To our knowledge, this is the first study to examine the impact of implementing an ACS service on wait-times for elective surgeries. Miller et al.[27] and Barnes et al.[15] observed a 23% and 44% increase in operative productivity in terms of elective caseloads, respectively, but an overall decline in general surgery operative Sapanisertib volumes because of a reduction in emergent cases [15]. However, neither study considered wait-times for elective cases. While many studies examining the impact of ACS services originate from the United States, American ACS services often

differ significantly from Canadian models. In Canada, general surgeons participating in ACS services often also perform cancer operations as part of their elective practices, whereas many American acute care surgeons are trauma specialists who do not routinely perform oncological operations. One of the limitations of this study is that the effect of ACCESS on wait-times

for non-cancer elective operations, such as elective bowel resections for non-malignant pathology or hernia repair, was not explored. Because of the lack of organized databases to measure wait-times for elective non-cancer operations, it was difficult to ascertain the impact ��-Nicotinamide of ACCESS on wait-times for these cases. However, surgeons are given the discretion to book elective cases during ACCESS OR time if there are no emergency cases on the board. Most have reported excellent patient satisfaction with the development of “standby lists”, whereby patients who are booked for elective non-cancer surgeries are called into the hospital on the day of their operation. Additionally, as discussed earlier, the recent integration of elective and emergency operating databases, which also include non-cancer operations, may allow for future prospective studies to address this important issue. In conclusion, the reallocation

of operating room resources from elective surgical practice towards an ACS service did not appear to affect the timeliness of care provided to patients waiting for elective cancer surgeries, and thus such concerns should not serve as a STAT inhibitor barrier for centres considering implementing an ACS service. selleck inhibitor References 1. Ball CG: Acute care surgery: a new strategy for the general surgery patients left behind. Can J Surg 2010, 53:84–85.PubMedCentralPubMed 2. Davis KA: Acute care surgery in evolution. Crit Care Med 2010, 38:S405-S410.PubMedCrossRef 3. Hameed SM, Brenneman FD, Ball CG, Pagliarello J, Razek T, Parry N, Widder S, Minor S, Buczkowski A, Macpherson C, Johner A, Jenkin D, Wood L, McLoughlin K, Anderson I, Davey D, Zabolotny B, Saadia R, Bracken J, Nathens A, Ahmed N, Panton O, Warnock GL: General surgery 2.0: the emergence of acute care surgery in Canada. Can J Surg 2010, 53:79–83.