Are Ambulatory Surgery Centers Safe for Outpatients?

Are Ambulatory Surgery Centers Safe for Outpatients?

As a medical transcription company serving surgeons in diverse healthcare settings, we look at the aspect of patient safety in ambulatory surgery centers.

MTS Transcription Services United States

Safety is an important consideration in any healthcare setting offering surgery. As a medical transcription company providing general surgery transcription for surgeons working in hospitals and ASCs (Ambulatory Surgery Centers), it was with keen interest that we followed a Consumer Reports research that highlighted the safety aspect of these healthcare settings. ASCs that routinely offered minor surgical procedures have now started offering more complicated procedures. Between 2010 and 2014, the hysterectomies offered at such centers increased from 36% to 64%. Research shows that even surgeries such as spine surgery and joint replacement are being performed at these centers. What about patients?

Patients prefer receiving care from these centers because they find them more convenient than hospitals, with reduced waiting time and more personalized care.

However, there are risks involved.

•

ASCs are not as tightly regulated or monitored to the same degree as hospitals and therefore there are concerns such as lack of cleanliness and possibility of serious infections.

•

They may not have appropriate safety equipment such as those available at a hospital in case an emergency arises.

•

The staff may not be sufficiently trained or skilled to handle an emergency as in a hospital.

Let us look at the benefits of having surgery done in an outpatient setting or in an ASC. Benefits of Outpatient Surgery •

It requires only a short stay and is much more affordable than inpatient surgery. A recent Blue Cross Shield Analysis of the claims data of approximately 43 million people found that those who chose to have angioplasty in an outpatient facility rather than inpatient saved an average of $1062 out of pocket expenses.

•

According to a study published in the Journal of Bone & Joint Surgery in 2016, people who had outpatient surgery for ankle fractures for instance, had lower rates of urinary tract infections, pneumonia, and blood clots, and required fewer blood transfusions.

Ambulatory Surgery Centers May Not Be Suitable for All ASCs are not suitable healthcare settings for all. First of all, you need to be in good health.

Older adults who are frail may take longer to heal, have stronger and longer lasting reactions to anesthesia and are more likely to experience surgical complications. These

www.medicaltranscriptionservicecompany.com

(800) 670 2809

patients have higher risks of complications and will be better off in a hospital that can quickly respond to emergencies. According to a University of Michigan study in 2013, at least 1 in 1000 people experiences major complications or even dies within 72 hours of surgery at an ASC or hospital outpatient centre. This study highlighted 7 main risk factors overweight, obesity, obstructive lung disease, hypertension, past history of heart attack, previous cardiac intervention and prolonged operating room time.

Choosing the Right Outpatient Center Consumer Reports provides recommendations to patients considering surgery at an ASC not affiliated to a hospital. The first thing to do is to identify whether the organization is CMScertified, i.e. if the center is to be reimbursed by Medicare, it should meet standards related to anesthesia administration, operating and

recovery rooms, medical staff and nursing

services. Other factors to consider are: •

The surgeon should have sufficient experience in her/his field to avoid any complications. Someone who has performed the surgery at least 50 times in the past year would be ideal.

•

Typically, local anesthesia or conscious sedation would be sufficient in an outpatient surgery setting or ASC. The anesthesiologist should keep an eye on the patient throughout the procedure. He/she should accept the patient’s insurance, be boardcertified, and have hospital admitting privileges as well.

•

It is important to make sure that the emergency medication and resuscitative equipment are available on-site. There should be a procedure for using them. The doctor should be certified in advanced resuscitation techniques. The facility should also have a plan for transferring the patient to a hospital, if necessary.

•

The doctor should be willing to share information regarding the infection and hospitalization rates after the procedure. Ideally, this rate should be zero.

Adults 60 years of age and above are more likely to be admitted to a hospital within 30 days after an outpatient surgery. This readmission can be prevented and returning home can be made easier and safer if the following are observed.

•

Get a detailed discharge summary with diet, medications, follow-up appointments, activities one can and cannot do etc.

•

The blood pressure and temperature of the patient should be normal and the patient should be able to move around without any dizziness.

www.medicaltranscriptionservicecompany.com

(800) 670 2809

•

The patient should have somebody to help at home during the initial days, especially in the case of joint replacement or any other complicated procedures.

•

The ASC usually calls the discharged patient within 24 to 72 hours of surgery. In case the patient is not able to eat, drink, or use the bathroom, or has a fever or bleeding, pain or nausea that does not respond to medication – that information has to be passed on to the ASC.

It is also important that insurers cover the surgical procedures provided at Ambulatory Surgical Centers. Medical transcription companies aware of medical billing requirements know that Medicare now covers surgeries in more than 5000 outpatient surgical centers.

Good data on outpatient surgery centers may be hard to find but should be available over time. Patients with serious health conditions should ideally choose a hospital that is better equipped to address complications than an ASC. Data forthcoming from agencies such as Consumer Reports is a great help for patients considering undergoing surgery in an outpatient setting.

www.medicaltranscriptionservicecompany.com

(800) 670 2809