Average Inpatient Census

[DrDawg]

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What is the average inpatient Census (for general surgery) at your main teaching hospital? Including consults. And how many residents are assigned to that service? I have done some quick leg work and can't find any suggestions for ACS, or from ACGME.

 

[Winged Scapula]

What is the average inpatient Census (for general surgery) at your main teaching hospital? Including consults. And how many residents are assigned to that service? I have done some quick leg work and can't find any suggestions for ACS, or from ACGME.

Depends - we have 4 general surgery services which really includes the subspecialties (vascular, transplant, surg onc/hepatobiliary and trauma). The highest census is always trauma and that can vary from 20-40+ with 4 or 5 residents to the low census generally for transplant (but that too can vary from just a couple to the teens).

You won't find any data on ACS or ACGME because this information varies W-I-D-E-L-Y!

 

[tussy]

It really depends on program to program and the actual workload is hard to predict by census alone - it also depends on how many residents are assigned, how sick the patients are, etc.

In my program The avg. Census was probably about 20 inpatients + 5 consults + 2-3 ICU.

The busiest service was the "acute surgical service" which included traumas and everything that came thru the ER. We usually had a census of around 30 patients + 10-20 consults + 5-10 ICU. The worst was the high turnover on the service - every day we had about 10 patients going home which meant dictations, paperwork, forms, perscriptions, etc. And then there would be a new bunch of patients every morning to learn. On that service we had 2 seniors (PGY 4 or 5), 2 juniors (pgy1) and 2 clerks. It was a resident run service with staff just rotating thru a week at a time (and some of them hating it and not wanting to know anything about the patients).

The least busy service was the Laparoscopic/breast service which had maybe 5 inpatients and maybe 1-2 consults (because most of these patients go home within a day or 2 of their surgery). There was 1 senior, 1 junior and 1 clerk on that service.

I hope this answers your questions. I'm interested to hear what others have to say on teh topic.

 

[jc7721]

We have 2 major teaching hospitals, one which is primarily trauma and the university hospital. There are 3 general surgery services at the univeristy, as well as transplant and CT. The 3 gen surg services typically run between 10 and 20 patients, of which 1-5 are ICU, and 1-10 consults. Transplant also runs between 10-20 inpatients. CT surg (including transplant) runs between 20-40 (currently 35) with 5-15 ICU and 5-15 consults. Just as the other posts here have mentioned, there is wide range in patient volume.

At the trauma hospital, it is much busier. There are 2 general surgery services, both trauma, with an R5, 4, two 3s, two 1s, and a separate ICU team with R2s. In the summer the census on each service runs between 40 and 60, with up to 30 in the ICU. It sounds crazy and it is. During the winter months the census is typically 20-40+ with 10-20 in the ICU.

 

[CBG23]

40 - 50 patirnts for two interns; double in the weekend

 

[womp]

This sounds utterly miserable. It's not safe, things get missed all the time, and it corresponds with my experience on GS/Trauma as well.

 

[Winged Scapula]

Not sure why we're bumping an 8 yo thread but agreed some of those numbers are ridiculous and potentially dangerous.

 

[ksav]

Agreed on the bump for an 8 yo thread.. but a lot depends on the service and how many resident you have. My program is big (8 residents/year) but we rotate through 5 hospitals. It also depends on how your services work; our junior residents see and write notes on all floor patients; 2nd/3rd covers ICU patients. 4s and 5s run the services... and while they round, they don't write the primary note or answer all the pages; they manage and fix problems.
Trauma - ICU intern - 15 GICU patients; ICU floor - 20-40; 2nd year sees 30-60 ER patients per day; 3rd year - 25 ICU patients (strict q3 call)
Onc1 - 15-20 between 2 interns
Onc2 - 10-15 for intern (chief runs service)
HPB - 10-15 for intern
University Gen Surg - 10-15 patients between 2 interns
Vascular - 20-30 patiens for the intern, 3-5 ICU for 3rd year
Transplant - 10 floor for intern; 5ish ICU for 3rd year
MIS - mostly outpatient, so maybe 10-15 for 3rd year
VA - 15ish floor patients between 2 interns, 5ish ICU for the 2nd year
Peds - 15-20 floor patients between 2 interns (ICUs covered by fellows)

 

[thedrjojo]

30-60 er pts a day... I call bs

 

[Arcan57]

Large volume teaching hospitals tend to top out somewhere in 100k/yr ED volume, which is approximately 275 pts/day. Hospitals with high acuity EDs admit maybe 25% of their patients which would be roughly 70 admits/day. Let's be generous and say 5% of discharged patients also get a consult note dropped, that's another 14 patients/day. So you're looking at 84 patients/day getting seen by a non-EM resident. I cannot fathom an environment where somewhere between 40-70% of all of consults/admits from the ED are being seen by a PGY-2 rotating through the trauma service. That's also 2.5 completed consults every hour for 24 hrs at your high end which is a godlike level of efficiency for a PGY-2 especially considering the average turn-around time of cross-sectional imaging, time it takes to run it up the ladder when your senior/chief/attendings are usually operating, and waiting for input from multiple other surgical specialties in order to develop a coherent plan.