Pulmonary Comorbidities in Endoscopic Retrograde Cholangio-Pancreatography Procedure and Ambulatory Anesthesia

2018 ◽  
pp. 115-120
Author(s):  
Ali R. Abdullah ◽  
Lu Zheng
Keyword(s):  
Ambulatory Surgery ◽  
Medical Center ◽  
Anesthetic Management ◽  
Ambulatory Setting ◽  
Anesthesia Care ◽  
Ambulatory Anesthesia ◽  
Endoscopic Retrograde ◽  
Outpatient Procedures ◽  
Ambulatory Procedure

Ambulatory surgery anesthesia is one of the fastest-growing subspecialties in anesthesia. Outpatient procedures cost less in the ambulatory setting than in hospitals and provide increased efficacy and convenience to both the proceduralist and the patient. The most common ambulatory procedure performed includes gastrointestinal procedures, performed under either general anesthesia or, more often, monitored anesthesia care. Although usually less complicated than most inpatient surgeries, anesthetic management in ambulatory surgery settings can be challenging and requires equal anesthesia expertise to be performed efficiently without compromising safety. This chapter uses the case study of a 63-year-old woman noticed to have jaundice and intermittent right upper quadrant abdominal pain since around 6 weeks ago who is scheduled to have an endoscopic retrograde cholangiopancreatography at the gastrointestinal suite of a tertiary medical center.

scholarly journals Patients With Type 2 Diabetes: Anesthetic Management in the Ambulatory Setting. Part 1: Pathophysiology and Associated Disease States

2016 ◽  
Vol 63 (4) ◽  
pp. 208-215 ◽  
Author(s):  
Bryant W. Cornelius
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Anesthetic Management ◽  
Multiple Organ ◽  
Ambulatory Setting ◽  
Diabetic Patients ◽  
Ambulatory Anesthesia ◽  
Disease States ◽  
Organ Systems ◽  
Patients With Diabetes

The increasing prevalence of diabetes mellitus in the general population has many implications for the ambulatory anesthesia provider. Complications, particularly associated with poor glycemic control, can affect multiple organ systems and jeopardize the safety of any planned anesthetic. It is essential that anesthesiologists and sedation providers have in-depth knowledge of the pathophysiology of diabetes mellitus and the comorbid conditions that commonly accompany it. Anesthesiologists and sedation providers must also understand certain surgical and anesthetic considerations when planning an effective and safe anesthetic for diabetic patients. This is a 2-part series concerning perioperative glycemic control for patients with diabetes mellitus. Part 1 will focus on the physiology of diabetes and its associated disease states. Part 2 will address the pharmacology associated with the wide variety of medications used to treat the disorder and the most recent guidelines for blood glucose management in ambulatory surgical patients.

Cancellation on the Day of Surgery in an Ambulatory Setting - A Retrospective Analysis

2021 ◽  
Author(s):  
João Manuel Teixeira Oliveira ◽  
Mariana Ginestal ◽  
Catarina Ferreira ◽  
Ana Povo ◽  
Eurico Castro Alves
Keyword(s):  
Inpatient Care ◽  
Ambulatory Surgery ◽  
Healthcare Management ◽  
Ambulatory Setting ◽  
Day Case ◽  
Chi Square ◽  
Day Case Surgery ◽  
Cancellation Rate ◽  
Case Surgery ◽  
Level Of Significance

Abstract Background: Cancellations on the day of surgery represent an important setback for patients and pose considerable drawbacks for healthcare management. Part of these cancellations are due to patients’ factors. Some studies have addressed this issue in inpatient care, but scarce information is found regarding ambulatory setting. This work intended to analyse the parameters that are important in patient cancellation on the day of surgery for ambulatory surgery, with a closer analysis on those that are patient dependent, specifying those that are significant in order to anticipate which patients will be cancelled beforehand.Methods: This work analysed a total of 19781 patients enrolled for elective day-case surgery in 2018, from which 1253 (6.33%) made a cancellation on their day of surgery. Results: Patients residing closer to the hospital (< 10 Km) had statistically more cancellations than those residing > 10 km away (p<0.05). Also, patients with 65 years of age or more had a higher cancellation rate (p<0.05). Finally, patients without a prior pre operative medical appointment might have a higher likelihood of same day cancellation (5.8% vs 14.01%, p<0.05). T-test and Chi-square tests were used with a level of significance of 0.05.Conclusions: We expect this work can contribute to anticipate the cancellation of a given patient, enabling quicker treatment with optimised resources.

Validating the primary provider theory in emergency medicine

2008 ◽  
Vol 21 (2) ◽  
pp. 120-130 ◽  
Author(s):  
Joseph S. Guarisco ◽  
Stefoni A. Bavin
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Pay For Performance ◽  
Medical Center ◽  
Waiting Times ◽  
Emergency Department Visits ◽  
Business Success ◽  
Content Type ◽  
The Impact

PurposeThe purpose of this paper is to provide a case study testing the Primary Provider Theory proposed by Aragon that states that: disproportionate to any other variables, patient satisfaction is distinctly and primarily linked to physician behaviors and secondarily to waiting times.Design/methodology/approachThe case study began by creating incentives motivating physicians to reflect and improve behaviors (patient interactions) and practice patterns (workflow efficiency). The Press Ganey Emergency Department Survey was then utilized to track the impact of the incentive programs and to ascertain any relationship between patient satisfaction with the provider and global patient satisfaction with emergency department visits by measuring patient satisfaction over an eight quarter period.FindingsThe findings were two‐fold: firstly, the concept of “pay for performance” as a tool for physician motivation was valid; and secondly, the impact on global patient satisfaction by increases in patient satisfaction with the primary provider was significant and highly correlated, as proposed by Aragon.Practical implicationsThese findings can encourage hospitals and physician groups to place a high value on the performance of primary providers of patient care, provide incentives for appropriate provider behaviors through “pay for performance” programs and promote physician understanding of the links between global patient satisfaction with physician behaviors and business growth, malpractice reduction, and other key measures of business success.Originality/valueThere are no other case studies prior to this project validating the Primary Provider Theory in an urban medical center; this project adds to the validity and credibility of the theory in this setting.

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