Patient Screening and Assessment in Ambulatory Surgical Facilities
Reports submitted to the Pennsylvania Patient Safety Authority from June 2004 to December 2008 show that patients who are not screened and assessed properly prior to surgery in an ambulatory surgical facility are at an increased risk of complications often requiring hospitalization. Of the 467 reports identified, 203 (43%) resulted in harm to a patient, most often involving a complication that required transfer to a hospital. Half of the total reports involved older patients (age 65 and over) and 5 percent (23 reports) involved a child. In 85 reports (18%) the patient had an undisclosed medical condition, such as sleep apnea, that may have put the patient at increased risk during the procedure.
Be Aware of Certain Medical Conditions
The most frequently missed medical conditions include heart and respiratory conditions such as obstructive sleep apnea (OSA). OSA is undiagnosed in an estimated 80 percent of affected patients with cases expected to rise five to 10 times in the next decade. For more sleep apnea consumer tips go to the Authority’s website.
Other medical conditions that may place a patient at increased risk of complications when undergoing a procedure in an ambulatory surgical facility include:
- Cardiovascular disease
- End-stage renal disease
- Peripheral vascular disease
- Positive HIV status
- The requirement to have to go under certain types of anesthesia
- OR procedures lasting greater than an hour
- Malignancies (Cancer)
If you have, or think you may have, any of these medical conditions be sure to let your healthcare provider know before undergoing any surgery.
What Else You Should Know Prior to Surgery in an Ambulatory Surgical Facility:
- Make sure you provide your primary care physician and/or your surgeon with as much information on your medical history and current medical condition that you can.
- Make sure you provide your primary care physician and/or your surgeon with an up-to-date list of medications you are currently taking, including any over-the-counter medication or herbal supplements.
- If you have a primary care physician, make sure he or she provides as much detailed information about your medical history as possible to the surgeon performing your planned procedure. The staff where your surgery is being performed should also know your detailed medical history.
- The ASF should receive your medical information from your primary care and/or surgeon about your medical history and your planned surgical procedure. Make sure that the ASF has received your medical information prior to surgery.
- You can expect a nurse from the ASF where your surgery is scheduled to call you and conduct a screening before your procedure. You may also be asked to come to the ASF for a face to face screening before your surgery. The nurse will ask you questions about your personal and family medical history as well as your current medical condition. Make sure you provide as much up-to-date information as possible.
- When you arrive on the day of your surgery, a nurse at the ASF will review and verify the information received from you and your primary care physician and/or surgeon about your medical history and medications.
For more information on patient screenings and assessments in ASFs, go to the 2009 March Pennsylvania Patient Safety Advisory article “Patient Screening and Assessment in Ambulatory Surgical Facilities” at www.patientsafety.pa.gov or click here.