The Importance of Patient Selection for Office-Based Procedures

The Importance of Patient Selection for Office-Based Procedures
September 18 10:44 2017 Print This Article

The relocation of surgical procedures from the hospital to office-based environments has resulted in a range of benefits for both medical practitioners and patients. These include an overall reduction in expenses for patients, better reimbursements for providers, more efficient patient care and higher patient satisfaction. The significant advancements in the surgical and anesthesia fields has led to more procedures being performed in the office-based, outpatient setting, and more procedures are expected to follow as the costs of health care rises. As this occur, it is important that patient safety remain the primary focus when executing anesthesia management solutions. This means that for every patient, the question should be asked whether he or she qualifies as an outpatient.

 Proper Patient Selection is Patient Safety

There are many factors that can affect the outcome of an office-based surgery. However, the success of these surgeries is directly associated with the appropriate preoperative screening of patients, including the comprehensive and accurate assessment of the condition of their health and any associated medical conditions.

 

In this context, patient selection refers solely to the fact that not all patients are ideal candidates for office-based surgery and anesthesia. This is particularly relevant as the procedures that are being performed in office settings have not only increased in number, but also in the degree of invasiveness.    

Consequences of Improper Vetting of Patients

The failure to properly select patients for an office-based surgery directly and negatively affects the perioperative results in a variety of ways and can result in:

  • Postponed discharges
  • Unexpected hospital admissions
  • A rise in complications after discharge
  • Readmissions for postoperative complications
  • Dissatisfaction in the patient and the patient’s family

Patient Selection Requirements

The American Society of Anesthesiologists provides strict guidelines for that surgeons should use when considering a patients for an office-based surgery. Anesthesia-specific concerns typically include:

  • Allergies to certain medications
  • History of sleep apnea, poor sleep or chronic and heavy snoring
  • Medical and surgical history, including a history of experiencing adverse events during the administration of anesthesia or sedatives

Other characteristics patients may exhibit that can indicate that their safety during a surgical procedure may best be served in settings other than an office environment can include:

  • A verified low tolerance for pain
  • Morbid obesity
  • Presence of respiratory diseases
  • A history of substance abuse

When implementing anesthesia management solutions, the highest priority should always be the safety of the patient. For practitioners who provide office-based surgical procedures, this requires that patients are assessed on both an administrative and clinical basis. To ensure that they have the best chances of a favorable outcome, patients who do not meet the criteria may have to be treated in a hospital setting.

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David Schantz
David Schantz

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