Quality Indicators in Ambulatory Surgery: A Literature Review Comparing Portuguese and International Systems

Nunes, João Silva; Gomes, Rebeca; Povo, Ana; Alves, Eurico Castro

doi:10.20344/amp.10416

Cited by 13 publications

(12 citation statements)

References 32 publications

(142 reference statements)

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“…Ambulatory surgery has revolutionized and streamlined many elective operations, allowing for health care cost savings, decreased risk of developing nosocomial infections, and a decreased disruption in patient's lives. 11,[14][15][16][17] Nevertheless, there remains a high rate of early hospital return after ambulatory surgery, 8 and studies have shown that few of these returns are for complications requiring hospital admission. 18 A detailed review at a large managed care hospital reinforces past studies that have identified several common complaints among those returning to the UC/ED within the first postoperative week after AR, LC, IHR, and UHR operations.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Physician Phone Calls as a Method to Decrease Urgent Care and Emergency Department Returns After Ambulatory General Surgery

Massoumi

Crain

Zhu

et al. 2020

The American Surgeon

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Unplanned returns after ambulatory surgery pose a burden to patients and health care providers alike. We hypothesized that a postoperative phone call by a physician would decrease avoidable returns to urgent care (UC) or the emergency department (ED) in the week after anorectal (AR), laparoscopic cholecystectomy (LC), inguinal hernia repair (IHR), and umbilical hernia repair (UHR) operations. A retrospective analysis from 1/2011 to 12/2015 across 14 Kaiser hospitals was conducted to determine baseline UC/ED return rates of patients pre-call. Between 10/2017 and 06/2019, physicians placed phone calls to patients within postoperative days (PODs) 1-4. The cohorts were compared using chi-squared analysis with significance determined at P < .05. In total, 276 patients received a call, with the majority placed on PODs 1-3. There were no statistically significant differences in return rates between the pre- and post-call groups. All of the AR, 50.0% of LC, 66.7% of IHR, and 50.0% of UHR patients returned prior to phone call placement. Our data indicate that a physician phone call does not help in decreasing UC/ED returns. However, it is noteworthy that many of the returns occurred pre-call placement. Future directions should be aimed at placing earlier postoperative phone calls.

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Section: Discussionmentioning

confidence: 99%

Postoperative Physician Phone Calls as a Method to Decrease Urgent Care and Emergency Department Returns After Ambulatory General Surgery

Massoumi

Crain

Zhu

et al. 2020

The American Surgeon

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“…For this reason, the Center for Medicare and Medicaid Services in the US recently included hospital transfer at the time of discharge among five quality measures that ASCs are required to report and which factor into reimbursement models (Centers for Medicare & Medicaid Services 2007, Rollins 2007). Recently, unplanned overnight admission has also been used as a quality indicator among international healthcare systems when assessing ambulatory surgery (Nunes et al 2018).…”

Section: Discussionmentioning

confidence: 99%

Functional status as a marker of need for hospital admission following outpatient hernia repair

Reeves

Mannix

Burton

et al. 2020

Journal of Perioperative Practice

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Introduction The careful selection of patients for hernia repair in ambulatory surgery centres is critical to prevent unanticipated inpatient admissions. The aim of this study was to evaluate risk factors associated with inpatient admission. Methods A multivariable logistic regression was performed utilising the ACS NSQIP database from 2007 to 2016. The primary outcome was same-day hospital discharge. The primary exposure variable was preoperative functional status. Additional covariates included sex, obesity, age, smoking status, steroid use, dyspnoea, diabetes mellitus, chronic obstructive pulmonary disease, congestive heart failure, hypertension, bleeding disorder, dialysis-dependence and American Society of Anesthesiologists classification score. Results A total of 194,822 patients underwent hernia repair in the outpatient setting; 8705 (4.5%) required hospital admission. The variables with the most significantly increased odds for hospital admission were partially dependent and totally dependent preoperative functional status. Conclusion A non-independent baseline functional status is the strongest predictor of need for admission following outpatient hernia repair.

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“…Day surgery has been gradually accepted by health professions globally from its first establishment in the 20th century in the UK [1]. Day surgery is also called "ambulatory surgery" or "outpatient surgery" in different studies [2]. In fact, the classical definition of day surgery was announced in 2011 by the IAAS (International Association for Ambulatory Surgery): the patients must be admitted and discharged within a calendar day, with day surgery as an intended management [3].…”

Section: Introductionmentioning

confidence: 99%

Thirty-Day Unplanned Readmission After Ambulatory Laparoscopic Cholecystectomy in Western China: A Retrospective Study

Huang

Dai

et al. 2021

Cureus

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Background Day surgery has been gradually accepted by health professions globally, which can shorten the hospital stay and reduce medical costs. The ambulatory laparoscopic cholecystectomy (LC) has been performed in China since over 10 years. However, few studies focus on its 30-day unplanned readmission rate of ambulatory LC and no standard of unplanned readmission rate for that now. Purpose This study aimed to evaluate the unplanned readmission rate and the reasons readmission after ambulatory LC in a tertiary hospital, which is the earliest ambulatory surgery implementation place in western China. Methods A retrospective analysis was conducted. The patients who underwent ambulatory LC from September 2015 to September 2019 in West China Hospital were screened. The 30-day unplanned readmission rate was calculated as the first outcome. The reasons for unplanned readmission were analyzed and classified as the second outcome. Results The study included 3,014 patients, and the unplanned readmission rate was 1.53%. The rate of patients diagnosed with cholecystolithiasis with cholecystitis was significantly higher in the unplanned readmission group (73.9% vs. 48.9%, p=0.003), and medical cost of unplanned readmission patients was significantly more than that of non-readmission patients (8,102.4±1,375.7 Yuan vs. 7,574.61±10,14.0 Yuan; p=0.008). It was observed that 71.7% readmission happened in the first seven days. Wound problems (60.9%) and abdominal pain (26.1%) went the two main reasons for unplanned readmission. Conclusions The analysis revealed that the unplanned readmission rate of 1.53% was low for ambulatory LC. Some causes of unplanned readmission, such as abdominal pain and wound site pain, wound exudate could be reduced by some simple interventions of the clinical professions.

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Quality Indicators in Ambulatory Surgery: A Literature Review Comparing Portuguese and International Systems

Abstract: On the literature review, same day surgery cancellations and patient satisfaction should be included in the National Health Assessment System created by the Portuguese Healthcare Regulation Authority.

Cited by 13 publications

References 32 publications

Postoperative Physician Phone Calls as a Method to Decrease Urgent Care and Emergency Department Returns After Ambulatory General Surgery

Postoperative Physician Phone Calls as a Method to Decrease Urgent Care and Emergency Department Returns After Ambulatory General Surgery

Functional status as a marker of need for hospital admission following outpatient hernia repair

Thirty-Day Unplanned Readmission After Ambulatory Laparoscopic Cholecystectomy in Western China: A Retrospective Study

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