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

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

doi:10.1186/s13017-017-0158-x

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

World J Emerg Surg. 2017 Oct 23:12:47. doi: 10.1186/s13017-017-0158-x. eCollection 2017.

Authors

M Sugrue¹, R Maier^{2

3}, E E Moore⁴, M Boermeester⁵, F Catena⁶, F Coccolini⁷, A Leppaniemi⁸, A Peitzman⁹, G Velmahos¹⁰, L Ansaloni¹¹, F Abu-Zidan¹², P Balfe¹³, C Bendinelli¹⁴, W Biffl¹⁵, M Bowyer¹⁶, M DeMoya¹⁷, J De Waele¹⁸, S Di Saverio¹⁹, A Drake²⁰, G P Fraga²¹, A Hallal²², C Henry²³, T Hodgetts²⁴, L Hsee²⁵, S Huddart²⁶, A W Kirkpatrick²⁷, Y Kluger²⁸, L Lawler²⁹, M A Malangoni³⁰, M Malbrain³¹, P MacMahon²⁹, K Mealy³², M O'Kane³³, P Loughlin³⁴, M Paduraru³⁵, L Pearce³⁶, B M Pereira²¹, A Priyantha³⁷, M Sartelli³⁸, K Soreide^{39

40}, C Steele⁴¹, S Thomas⁴², J L Vincent⁴³, L Woods⁴⁴

Affiliations

¹ Department of Surgery, Letterkenny University Hospital and Donegal Clinical Research Academy, Donegal, Ireland.
² Department of Surgery, University of Washington, Seattle, USA.
³ Harborview Medical Center, Seattle, USA.
⁴ University of Colorado, Denver, USA.
⁵ Department of Surgery, Academic Medical Center, Amsterdam, Netherlands.
⁶ Department of Emergency Surgery, Maggiore Hospital, Parma, Italy.
⁷ Department of Emergency, General and Transplant Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy.
⁸ Abdominal Center, University Hospital Meilahti, Helsinki, Finland.
⁹ Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA USA.
¹⁰ Department of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Boston, MA USA.
¹¹ General Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
¹² Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
¹³ Department of Surgery, St. Luke's Hospital, Kilkenny, Ireland.
¹⁴ Department of Surgery, John Hunter Hospital, Newcastle, NSW Australia.
¹⁵ Acute Care Surgery, The Queens Medical Center, Honolulu, HI USA.
¹⁶ Department of Surgery, Uniformed Services University and Walter Reed National Military Medical Center, Bethesda, MD USA.
¹⁷ Department of Trauma/Critical Care, Massachusetts General Hospital, Boston, MA USA.
¹⁸ Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium.
¹⁹ Maggiore Hospital of Bologna, AUSL, Bologna, Italy.
²⁰ Letterkenny University Hospital and Donegal Clinical Research Academy, Donegal, Ireland.
²¹ Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas, Campinas, Brazil.
²² Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
²³ National Clinical Advisor for the Acute Hospitals Division, Health Service Executive, Dublin, Ireland.
²⁴ Trauma Governance, UK Defence Medical Services, Lichfield, UK.
²⁵ Department of Trauma and Acute Care Surgery, Auckland City Hospital, Auckland, New Zealand.
²⁶ Department of Anaesthesiology, Royal Surrey County Hospital, Guildford, UK.
²⁷ Department of Surgery, Critical Care Medicine and Regional Trauma Service, Foothills Medical Centre, Calgary, AB Canada.
²⁸ Department of General Surgery, Division of Surgery, Rambam Health Care Campus, Haifa, Israel.
²⁹ Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland.
³⁰ American Board of Surgery, Philadelphia, PA USA.
³¹ Intensive Care Unit and High Burn Unit, ZNA "Ziekenhuis Netwerk Antwerpen" Stuivenberg and ZNA St-Erasmus hospitals, Antwerp, Belgium.
³² Department of Surgery, Wexford University Hospital, Wexford, Ireland.
³³ Department of Pathology, Altnagelvin Hospital, Londonderry, UK.
³⁴ Department of Surgery, Altnagelvin Hospital, Londonderry, UK.
³⁵ Department of General and Emergency Surgery, Milton Keys, UK.
³⁶ Northwest Research Collaborative, Manchester, UK.
³⁷ Department of Gastroenterology, Teaching Hospital, South, Colombo, Sri Lanka.
³⁸ Department of Surgery, Macerata Hospital, Macerata, Italy.
³⁹ Department of Clinical Medicine, University of Bergen, Bergen, Norway.
⁴⁰ Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.
⁴¹ Department of Gastroenterology, Letterkenny University Hospital and Donegal Clinical Research Academy, Donegal, Ireland.
⁴² Department of Trauma Services, Memorial Hospital of South Bend, Indiana, USA.
⁴³ Department of Intensive Care, Erasme Hospital, Université libre de bruxelles, Brussels, Belgium.
⁴⁴ Department of Acute Hospitals, Health Services Executive, Dublin, Ireland.

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.

Keywords: Emergency surgery; Optimal care; Performance indicators; Surgical outcomes.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Accidental Falls / mortality
Accidental Falls / statistics & numerical data
Accidents, Traffic / mortality
Accidents, Traffic / statistics & numerical data
Adolescent
Arab World
Brain Injuries, Traumatic / epidemiology
Brain Injuries, Traumatic / surgery*
Child
Child, Preschool
Delphi Technique
Female
Humans
Infant
Male
Middle East / epidemiology
Pediatrics / methods*
Pediatrics / trends
Retrospective Studies
Trauma Centers / organization & administration
Trauma Centers / statistics & numerical data
Treatment Outcome