Creating a Novel Shared Surgical Coverage Model

As a small rural hospital that runs a full service Emergency Department, Western Maine Health (WMH) based in Norway, ME, needs 24/7 general surgical call coverage. As the Norway community’s population decreased over the last several years, so has the demand for WMH’s emergency services and 24/7 in-person on-call coverage. Leadership at WHM and Maine Medical Center (MMC) in Portland recognized this shift in demand as an opportunity to increase efficiency and best use care team members in new ways. Together, the institutions developed a novel care team model.

In this new remote care model, patients who present at the WMH Emergency Department with general surgery needs are typically triaged for transfer or admission to WMH by the local hospitalist staff, with the consultative support of a covering MMC surgeon. After a weekend of 24/7 call, a WMH general surgeon then passes off service to the covering MMC surgeon. The coverage care model and supporting protocols ensure that there is coverage and effective hand– offs throughout every weekend.

The shared coverage care model enables WMH and MMC care team members to view the patient record and document treatment in the electronic medical record in the same way. This care model is supported by a Community Call Plan based on Emergency Medical Treatment and Labor Act (EMTALA) guidance. This model also has the support of MaineHealth regulatory and legal partners.

“We’ve been doing this for a year and half with good success!” says one team member. “Patients that can remain local stay local, those that need transfer are transferred, and our local surgeons can maintain sustainable call expectations.”

TEAM