Outpatient Surgery Magazine

Special Edition: Anesthesia - July 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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the end. Golden opportunity Let's consider this unique moment in time. The importance and power of ERAS is greater than ever — especially in outpatient envi- ronments. The long-running shift of surgeries of increasing complex- ity from inpatient to outpatient ORs undoubtedly will accelerate, thanks in no small part to the perception among many patients and perioperative professionals that an outpatient environment is safer from a COVID-19 perspective. Perhaps you view enhanced recovery and the surgical home as more appropriate for inpatient cases, but it's just as appropriate in outpatient settings. I was first in the U.S. to start an inpatient PSH model, which is a similar model to ERAS just, in my view, a bit more comprehensive. We started with orthopedic inpatients, then moved into outpatient facilities, where we added patients undergo- ing cholecystectomies to those undergoing ortho procedures. We showed that enhanced recovery methodologies significantly reduced the time patients spent in ambulatory facilities — by hours, for the cholecystectomy patients — improved patient experience scores, and lowered both pain scores and incidences of PONV (osmag.net/kVA5Hp). However, the ultimate goals of ERAS are different for your outpa- tient facilities than they are for an inpatient hospital stay. In the out- patient environment, you need to focus on improving: • time to discharge (length of stay still applies, but here it's about how long the patient stays in PACU); • patient experience scores (highly important in the outpatient envi- ronment); and • 30-day revisits to the ER for reasons like pain and PONV. 4 4 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • J U L Y 2 0 2 0

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