title: Surgeon accountability for patient safety in the Acute Care Surgery paradigm: a critical appraisal and need of having a focused knowledge of the patient and a specific subspecialty experience.
abstract: There is an increasing evidence in the literature showing that Acute Care surgical patients, likewise patients from every other surgical subspeciality, should be best first approached and managed only by attending surgeons with approriate expertise in the field of Emergency and Trauma Surgery, as well as the occurrence of postoperative complications can be prevented or safely and appropriately treated when arising, only by those attending surgeons having a focused knowledge of the patient and specific subspeciality experience. The advantages of a consultant-led, patient-centered surgical management come along with the opportunity of maintaining the principles of continuity of care and specificity of expertise in managing surgical patients and their complications and readmissions. These principles should be particularly valid in the well-recognized subspeciality of Acute Care and Trauma Surgery; managing the challenging emergency surgical patients either in the preoperative and postoperative periods with the aim to improve the outcomes of Emergency Surgery, should only be by surgeons trained and experienced in both Acute Care Surgery and Trauma.
authors.affiliation: Maggiore Hospital Regional Emergency Surgery and Trauma Center - Bologna Local Health District, Bologna, Italy.
authors.forename: Salomone
authors.identifier: 0000-0001-5685-5022
authors.initials: S
authors.lastname: Di Saverio
authors.affiliation: Maggiore Hospital Regional Emergency Surgery and Trauma Center - Bologna Local Health District, Bologna, Italy.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Tugnoli
authors.affiliation: Maggiore Hospital of Parma, Parma, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Catena
authors.affiliation: Maggiore Hospital Regional Emergency Surgery and Trauma Center - Bologna Local Health District, Bologna, Italy.
authors.forename: Arianna
authors.initials: A
authors.lastname: Birindelli
authors.affiliation: Maggiore Hospital Regional Emergency Surgery and Trauma Center - Bologna Local Health District, Bologna, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Coniglio
authors.affiliation: Maggiore Hospital Regional Emergency Surgery and Trauma Center - Bologna Local Health District, Bologna, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gordini
keywords: Consultant-led surgical service; Continuity of care; Dedicated acute surgical admission ward; Emergency surgery management and outcomes; Outcomes; Postoperative morbidity; Risk of mortality after major surgery; Specificity of expertise; Surgical postoperative complications; Surgical ward-care checklists