reinke, Angela M. Ingraham, Daniel N. Holena, Joaquim M. Havens, Mark R. Hemmila, Joseph V. Sakran, Kristan Staudenmayer, Lena M. Napolitano, Raúl Coimbra
Abstract
Emergency general surgery (EGS) accounts for 11% of hospital admissions, with more than 3 million admissions per year and more than 50% of operative mortality in the US. Recent research into EGS has ignited multiple quality improvement initiatives, and the process of developing national standards and verification in EGS has been initiated. Such programs for quality improvement in EGS include registry formation, protocol and standards creation, evidenced-based protocols, disease-specific protocol implementation, regional collaboratives, targeting of high-risk procedures such as exploratory laparotomy, focus on special populations like geriatrics, and targeting improvements in high opportunity outcomes such as failure to rescue. The authors present a collective narrative review of advances in quality improvement structure in EGS in recent years and summarize plans for a national EGS registry and American College of Surgeons verification for this under-resourced area of surgery.