Total care of trauma patients from triage to discharge at Chang Gung Memorial Hospital: introducing the development of an iconic acute care surgery system in Taiwan

Abstract Background The Acute Care Surgery (ACS) model has evolved to provide structured care across trauma, critical care, and emergency general surgery. This innovative model effectively addresses significant challenges within trauma care. Research indicates that trauma surgeons operating under th...

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Main Authors: Chi-Hsun Hsieh, Chien-Hung Liao, Chi-Tung Cheng, Chih-Yuan Fu, Shih-Ching Kang, Yu-Pao Hsu, Chih-Po Hsu, Szu-An Chen, Chien-An Liao, Yu-Hao Wang, Ling-Wei Kuo, Chia-Cheng Wang, Yu-San Tee, Feng-Jen Hsieh, Chun-Hsiang Ou-Yang, Pei-Hua Li, Sheng-Yu Chan, Jen-Fu Huang, Yu-Tung Wu
Format: Article
Language:English
Published: BMC 2025-04-01
Series:World Journal of Emergency Surgery
Subjects:
Online Access:https://doi.org/10.1186/s13017-025-00603-9
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author Chi-Hsun Hsieh
Chien-Hung Liao
Chi-Tung Cheng
Chih-Yuan Fu
Shih-Ching Kang
Yu-Pao Hsu
Chih-Po Hsu
Szu-An Chen
Chien-An Liao
Yu-Hao Wang
Ling-Wei Kuo
Chia-Cheng Wang
Yu-San Tee
Feng-Jen Hsieh
Chun-Hsiang Ou-Yang
Pei-Hua Li
Sheng-Yu Chan
Jen-Fu Huang
Yu-Tung Wu
author_facet Chi-Hsun Hsieh
Chien-Hung Liao
Chi-Tung Cheng
Chih-Yuan Fu
Shih-Ching Kang
Yu-Pao Hsu
Chih-Po Hsu
Szu-An Chen
Chien-An Liao
Yu-Hao Wang
Ling-Wei Kuo
Chia-Cheng Wang
Yu-San Tee
Feng-Jen Hsieh
Chun-Hsiang Ou-Yang
Pei-Hua Li
Sheng-Yu Chan
Jen-Fu Huang
Yu-Tung Wu
author_sort Chi-Hsun Hsieh
collection DOAJ
description Abstract Background The Acute Care Surgery (ACS) model has evolved to provide structured care across trauma, critical care, and emergency general surgery. This innovative model effectively addresses significant challenges within trauma care. Research indicates that trauma surgeons operating under this expanded scope deliver high-quality care while enjoying professional satisfaction. This article discusses the introduction of the ACS model in Taiwan. Main Body Before the 1990s, Taiwan’s trauma care system relied on general surgeons who operated under an “on-call” model, lacking dedicated trauma specialists. Significant reforms were initiated in 2009, when the government implemented a grading system for hospital emergency capabilities, categorizing hospitals into three levels: General (offering 24 h services), Intermediate (capable of managing stable trauma cases), and Advanced (providing comprehensive care for critically ill patients). All medical centers are classified as advanced level hospitals and are equipped with trauma teams. However, these trauma teams operate under various models, ranging from those focused exclusively on trauma to others with comprehensive responsibilities. The trauma center at Chang Gung Memorial Hospital (CGMH) adopted a comprehensive ACS model, encompassing the entire spectrum of care from emergency admission to discharge, all led by trauma surgeons. This approach ensures continuity and coordination in trauma patient care. Additionally, the model integrates emergency general surgery and surgical critical care, broadening the scope of practice for trauma surgeons and enhancing their overall capabilities, providing significant flexibility in their career paths. The ACS model implemented at CGMH has achieved remarkable success, establishing it as a leading trauma center in Taiwan. Conclusion The emergence of the ACS model aims to reverse the decline in the trauma field that began decades ago. This model not only helps retain skilled professionals but also maintains the expertise of trauma surgeons, ensuring that trauma patients receive the highest quality of care.
