The migration of procedures to the ambulatory setting has been well-documented. With approximately 60% of all operations conducted in the outpatient environment – a number that’s expected to rise with the continued implementation of the Affordable Care Act – a need to understand how to best serve the patient mix will rise as well.
One such step was taken recently in a new study conducted by researchers at the University of Michigan. Reviewing 240,000 records in a national database, the team was able to identify seven preoperative conditions that increase the risk for adverse events following a procedure.
- History of cancer
- Age 70 years or older
- Use of steroids
- Chronic obstructive pulmonary disease
- History of transient ischemic attack or stroke
The findings shouldn’t be cause for alarm, as it’s generally accepted that outpatient procedures are safe (in this study only 0.3% of cases involved major morbidity or mortality). What this study does indicate, according to Michael Mathis, MD, one of the members of the research team, is the need for anesthesia clinicians to be prominently involved in preoperative screening.
Somnia Anesthesia’s national director of ambulatory anesthesia, Jeanette Brown, agrees with that sentiment. “Suitability is not always dependent on patients’ morbidities though; it is much more complex than that,” says Brown. “It also depends on the planned surgery, the anesthesia technique and the capability of the facility – something we refer to as the ‘Somnia Table.’ Not thinking through each one of these considerations is akin to sitting at a table that is missing one or more legs. Anesthesia clinicians, and anesthesia management companies can help facilities think through these situations by using the Somnia Anesthesia Table.”