Mortality in Outpatient Surgery

Keyes, Geoffrey R.; Singer, Robert D.; Iverson, Ronald E.; McGuire, Michael F.; Yates, James A.; Gold, Alan; Reed, L. E.; Pollack, H.M.; Thompson, Dennis P.

doi:10.1097/prs.0b013e31817747fd

Cited by 137 publications

(46 citation statements)

References 15 publications

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“…20,21 Studies showing that certain outpatient plastic surgery operations have low mortality rates and complication profiles compared to corresponding inpatient procedures have only helped expand on these associated advantages. [20][21][22][23][24][25][26] A transition to outpatient surgery is important to health care reform, as it is associated with lower costs. 27 Nevertheless, little is known about readmission rates in this setting, and without such critical outcomes data, it will be more difficult to improve processes (and thereby avoid potential future punitive action from regulatory agencies).…”

mentioning

confidence: 99%

Predictors of Readmission after Outpatient Plastic Surgery

Mioton

Buck

Rambachan

et al. 2014

Plastic and Reconstructive Surgery

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Unplanned readmission after outpatient plastic surgery is infrequent and compares favorably to rates of readmission among other specialties. Obesity, wound infection within 30 days of the index operation, and American Society of Anesthesiologists class 3 or 4 physical status are independent predictors of readmission. As procedures continue to transition into outpatient settings and the drive to improve patient care persists, these findings will serve to optimize outpatient surgery use.

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confidence: 99%

Predictors of Readmission after Outpatient Plastic Surgery

Mioton

Buck

Rambachan

et al. 2014

Plastic and Reconstructive Surgery

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“…Once the surgical procedure is deemed safe enough to perform in the outpatient setting, the risk of an adverse event (AE) is perceived to be low. [1][2][3][4][5][6] Subsequently, few studies have examined ambulatory surgery outcomes, including harm to patients and increased use of postoperative medical services. Assessment of quality of care and benchmarking efforts have focused on inpatient surgery; the development of methods to detect and identify AEs in ambulatory surgery lag far behind.…”

Section: Introductionmentioning

confidence: 99%

Development and Testing of Tools to Detect Ambulatory Surgical Adverse Events

Mull

Borzecki²,

Hickson³

et al. 2013

Journal of Patient Safety

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Objectives-Numerous healthcare systems in the U.S., including the Veterans Health Administration (VA), use the National Surgical Quality Improvement Program (NSQIP) to detect surgical adverse events (AEs). VASQIP sampling methodology excludes many routine ambulatory surgeries from review. Triggers, algorithms derived from clinical logic to flag cases where AEs have most likely occurred, could complement VASQIP by detecting a higher yield of ambulatory surgeries with a true surgical AE.Methods-We developed and tested a set of ambulatory surgical AE trigger algorithms using a sample of fiscal year 2008 ambulatory surgeries from the VA Boston Healthcare System. We used VA Boston VASQIP-assessed cases to refine triggers, and VASQIP-excluded cases to test how many trigger-flagged surgeries had a nurse chart review-detected surgical AE. Chart review was performed using the VA electronic medical record. We calculated the ratio of cases with a true U.S. Department of Veterans AffairsPublic Access Author manuscript J Patient Saf. Author manuscript; available in PMC 2015 September 04. VA Author ManuscriptVA Author Manuscript VA Author Manuscript surgical AE over flagged cases (i.e., the positive predictive value (PPV)), and the 95% confidence interval for each trigger.Results-Compared to the VASQIP rate (9 AEs, or 2.8%, of the 322 charts assessed), nurse chart review of the 198 trigger-flagged surgeries yielded more cases with at least one AE (47 surgeries with an AE, or 6.0%, of the 782 VASQIP-excluded ambulatory surgeries). Individual trigger PPVs ranged from 12.4% to 58.3%.Conclusions-In comparison with VASQIP, our set of triggers identified a higher rate of surgeries with AEs in fewer chart-reviewed cases. Because our results are based on a relatively small sample, further research is necessary to confirm these findings.

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“…Statistical data on the mortality from the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) were reported by Keyes 43 in 2008. Using accumulated data from the AAAASF's quality assurance and peer review reporting system from 2001 through 2006, Keyes found 23 deaths in 1,141,418 outpatient procedures (1:49,626 or 0.002%).…”

Section: Safety Of Office-based Anesthesiamentioning

confidence: 99%

Office-based anesthesia

Kurrek

Twersky

2010

Can J Anesth/J Can Anesth

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Purpose Ambulatory office-based anesthesia (OBA) is a relatively new but rapidly growing field. OBA requires a different approach than that used in the hospital, because there are unique considerations that must be recognized when administering anesthesia in a free-standing office facility. This review provides a summary of the important issues and aspects of safe patient care. Methods The Medline, Embase, Biological Abstract, Science Citation Index, and Healthstar databases were searched under

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Mortality in Outpatient Surgery

Cited by 137 publications

References 15 publications

Predictors of Readmission after Outpatient Plastic Surgery

Predictors of Readmission after Outpatient Plastic Surgery

Development and Testing of Tools to Detect Ambulatory Surgical Adverse Events

Office-based anesthesia

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