scholarly journals Ambulatory surgery in proctology

2004 ◽  
Vol 51 (2) ◽  
pp. 81-83 ◽  
Author(s):  
P. Kosorok
Keyword(s):  
Ambulatory Surgery ◽  
Day Surgery ◽  
Tension Free ◽  
Anal Surgery ◽  
Skin Tags ◽  
Minor Surgery ◽  
Anal Warts ◽  
Treat All ◽  
Longo Procedure ◽  
Groin Hernias

Introduction: In our institution we?ve had a lot of exerience in proctology. Ten years ago, we introduced one day surgery in our practice and had really good results in treating practically all patients who needed proctologic surgery. Materials, methods and results: During this period of time 9.636 out of 73.235 outpatient cases were chosen for surgery. Among them, 2664 were patients with operations of perianal haematomas. We had some experiences with minor anal surgery (excisions of skin tags in 537 patients, excisions of papillas in 545 patients); patients with haemorrhoids, operated classically on Milligan- Morgan procedure (1116) or by the new PPH - Longo procedure (270) and HAL technique (12). We also treated patients with fistulas - either with fistulotomy or excision of fistulae - and 1007patients with minor surgery. We made excisions of anorectal polyps in 265 patients, excisions of pilonidal cysts in 421 patients and treated 211 patients with anal abscesses. We had 282 patients with anal warts, 310 patients with anal fisures. In 35 patients we made some other small proctological interventions. In addition to proctology we made tension free operations of groin hernias in 627 patients, corrections of epigastric and umbillical hernias (26 patients) and corrections of stomas in 11 patients. The rest of our peogramm were small aseptic interventions (operations of fibromas, atheromas, verrucas, ganglions, lipomas etc.). Conclusion: We have experienced ambulatory surgery (i.e. day surgery hospital) as an appropriate choice for treating the patients with proctologic pathology. However, it used to be the practice to treat all these patients in hospitals, where they occupied bed facilities that could be intended for other patients. To conclude, our present results have confirmed the decision for ambulatory surgery to be correct in the field of proctology.

Ambulatory Case Mix Funding Systems in Canada

1994 ◽  
Vol 7 (2) ◽  
pp. 21-28 ◽  
Author(s):  
Philip Jacobs ◽  
Judith R. Lave ◽  
Edward Hall ◽  
Charles Botz
Keyword(s):  
United States ◽  
Emergency Care ◽  
Outpatient Care ◽  
Ambulatory Surgery ◽  
The United States ◽  
Day Surgery ◽  
Case Mix ◽  
Outpatient Basis ◽  
Inpatient Case

The implementation of inpatient case mix funding in Alberta and Ontario does not allow for adequate incentives to shift resources to an outpatient basis, where appropriate, or to provide outpatient care efficiently. This paper explores the prospects and problems of further extending case mix tools into this area. The availability of tools to characterize output for day surgery, special clinics and emergency care is surveyed. We conclude that case mix funding is desirable and feasible for ambulatory surgery; however, it is questionable for emergency care and special clinics. However, developments in this area in the United States will continue, and this will likely maintain an interest in Canada.

scholarly journals Emergency department use and hospital admission in children following ambulatory surgery: a retrospective population-based cohort study

2021 ◽  
Vol 5 (1) ◽  
pp. e001188
Author(s):  
Monakshi Sawhney ◽  
Elizabeth G VanDenKerkhof ◽  
David H Goldstein ◽  
Xuejiao Wei ◽  
Genevieve Pare ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Hospital Admission ◽  
Hospital Admissions ◽  
Ambulatory Surgery ◽  
Day Surgery ◽  
Population Based ◽  
Administrative Database ◽  
Same Day Discharge ◽  
Ed Visits

IntroductionPaediatric ambulatory surgery (same day surgery and planned same day discharge) is more frequently being performed more in Canada and around the world; however, after surgery children may return to hospital, either through the emergency department (ED) or through a hospital admission (HA). The aim of this study was to determine the patient characteristics associated with ED visits and HA in the 3 days following paediatric ambulatory surgery.MethodsThis population-based retrospective cohort study used de-identified health administrative database housed at ICES and included residents of Ontario, younger than 18 years of age, who underwent ambulatory surgery between 2014 and 2018. Patients were not involved in the design of this study. The proportion of ED visit and HA were calculated for the total cohort, and the type of surgery. The ORs and 95% CIs were calculated for each outcome using logistic regression.Results83 468 children underwent select ambulatory surgeries. 2588 (3.1%) had an ED visit and 608 (0.7%) had a HA in the 3 days following surgery. The most common reasons for ED visits included pain (17.2%) and haemorrhage (10.5%). Reasons for HA included haemorrhage (24.8%), dehydration (21.9%), and pain (9.1%).ConclusionsOur findings suggest that pain, bleeding and dehydration symptoms are associated with a return visit to the hospital. Implementing approaches to prevent, identify and manage these symptoms may be helpful in reducing ED visits or hospital admissions.