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series World Journal of Emergency Surgery
spelling doaj-art-b8663d98c4cc4128b173b7fc7ebde64e2025-08-20T03:04:59ZengBMCWorld Journal of Emergency Surgery1749-79222025-04-012011710.1186/s13017-025-00603-9Total care of trauma patients from triage to discharge at Chang Gung Memorial Hospital: introducing the development of an iconic acute care surgery system in TaiwanChi-Hsun Hsieh0Chien-Hung Liao1Chi-Tung Cheng2Chih-Yuan Fu3Shih-Ching Kang4Yu-Pao Hsu5Chih-Po Hsu6Szu-An Chen7Chien-An Liao8Yu-Hao Wang9Ling-Wei Kuo10Chia-Cheng Wang11Yu-San Tee12Feng-Jen Hsieh13Chun-Hsiang Ou-Yang14Pei-Hua Li15Sheng-Yu Chan16Jen-Fu Huang17Yu-Tung Wu18Department of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalDepartment of Trauma and Emergency Surgery, Chang Gung Memorial HospitalAbstract Background The Acute Care Surgery (ACS) model has evolved to provide structured care across trauma, critical care, and emergency general surgery. This innovative model effectively addresses significant challenges within trauma care. Research indicates that trauma surgeons operating under this expanded scope deliver high-quality care while enjoying professional satisfaction. This article discusses the introduction of the ACS model in Taiwan. Main Body Before the 1990s, Taiwan’s trauma care system relied on general surgeons who operated under an “on-call” model, lacking dedicated trauma specialists. Significant reforms were initiated in 2009, when the government implemented a grading system for hospital emergency capabilities, categorizing hospitals into three levels: General (offering 24 h services), Intermediate (capable of managing stable trauma cases), and Advanced (providing comprehensive care for critically ill patients). All medical centers are classified as advanced level hospitals and are equipped with trauma teams. However, these trauma teams operate under various models, ranging from those focused exclusively on trauma to others with comprehensive responsibilities. The trauma center at Chang Gung Memorial Hospital (CGMH) adopted a comprehensive ACS model, encompassing the entire spectrum of care from emergency admission to discharge, all led by trauma surgeons. This approach ensures continuity and coordination in trauma patient care. Additionally, the model integrates emergency general surgery and surgical critical care, broadening the scope of practice for trauma surgeons and enhancing their overall capabilities, providing significant flexibility in their career paths. The ACS model implemented at CGMH has achieved remarkable success, establishing it as a leading trauma center in Taiwan. Conclusion The emergence of the ACS model aims to reverse the decline in the trauma field that began decades ago. This model not only helps retain skilled professionals but also maintains the expertise of trauma surgeons, ensuring that trauma patients receive the highest quality of care.https://doi.org/10.1186/s13017-025-00603-9Acute care surgeryTrauma surgeryEmergency general surgerySurgical critical care
spellingShingle Chi-Hsun Hsieh
Chien-Hung Liao
Chi-Tung Cheng
Chih-Yuan Fu
Shih-Ching Kang
Yu-Pao Hsu
Chih-Po Hsu
Szu-An Chen
Chien-An Liao
Yu-Hao Wang
Ling-Wei Kuo
Chia-Cheng Wang
Yu-San Tee
Feng-Jen Hsieh
Chun-Hsiang Ou-Yang
Pei-Hua Li
Sheng-Yu Chan
Jen-Fu Huang
Yu-Tung Wu
Total care of trauma patients from triage to discharge at Chang Gung Memorial Hospital: introducing the development of an iconic acute care surgery system in Taiwan
World Journal of Emergency Surgery
Acute care surgery
Trauma surgery
Emergency general surgery
Surgical critical care
title Total care of trauma patients from triage to discharge at Chang Gung Memorial Hospital: introducing the development of an iconic acute care surgery system in Taiwan
title_full Total care of trauma patients from triage to discharge at Chang Gung Memorial Hospital: introducing the development of an iconic acute care surgery system in Taiwan
title_fullStr Total care of trauma patients from triage to discharge at Chang Gung Memorial Hospital: introducing the development of an iconic acute care surgery system in Taiwan
title_full_unstemmed Total care of trauma patients from triage to discharge at Chang Gung Memorial Hospital: introducing the development of an iconic acute care surgery system in Taiwan
title_short Total care of trauma patients from triage to discharge at Chang Gung Memorial Hospital: introducing the development of an iconic acute care surgery system in Taiwan
title_sort total care of trauma patients from triage to discharge at chang gung memorial hospital introducing the development of an iconic acute care surgery system in taiwan
topic Acute care surgery
Trauma surgery
Emergency general surgery
Surgical critical care
url https://doi.org/10.1186/s13017-025-00603-9
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