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sia providers and surgeons to cancel cases. For example, would you perform a
hysterectomy on a 55-year-old woman with a BMI of 35 who's a treated hypertensive and lifelong smoker? Eighty-two percent of the audience said they
would. What about an 88-year-old woman who presents for hip replacement
with congestive heart failure and diabetes? Sixty-four percent of the audience
would cancel that case.
They're tough calls, especially for administrators caught in the tug-of-war
between focusing on patient safety and the bottom line. "Facilities make money
when they host cases," says Dr. Sinha. "Let's not pretend economic pressure
doesn't play a part in deciding which cases to bring into the OR."
He believes facility leaders need to discuss potential hazards with surgeons
and anesthesia providers, and clearly communicate those dangers to patients
and their families. "If everyone accepts the risks, you can proceed with the
case," says Dr. Sinha. "You accept the risks, and do the best to prevent them."
That's what do you do in the real world. You work to ensure people get the
care they need in the safest possible setting.
Everything that can be done in an outpatient setting, should be done in an outpatient setting, says Dr. Sinha. But who ultimately makes that decision?
Everyone involved in providing care.
"The focus should always be on the patient," says Dr. Sinha. "If we do what's
best for them, we can all sleep better."
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— D.C.
S U P P L E M E N T T O O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | D E C E M B E R 2013
