Emergencies in freestanding ambulatory surgery centre

Karlsson, Elin; Jakobsson, Jan

doi:10.1097/aco.0000000000001058

Cited by 5 publications

(2 citation statements)

References 44 publications

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“…Patient selection as well as surgical procedures performed may differ to some extent depending on the center location and subsequent availability of emergency team, and high care facilities. There must of course be emergency plans to secure safety in all settings [55]. Firm discharge criteria, and plan for handling if complications occur following discharge must also be in place.…”

Section: Logisticsmentioning

confidence: 99%

Ambulatory anesthesia and discharge: an update around guidelines and trends

Rohi

Olofsson

Jakobsson

2022

Current Opinion in Anaesthesiology

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Purpose of reviewProvide an oversight of recent changes in same-day discharge (SDD) of patient following surgery/anesthesia.Recent findingsEnhanced recovery after surgery pathways in combination with less invasive surgical techniques have dramatically changed perioperative care. Preparing and optimizing patients preoperatively, minimizing surgical trauma, using fast-acting anesthetics as well as multimodal opioid-sparing analgesia regime and liberal prophylaxis against postoperative nausea and vomiting are basic cornerstones. The scope being to maintain physiology and minimize the impact on homeostasis and subsequently hasten and improve recovery.SummaryThe increasing adoption of enhanced protocols, including the entire perioperative care bundle, in combination with increased use of minimally invasive surgical techniques have shortened hospital stay. More intermediate procedures are today transferred to ambulatory pathways; SDD or overnight stay only. The traditional scores for assessing discharge eligibility are however still valid. Stable vital signs, awake and oriented, able to ambulate with acceptable pain, and postoperative nausea and vomiting are always needed. Drinking and voiding must be acknowledged but mandatory. Escort and someone at home the first night following surgery are strongly recommended. Explicit information around postoperative care and how to contact healthcare in case of need, as well as a follow-up call day after surgery, are likewise of importance. Mobile apps and remote monitoring are techniques increasingly used to improve postoperative follow-up.

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Section: Logisticsmentioning

confidence: 99%

Ambulatory anesthesia and discharge: an update around guidelines and trends

Rohi

Olofsson

Jakobsson

2022

Current Opinion in Anaesthesiology

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“…Identifying suitable candidates for ambulatory surgery is complex, and not only dependent on patients’ characteristics but also on a wide range of considerations including the clinical staff experience, surgical approach, and the type of institution [8 ▪▪ ], as well as the ability to handle unexpected emergencies [9 ▪ ]. In addition to a safe procedure, patients should be sure to receive adequate management postoperatively, including nausea/vomiting treatment and pain control after discharge [10 ▪ ].…”

Section: Why Do We Assess Risk – Who Needs What?mentioning

confidence: 99%

Modern preoperative evaluation in ambulatory surgery – who, where and how?

Filipovic

Schwenter

Luedi

et al. 2022

Current Opinion in Anaesthesiology

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Purpose of reviewAmbulatory surgery is increasingly performed in medically complex patients. This dynamic environment requires new approaches to ensure cost-effective, efficient, and ultimately safe preoperative evaluation of the patient. This review investigates recent advances in the assessment of ambulatory patients, with a special focus on patient screening, digital communication, and multidisciplinary team evaluation.Recent findingsIdentifying suitable candidates for ambulatory surgery relies on a variety of medical, surgical, and institutional factors. Identification of high-risk patients and optimization of their treatment can be achieved through multidisciplinary protocols specific to the local institution and in line with current guidelines. Virtual assessment may be sufficient for most patients and provide an efficient evaluation strategy and high patient satisfaction. Prescreening can be supported by preoperative nursing teams.SummaryThe increasing complexity of treatment provided in day surgery offers a unique opportunity to highlight the importance of anesthesiology staff as perioperative caregivers. Preoperative evaluation serves as a central junction to integrate a variety of surgical, medical, and institutional factors to provide safe, satisfactory, and efficient care for patients. Implementing technological innovation to streamline and facilitate this process is paramount.

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Qualitätskriterien im Kontext einer Ambulantisierung

Geraedts

2024

Krankenhaus-Report 2024

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ZusammenfassungBei einer Ambulantisierung vormals stationär erbrachter Leistungen rechnet man vor allem mit einer Kostenreduktion. Diese Reduktion sollte jedoch nicht mit einer Qualitätsminderung bis hin zur Gefährdung der Patientensicherheit einhergehen. Deshalb muss die Qualität der ambulantisierten Versorgung kontinuierlich überwacht werden. Dazu dient ein Qualitätsmonitoring, das auf Qualitätsindikatoren beruht, die wiederum wesentliche Qualitätskriterien operationalisieren. Diese Kriterien berücksichtigen typischerweise die Effektivität, Patientenzentrierung, Sicherheit und Gerechtigkeit der Versorgung. Qualitätsindikatoren, die den Erfüllungsgrad der Kriterien bewerten, können aus der Literatur abgeleitet oder de novo formuliert werden. Letztlich muss damit bewertet werden, ob die zur Durchführung der ambulantisierten Behandlung essenziellen personellen und sachlichen Strukturen vorgehalten werden, die Behandlung selbst fachgerecht indiziert und durchgeführt wird und die klinischen sowie von Patientinnen und Patienten berichteten Ergebnisse und Behandlungserfahrungen positiv und ohne Sicherheitsgefährdung ausfallen.

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Emergencies in freestanding ambulatory surgery centre

Cited by 5 publications

References 44 publications

Ambulatory anesthesia and discharge: an update around guidelines and trends

Ambulatory anesthesia and discharge: an update around guidelines and trends

Modern preoperative evaluation in ambulatory surgery – who, where and how?

Qualitätskriterien im Kontext einer Ambulantisierung

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