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

2018 ◽  
Vol 31 (7-8) ◽  
pp. 425 ◽  
Author(s):  
João Silva Nunes ◽  
Rebeca Gomes ◽  
Ana Povo ◽  
Eurico Castro Alves
Keyword(s):  
Literature Review ◽  
Quality Indicators ◽  
Ambulatory Surgery ◽  
Health Assessment ◽  
Day Surgery ◽  
Assessment System ◽  
Perioperative Morbidity ◽  
Global Quality ◽  
Healthcare Regulation ◽  
Number Of Patients

Introduction: According to several studies conducted in North America and Europe, ambulatory surgery is a practice that has grown over the years, and both the number of more complex surgical procedures deemed suitable for ambulatory surgery and the number of patients with different co-morbidities which are now suitable for this type of procedure have been increasing. In order to respond to the increased number of day surgeries, as well as to avoid a potential proportional increase in perioperative morbidity, quality control systems must be adopted to enable continuous improvement and minimise predicted risks. The purpose of this study is to review global quality indicators used in ambulatory surgery and compare them with those used in Portugal.Material and Methods: The authors conducted a comprehensive search of medical databases, using MeSH words. Limits were applied to include only studies published after 1998 written in Portuguese, English and Spanish. Ambulatory surgery indicators for Portugal were also obtained.Results: Twenty-one different quality indicators for ambulatory surgery were identified. The Portuguese Healthcare Regulation Authority has defined seven quality indicators for ambulatory surgery.Discussion: The Portuguese quality indicators for ambulatory surgery are generally well adapted to current international practices. Nevertheless, after analysing the relevant international literature based on this study, it is important to consider two additional indicators for ambulatory surgery – same day surgery cancellations and patient satisfaction.Conclusion: 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.

scholarly journals Day surgery in a teaching hospital: identifying barriers to productivity

2014 ◽  
Vol 3 (6) ◽  
pp. 216
Author(s):  
Abdelmonim E. A Salih ◽  
Babak Meshkat ◽  
Gary A Bass ◽  
Seamus McHugh ◽  
Sinead Fox ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Patient Management ◽  
Ambulatory Surgery ◽  
Standard Of Care ◽  
Day Surgery ◽  
Cancellation Rate ◽  
Active Patient ◽  
Study Interval ◽  
Bed Capacity ◽  
Reduced Risk

Introduction: Ambulatory surgery is a standard of care for many surgical procedures due to cost-effectiveness and benefits to patients including the reduced risk of contracting hospital infection by reducing the hospital stay. However, late cancellations can be costly. We examined the utilisation of the surgical day ward in our institution over a four-year period. Methods: A retrospective study of surgical day ward records from September 2007 to September 2011 in one institution. Parameters investigated included the number of planned admissions. Reasons for cancellations were also collected. Results: A total of 17,461 procedures were intended as a day ward admission during the study interval. There were 3,539 procedures that were cancelled (20.3%). The prevalent proportion of cancellations (n = 1,367) (38.6%) were due to patients not showing up for their procedures (7.8% of planned admissions); 1,188 (33.6%) patients were cancelled by the admissions office due to bed shortages, accounting for 6.8 % of planned admissions and 650 (18.4%) of cases were due to last minute cancellations by patients, accounting for 3.7% of all planned admission. The remaining 334 (9.4%) of cases were cancelled on medical grounds including patients who were considered unfit for the intended procedure, or anti-coagulations not appropriately ceased prior to surgery, accounting for 1.9% of all planned admissions. Conclusion: The cancellation rate in this study was high, mainly due to failure of patients to attend or signal their intentions, inadequate bed capacity and bed closure strategies. The ring fencing and protection of day beds and a more active patient management interaction would have had the greatest impact on increased efficiency. 

Morphine Delays Discharge following Ambulatory Surgery: A Prospective Institutional study

2009 ◽  
Vol 19 (8) ◽  
pp. 254-256 ◽  
Author(s):  
Narendra Nath Basu ◽  
Bengt Kald ◽  
Dugal Heath
Keyword(s):  
Side Effects ◽  
Ambulatory Surgery ◽  
Demographic Data ◽  
Day Surgery ◽  
Not Given ◽  
Morphine Analgesia ◽  
Morphine Group ◽  
Delayed Discharge ◽  
Recovery Times

Introduction - Morphine is used regularly in day surgery despite its known side-effects. We assessed whether this delayed discharge. Patients and methods - 100 patients were divided into 2 groups: 50 patients received morphine and 50 patients received non-morphine analgesia. Demographic data and reasons for delayed discharge were recorded. Results – 73% of all major cases received morphine compared to only 19% of minor cases. Operative and recovery times were significantly greater in the morphine group. 58% of patients given morphine had a delayed discharge compared to 14% of patients not given morphine. Conclusions - Morphine use in day surgery is associated with increased operating and recovery times and higher rates of delayed discharge.

Cost Savings From Utilization of an Ambulatory Surgery Center for Orthopaedic Day Surgery

2016 ◽  
Vol 24 (12) ◽  
pp. 865-871 ◽  
Author(s):  
Peter D. Fabricant ◽  
Mark A. Seeley ◽  
Joshua C. Rozell ◽  
Evan Fieldston ◽  
John M. Flynn ◽  
...  
Keyword(s):  
Ambulatory Surgery ◽  
Cost Savings ◽  
Day Surgery ◽  
Ambulatory Surgery Center ◽  
Surgery Center
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