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plex. Everyone's interested in patient safety, but could there be an
underlying internal tug-of-war between volume-driven surgeons and
anesthetists who make the ultimate call on which patients can be oper-
ated on in an outpatient setting?
"There can be," admits Ms. Vahle, but she says her providers strike the
right balance between patient safety and scheduling pressures, and work
closely with surgeons to ensure the right patients enter the ORs. Her
nurses flag potential concerns — high body-mass index, untreated sleep
apnea, unresolved lung issues — and ask the anesthesiologists to review
the charts to see if the patients are suitable for outpatient surgery.
Oftentimes, they'll come to the center to assess high-acuity patients in
person, which some providers aren't always willing to do.
Kari Stewart, CASC, administrator of the Pasadena (Calif.) Plastic
Surgery Center, says her providers help avoid case cancellations by
screening patients for troublesome comorbidities. "When necessary, they
can be counted on to make a good judgment call regarding case selec-
tion," she says.
Ms. Stewart values the flexibility and communication skills of her
A N E S T H E S I A
Work with surgeons to
bring challenging cases to
the outpatient arena.
Strongly agree 51%
Agree 30%
Disagree 16%
Strongly disagree 2%
Always comply with your facility's
policies and procedures.
Strongly agree 31%
Agree 46%
Disagree 22%
Strongly disagree 1%
Follow proper infection
prevention practices.
Strongly agree 37%
Agree 43%
Disagree 17%
Strongly disagree 3%
