Acute care surgery program: mentoring fellows and patient outcomes

Area of Science:

• Surgery
• Trauma Surgery
• Surgical Outcomes

Background:

• Acute care surgery programs integrate Emergency General Surgery (EGS) without impacting trauma patient outcomes.
• Previous studies have not evaluated EGS patient outcomes or fellow mentorship.
• This study investigates whether provider level affects EGS patient outcomes under evidence-based medicine (EBM) protocols.

Purpose of the Study:

• To determine if Emergency General Surgery (EGS) patient outcomes differ based on provider level (faculty vs. fellows).
• To assess the effectiveness of a faculty mentoring model for fellows in EGS.
• To evaluate the impact of evidence-based medicine (EBM) protocols on EGS patient outcomes.

Main Methods:

• Retrospective analysis of a prospectively collected EGS repository from 2003-2007 at an academic Level I trauma center.
• Inclusion of 14 faculty and 7 fellows providing EGS coverage, with faculty mentoring for fellows.
• Data collected included demographics, length of stay (LOS), ICU LOS, ventilator days, disposition, and infectious complications (IC); primary outcome was mortality.

Main Results:

• 1769 patients met study criteria; mean age 47.1 years, 47% male.
• No statistically significant differences were observed in mortality, LOS, ICU LOS, disposition, ventilator days, or infectious complications between faculty and fellow providers.
• The faculty mentoring model did not negatively impact EGS patient outcomes.

Conclusions:

• An EGS service utilizing EBM protocols ensures consistent patient outcomes irrespective of provider level.
• The established fellow mentoring model within the EGS service is effective and does not compromise patient outcomes.