1. Do they know the dynamics of outpatient surgery?
Efficiency is paramount at outpatient centers, where the cases, the
recovery and the turnover times are short. The setting is often more
limited in terms of resources, especially when it comes to the number
of pre-op and PACU bays. A group might be able to get away with
having inpatients linger in the recovery room for hours at a hospital
— not that they should let it happen there, either — but they have to
know that it's unacceptable in an outpatient setting. The ability to
manage pain and prevent nausea are essential skills.
2. How will they help you improve efficiency?
The more effort your anesthesia team puts into optimizing patients
before surgery, the better your outcomes will be, both in the OR and
afterward. Whether they work with your staff or provide their own,
it's crucial that they identify any issues — a history of difficult intuba-
tion, coronary artery disease, untreated or poorly managed diabetes,
or obstructive sleep apnea, for example — before the scheduled day
of surgery to minimize surprises and cancellations. You want time to
address these concerns well beforehand. You may need to tell a
patient to bring in his CPAP machine. Or maybe you need to dig a lit-
tle deeper into the patient's cardiac history. Do you have the proper
lab work and pre-op testing (while containing expenses by not order-
ing unnecessary lab work or imaging)?
Your anesthesia team should work closely with pre-op nurses on
health history phone interviews. The information they gather should
be based on the type of procedure (low-, intermediate- or high-risk)
and the patient's comorbidities to determine whether additional test-
ing is needed.
M a y 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 5 3
