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Ambulatory surgical centers

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https://www.readbyqxmd.com/read/28210917/adjuvant-agents-in-regional-anesthesia-in-the-ambulatory-setting
#1
REVIEW
Veerandra Koyyalamudi, Sudipta Sen, Shilpadevi Patil, Justin B Creel, Elyse M Cornett, Charles J Fox, Alan D Kaye
PURPOSE OF REVIEW: A majority of surgical practice has involved ambulatory centers with the number of outpatient operations in the USA doubling to 26.8 million per year. Local anesthesia delivery provides numerous benefits, including increased satisfaction, earlier discharge, and reduction in unplanned hospital admission. Further, with the epidemic of opioid mediated overdoses, local anesthesia can be a key tool in providing an opportunity to reduce the need for other analgesics postoperatively...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28210648/utilization-of-platelet-rich-plasma-for-musculoskeletal-injuries-an-analysis-of-current-treatment-trends-in-the-united-states
#2
Joanne Y Zhang, Peter D Fabricant, Chad R Ishmael, Jeffrey C Wang, Frank A Petrigliano, Kristofer J Jones
BACKGROUND: Platelet-rich plasma (PRP) has emerged as a popular biologic treatment for musculoskeletal injuries and conditions. Despite numerous investigations on the efficacy of PRP therapy, current utilization of this treatment within the United States is not widely known. PURPOSE: To investigate the national utilization of PRP, including the incidence and conditions for which it is used in the clinical setting, and to determine the current charges associated with this treatment...
December 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28169943/bedside-glucose-monitoring-is-it-safe-a-new-regulatory-compliant-risk-assessment-evaluation-protocol-in-critically-ill-patient-care-settings
#3
Jeffrey Anton DuBois, Robbert Jan Slingerland, Marion Fokkert, Alain Roman, Nam Khoa Tran, William Clarke, David Alan Sartori, Tina Louise Palmieri, Andrei Malic, Martha Elizabeth Lyon, Andrew William Lyon
OBJECTIVES: New data have emerged from ambulatory and acute care settings about adverse patient events, including death, attributable to erroneous blood glucose meter measurements and leading to questions over their use in critically ill patients. The U.S. Food and Drug Administration published new, more stringent guidelines for glucose meter manufacturers to evaluate the performance of blood glucose meters in critically ill patient settings. The primary objective of this international, multicenter, multidisciplinary clinical study was to develop and apply a rigorous clinical accuracy assessment algorithm, using four distinct statistical tools, to evaluate the clinical accuracy of a blood glucose monitoring system in critically ill patients...
February 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28157426/comparison-of-healthcare-costs-among-commercially-insured-women-in-the-united-states-who-underwent-hysteroscopic-sterilization-versus-laparoscopic-bilateral-tubal-ligation-sterilization
#4
Patricia I Carney, Jianying Yao, Jay Lin, Amy Law
BACKGROUND: This study evaluated healthcare costs of index procedures and during a 6-month follow-up of women who had hysteroscopic sterilization (HS) versus laparoscopic bilateral tubal ligation (LBTL). MATERIALS AND METHODS: Women (18-49 years) with claims for HS and LBTL procedures were identified from the MarketScan commercial claims database (January 1, 2010, to December 31, 2012) and placed into separate cohorts. Demographics, characteristics, index procedure costs, and 6-month total healthcare costs and sterilization procedure-related costs were compared...
February 3, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28149220/factors-affecting-hand-surgeon-operating-room-turnover-time
#5
Michael B Gottschalk, Richard M Hinds, Raghuveer C Muppavarapu, Kenneth Brock, Anthony Sapienza, Nader Paksima, John T Capo, S Steven Yang
Background: The purpose of this study was to determine the factors that affect hand surgeon operating room (OR) turnover time. We hypothesized that surgeon presence in the OR, decreased American Society of Anesthesiologists (ASA) class, smaller case type, and earlier case time, as well as other factors, decreased OR turnover time. Methods: A total of 685 hand surgery cases performed by 5 attending hand surgeons between September 2013 and December 2014 were identified. Turnover time, patient comorbidities (ASA class), surgeon, prior OR surgical procedure, current OR surgical procedure, location of the surgery (ambulatory surgical center [ASC] vs orthopedic specialty hospital [OSH]), time of surgery, and order of OR cases were recorded...
December 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28141817/comparing-the-quality-of-ambulatory-surgical-care-for-skin-cancer-in-a-veterans-affairs-clinic-and-a-fee-for-service-practice-using-clinical-and-patient-reported-measures
#6
Matthew P Dizon, Eleni Linos, Sarah T Arron, Nancy K Hills, Mary-Margaret Chren
The Institute of Medicine has identified serious deficiencies in the measurement of cancer care quality, including the effects on quality of life and patient experience. Moreover, comparisons of quality in Veterans Affairs Medical Centers (VA) and other sites are timely now that many Veterans can choose where to seek care. To compare quality of ambulatory surgical care for keratinocyte carcinoma (KC) between a VA and fee-for-service (FFS) practice, we used unique clinical and patient-reported data from a comparative effectiveness study...
