Skagit Regional Health—the umbrella name for Skagit Valley Hospital, Skagit Regional Clinics, and Cascade Valley Hospital and Clinics—launched the DEBUT study at their sites in December 2016. The DEBUT study grew out of a collaboration with the Surgical Care and Outcome Assessment Program (SCOAP), which Skagit Regional Health has participated in for many years. After DEBUT investigators Drs. David Flum and Giana Davidson contacted SCOAP’s physician champion at Skagit Regional Health, Dr. Allison Porter, to ask if they wanted to get involved in DEBUT, Dr. Porter became DEBUT’s physician champion as well.
“We work at a rural hospital as general surgeons because we want to help patients, but we also think it’s important to be forwarding knowledge—especially knowledge that affects every acute care surgeon in the U.S. and possibly the world,” Dr. Porter says.
Skagit Regional Health’s investigative team includes five practicing elective general surgeons and two surgical hospitalists, all of whom have a wide array of surgical training. As a group, they see between 30-60 patients with diverticulitis per year. While a few patients show up electively in the clinic, most usually present in the emergency department or hospital as inpatients.
Though Skagit Regional Health is close to urban centers, most of their patients live in a rural environment. “Cascade Valley Hospital is a local, public hospital. We are the county hospital for Skagit County in same way as Harborview is for King County,” Dr. Porter says. “We are ‘primary care surgery’ in a way, because we are usually the first surgeons that a patient encounters before they are referred. We see a huge array of patients, and no one gets turned away.”
Dr. Porter feels it is important to be involved in DEBUT because diverticulitis is a topic that is applicable to practitioners in a broad-based surgery environment. “It’s not an esoteric zebra—it is very common, and any general surgeon who takes acute care call is going to see diverticulitis patients,” she says. “The guidelines for when to operate on these patients aren’t clear, and the DEBUT study will put some data behind the practice about who we should be operating on.”