Outpatient Surgery Magazine

Heavy Duty - October 2016 - 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.

Issue link: http://outpatientsurgery.uberflip.com/i/736989

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Page 17 of 126

T he patient's dressed and ready for discharge, but there's no one in the waiting room to take him home. He wants to call a cab or Uber. Three-fourths (75%) of your colleagues that we polled would not let a patient go home alone in a taxi. What would you do? "Reschedule the case until a friend can accompany him in the taxi or drive him home and stay with him during the initial hours of recovery," says Emily Duncan, RN, BS, CASC, CNOR, the CEO of the Lakeland (Fla.) Surgical & Diagnostic Center. "Even if a loved one is waiting at home, someone still needs to accompany patients on the ride from the facility." Unless the patient wasn't sedated during surgery, Medicare-certified facilities can't let unaccompanied patients leave, says anesthesiologist Thomas Durick, MD, medical director of the Bay Surgery Center in Oakland, Calif. "The treating surgeon needs to write an order in the chart permitting the patient to be discharged without accompaniment, and note that sedation was not used in the case," says Dr. Durick. Patients who undergo surgery under any type of sedation at the Pennsylvania Eye & Ear Surgery Center in Wyomissing, Pa., must prove they have a responsible adult to provide transportation home. If they don't, their cases are cancelled, says Vanessa Tobias, RN, the clinical director. Another manager says her facility admits patients who don't have escorts to a local hospital for 23-hour observation. Patients who refuse to get a ride home with a responsible caregiver? "We have them sign an against medical advice (AMA) form, write up an incident report and notify their surgeon," says Amy Sinder, MS, administrator of the CBC Surgery Center in Crown Point, Ind. Like 18% of our poll respondents, some facilities are more lenient. Patients who meet discharge criteria at CGH Medical Center in Sterling, Ill., can leave in taxis, says Lisa Holmes RN, CNOR, BA, the 1 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 6 Do You Let Patients Go Home Alone in a Taxi? Ideas Work That

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