2017: PloS One
https://www.readbyqxmd.com/read/28129297/toxic-anterior-segment-syndrome-inadvertent-administration-of-intracameral-lidocaine-1-and-phenylephrine-2-5-preserved-with-10-benzalkonium-chloride-during-cataract-surgery
#7
Brett P Bielory, Ayesha Shariff, Rehan M Hussain, Jose Antonio Bermudez-Magner, Sander R Dubovy, Kendall E Donaldson
PURPOSE: To report 3 patients with corneal decompensation and anterior uveitis within 24 hours of cataract surgery from a single ambulatory surgery center using intracameral lidocaine HCl 1% and phenylephrine 2.5% inadvertently preserved with 10% benzalkonium chloride. METHODS: This case series describes 3 patients who underwent traditional cataract extraction with a significant decrease in visual acuity in the immediate postoperative period resulting in secondary surgical intervention for corneal decompensation in 2 patients...
January 26, 2017: Cornea
https://www.readbyqxmd.com/read/28057478/developments-in-ambulatory-surgery-in-orthopedics-in-france-in-2016
#8
REVIEW
C Hulet, G Rochcongar, C Court
Under the new categorization introduced by the Health Authorities, ambulatory surgery (AS) in France now accounts for 50% of procedures, taking all surgical specialties together. The replacement of full hospital admission by AS is now well established and recognized. Health-care centers have learned, in coordination with the medico-surgical and paramedical teams, how to set up AS units and the corresponding clinical pathways. There is no single model handed down from above. The authorities have encouraged these developments, partly by regulations but also by means of financial incentives...
November 15, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28041805/basilic-elevation-transposition-may-improve-the-clinical-outcomes-for-superficialization-of-basilic-arteriovenous-fistula-veins
#9
Shouwen Wang, Michele S Wang, William C Jennings
OBJECTIVE: Basilic vein arteriovenous fistulas are an important and common option for hemodialysis access and require superficialization before use. Various superficialization techniques have been employed, such as basilic tunnel transposition (BTT), basilic elevation, and basilic elevation transposition (BET). Each technique may have advantages and disadvantages, and there have been few reports directly comparing the outcomes of these techniques. This report compares the clinical outcomes of BET vs BTT performed by a single operator and discusses some technical considerations derived from this study and the literature...
December 29, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28026838/predictors-of-unanticipated-admission-within-30-days-of-outpatient-sinonasal-surgery
#10
I Gengler, L Carpentier, X Pasquesoone, D Chevalier, G Mortuaire
OBJECTIVES: To identify predictive factors of readmission after day-case rhinologic surgery. METHODS: A 2-year retrospective chart review of patients scheduled for ambulatory sinonasal surgery in a tertiary medical center was conducted. The operating room and the anesthetic files were screened to identify demographic data, types of procedure, comorbidities and post-operative complications. RESULTS: From January 2014 to January 2016, 924 outpatient sinonasal procedures were identified...
December 27, 2016: Rhinology
https://www.readbyqxmd.com/read/28012519/surgical-scheduling-categorization-system-sscs-a-novel-classification-system-to-improve-coordination-and-scheduling-of-operative-cases-in-a-tertiary-pediatric-medical-system
#11
Eric A Gantwerker, Cassandra Bannos, Michael J Cunningham, Reza Rahbar
OBJECTIVE: To describe a surgical categorization system to create a universal nomenclature, delineating patient complexity as a first step toward developing a true risk stratification system. METHODS: Retrospective database review of all otolaryngology surgical procedures performed in a tertiary pediatric hospital system over one academic year (July 2012-June 2013). All otolaryngology surgical procedures were reviewed, encompassing 8478 procedures on 5711 patients...
January 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28005705/denervation-of-the-distal-renal-arterial-branches-vs-conventional-main-renal-artery-treatment-a-randomized-controlled-trial-for-treatment-of-resistant-hypertension
#12
Stanislav E Pekarskiy, Andrei E Baev, Victor F Mordovin, Galina V Semke, Tatyana M Ripp, Alla U Falkovskaya, Valeria A Lichikaki, Ekaterina S Sitkova, Irina V Zubanova, Sergei V Popov
BACKGROUND: Effective treatment of uncontrolled hypertension using catheter-based percutaneous renal denervation may depend strongly on the anatomic strategy applied when delivering therapy. We hypothesized that concentering renal denervation treatment in the distal region of the artery would improve clinical response. METHODS AND RESULTS: We conducted a single-center, double-blind, randomized, controlled, and parallel group study (ClinicalTrials.gov NCT02667912)...
February 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28002212/ambulatory-surgical-centers-a-review-of-complications-and-adverse-events
#13
Charles A Goldfarb, Anchal Bansal, Robert H Brophy
An increasing number of orthopaedic surgeries are performed at ambulatory surgical centers (ASCs), as is exemplified by the 272% population-adjusted increase in outpatient rotator cuff repairs from 1996 to 2006. Outpatient surgery is convenient for patients and cost effective for the healthcare system. The rate of complications and adverse events following orthopaedic surgeries at ASCs ranges from 0.05% to 20%. The most common complications are pain and nausea, followed by infection, impaired healing, and bleeding; these are affected by surgical and patient risk factors...
