Organizational aspects to optimize patient's ambulatory pathway

Beaussier, Marc; Marchand-Maillet, Florence; Dufeu, Nicolas; Sciard, Didier

doi:10.1097/aco.0000000000000259

Cited by 19 publications

(1 citation statement)

References 31 publications

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“…Second, apart from benchmarking by the use of clinical outcome parameters, patient centered quality indicators such as patient satisfaction serve to improve quality of care from studies in inpatient anesthesia [56]. Although complication rates certainly impact patient satisfaction with ambulatory surgery, the management of postoperative pain and organizational factors are additional key determinants of patient satisfaction in the ambulatory setting [57,58]. The extent to which other patient related factors such as anxiety [59] or trust, discomfort and treatment by the team [60,61] are impacted by an ambulatory setting or even more by telehealth solutions for pre anesthetic visits or post discharge follow-ups in the outpatient setting has only been studied recently and still remains an open question to be examined.…”

Section: Quality Managementmentioning

confidence: 99%

Ambulatory anesthesia: restructuring for success

Bello,

Romero,

Heinimann

et al. 2023

Current Opinion in Anaesthesiology

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Purpose of review We review current evidence about organizational structures, patient selection criteria, safety measures, economic considerations, quality management, and staffing challenges in ambulatory anesthesia. The focus is on the facilitators and barriers related to the peri-interventional period and the potential concepts and innovations for further development of ambulatory anesthesia services. Recent findings Recent findings shed light on organizational structures in ambulatory anesthesia, including hospital-based centers, freestanding ambulatory centers, and office-based practices. Patient selection for ambulatory anesthesia involves a two-step process, considering both surgical and anesthetic factors. Safety measures, such as standardized guidelines and scoring systems, aim to ensure patient well being during the perioperative course. Economic considerations pose challenges due to the complexities of managing operating room efficiency and the variations in reimbursement systems. Quality management in ambulatory anesthesia emphasizes the need for outcome studies and patient-centered quality indicators. Staffing requirements necessitate highly skilled professionals with both technical and nontechnical skills, and structured education and training are essential. Summary Ambulatory anesthesia is gaining importance due to advancements in surgical techniques and periinterventional care. The review highlights the need for addressing challenges related to organizational structures, patient selection, patient safety, economic considerations, quality management, and staffing in ambulatory anesthesia. Understanding and addressing these factors are crucial for promoting the further development and improvement of ambulatory anesthesia services.

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Section: Quality Managementmentioning

confidence: 99%

Ambulatory anesthesia: restructuring for success

Bello,

Romero,

Heinimann

et al. 2023

Current Opinion in Anaesthesiology

View full text Add to dashboard Cite

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Clinical Interest and Economic Impact of Preoperative SMS Reminders before Ambulatory Surgery: A Propensity Score Analysis

et al. 2018

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Patient contact by telephone the day before ambulatory surgery is considered as a best practice. The Short Message Service (SMS) could be a suitable alternative. The objective of this prospective study was to evaluate the interest of preoperative instruction (PI) reminders by SMS compared to telephone calls. This was a prospective single center before-and-after study. Patients scheduled in ambulatory surgery were included during 2 consecutive periods of 10 weeks. The "Call" group received a telephone call for preoperative instructions (PI) and the "SMS" group received an automated protocol SMS reminder. The primary endpoint was patient compliance with PI and time of convocation. The two populations were compared with a non-inferiority hypothesis and the impact of the contact modality on compliance with the PI was assessed using a propensity score. The analysis concerned 301 patients in the Call group and 298 in the SMS group. The absence of dysfunction was observed in 75% of patients in the SMS group compared with 61% in the Call group (Risk difference: 14% [95%CI: 7-21]). The use of SMS was associated with a significant improvement in compliance with the PI (Odds ratio: 1.90 [1.48-2.42]; p < 0.0001). Patient satisfaction was similar regardless of the method of PI reminders. The automation of preoperative SMS reminders is associated with a better respect of the PI compared to the conventional calling method. This PI reminder method satisfies the majority of patients and may have a favorable financial impact.

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