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Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011 1
©2009. Nova Medical Centers. Strictly private and confidential
Dr. M G Bhat MS, FRCS(England), FRCS ( Edinburgh), FICS, DMLE (Law), DMIRCSEd (Informatics)
Consultant Surgeon, Bangalore Medical Director, Nova Medical Centers Ltd, India
Greetings From…
Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011 2
This delivery system is growing in the Europe. And we in India are in the process of Developing and Popularizing the Ambulatory Surgery.
The Ambulatory Surgery (Day Surgery & Short Stay Surgery)
Ambulatory Surgery in USA, in the last two decades has become the most efficient form of Surgical Healthcare Delivery.
Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011 3
•Progress in Anesthesia •Improved Surgical Techniques •Fast Tracking Approach •Post Operative Management •Pain Management •Doctors Mindset •Patients Mindset
Reasons for the Popularity
Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011 4
From Patient’s Point
• Surgery is a major stressor for all Patients.
• Anxiety and fear are normal.
• Fear of the unknown is the most prevalent fear prior to surgery and is the fear that is the easiest for all the staff to help the patient to overcome.
Risks and Fears in Ambulatory Surgery
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Small Stand Alone Centers With State of the Art Facilities
•Efficient •Attractive •Cost Effective
• Financial and organizational Benefits • Multispecialty Procedures performed On fit patients (Minor to Supramajor) • Discharged in a Short Period
Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011 6
The only way Ambulatory Surgery will become Popular and Accepted is if the Healthcare delivery is safe and effective
Safety is the key for Success
Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2 Sept 2011 7
803
560
432 378
138 110 42 4
Total Surgeries 2009-11 (2470)
Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011 8
Experience From One Center
Untoward Events
• Complications • Transfer to Hospital • Readmission
Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2 Sept 2011 9
Patients Requiring Transfer 5 Transfers and One Treatment/2470
• Post Lap Chole – Chest Problems • Post Adenoidectomy- Bleeding Managed in
center with Blood Transfusion
• Post Septoplasty- Bleed – • Post Adenoidectomy- Breathing Problem- • Post TURP- Urinary Retention
• Intestinal Tear during surgery- shifted for Hospitalization
Compared to 1-2% in USA
Risks and Fears in Ambulatory Surgery
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Factors for Safety
• Analyze the Risks and Fears & Solve them • Qualified and Skilled Doctors & Staff • Comply with All Regulatory Rules • Ensure Quality of Service ( Accreditation) • Comply with All Legal Requirements • Incident Reporting & Corrective Measures
Risks and Fears in Ambulatory Surgery
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• Availability of Continuous Care • Good Selection of Patient • Patient well informed • Good Post Op Care • Home Support • Shift Patient if required
Provide Good Care
Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011 12
Thank you