January 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27965523/a-prospective-multicenter-registry-of-patients-undergoing-hysteroscopic-morcellation-of-uterine-polyps-and-myomas
#14
Michael D Scheiber, Serena H Chen
Background: Hysteroscopic morcellation removes uterine pathology under direct visualization with continuous real-time tissue fragment removal. Objective: The aim of this study was to explore the feasibility of hysteroscopic morcellation across a diverse set of facilities, including both surgical and office-based settings. Design: This was a prospective, single-arm, multicenter registry development (Canadian Task Force classification II-3). Materials and Methods: Thirty-four U.S. obstetrics and gynecology facilities enrolled subjects into the registry...
December 1, 2016: Journal of Gynecologic Surgery
https://www.readbyqxmd.com/read/27936028/cost-effectiveness-of-screening-colonoscopy-depends-on-adequate-bowel-preparation-rates-a-modeling-study
#15
James Kingsley, Siddharth Karanth, Frances Lee Revere, Deepak Agrawal
BACKGROUND: Inadequate bowel preparation during screening colonoscopy necessitates repeating colonoscopy. Studies suggest inadequate bowel preparation rates of 20-60%. This increases the cost of colonoscopy for our society. AIM: The aim of this study is to determine the impact of inadequate bowel preparation rate on the cost effectiveness of colonoscopy compared to other screening strategies for colorectal cancer (CRC). METHODS: A microsimulation model of CRC screening strategies for the general population at average risk for CRC...
2016: PloS One
https://www.readbyqxmd.com/read/27906530/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment-systems-and-quality-reporting-programs-organ-procurement-organization-reporting-and-communication-transplant-outcome-measures-and-documentation-requirements-electronic
#16
(no author information available yet)
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2017 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system...
November 14, 2016: Federal Register
https://www.readbyqxmd.com/read/27890310/same-day-total-hip-arthroplasty-performed-at-an-ambulatory-surgical-center-90-day-complication-rate-on-549-patients
#17
Gregg R Klein, Jason M Posner, Harlan B Levine, Mark A Hartzband
BACKGROUND: There is an increasing interest in outpatient total hip arthroplasty (THA), as there are perceived benefits to the patient, insurer, and overall healthcare system. However, the safety of outpatient total joint arthroplasty has not been studied. METHODS: Five hundred forty-nine patients who underwent mini-posterior THA at a freestanding independent ambulatory surgical center (ASC) were reviewed. All patients were discharged to home on the day of surgery...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27890061/preoperative-screening-for-sleep-disordered-breathing-in-children-a-systematic-literature-review
#18
Erin E Bauer, Rebecca Lee, Yasmine N Campbell
Clinicians frequently underestimate or do not assess sleep-disordered breathing (SDB) in children in ambulatory surgical centers. Identifying the disorder and obtaining information relevant to anesthesia management can be assisted by the use of a standard questionnaire during preoperative assessment. We wanted to determine whether a preoperative screening tool increases clinician awareness of SDB in children and leads to a decrease in perioperative respiratory adverse events. We reviewed 21 articles to identify reliable screening tools for pediatric SDB in ambulatory surgical centers and selected six articles for the review...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27871578/children-with-heart-disease-risk-stratification-for-non-cardiac-surgery
#19
Angela K Saettele, Jacob L Christensen, Kelly L Chilson, David J Murray
STUDY OBJECTIVE: Children with congenital or acquired heart disease have an increased risk of anesthesia related morbidity and mortality. The child's anesthetic risk is related to the severity of their underlying cardiac disease, associated comorbidities, and surgical procedure. The goal of this project was to determine the ease of use of a preoperative risk stratification tool for assigning pediatric cardiac staff and to determine the relative frequency that children with low, moderate, and high risk cardiac disease present for non-cardiac surgery at a tertiary pediatric hospital...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871557/effect-of-adjunctive-dexmedetomidine-on-postoperative-intravenous-opioid-administration-in-patients-undergoing-thyroidectomy-in-an-ambulatory-setting
#20
Kristin Long, Joseph Ruiz, Spencer Kee, Alicia Kowalski, Farzin Goravanchi, Jeff Cerny, Katy French, Mike Hernandez, Nancy Perrier, Elizabeth Rebello
STUDY OBJECTIVE: Two of the most feared complications for patients undergoing thyroid surgery are pain and postoperative nausea and vomiting. Thyroidectomy is considered high risk for postoperative nausea and vomiting, and recent studies have looked at adjuncts to treat pain, limit narcotic use, "fast-track" the surgical process, and enhance recovery without compromising the patient's safety. One such perioperative medication of interest is dexmedetomidine (Dex), a centrally acting α-2 agonist that has been associated with reducing pain and postoperative opioid consumption...
December 2016: Journal of Clinical Anesthesia
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