Neil Mendhiratta, Herman Hauver, Whitley Hatton, Andrew Ostrusky, Devika S Sathe, Sandeep Gurram, Patricia Rice, Heather Chalfin
Outcomes of a universal germline screening program in a community urology practice
Clinical genetics
united states ambulatory surgeries account 87 surgical procedures 1 estimated 192 million ambulatory surgeries performed 2018 httpswwwhcupusahrqgovreportsstatbriefssb287ambulatorysurgeryoverview2019pdf cataract procedures musculoskeletal surgeries common surgical interventions performed ambulatory centers however complex surgical interventions sleeve gastrectomies oncological spine surgeries even arthroplasties routinely performed day cases model ambulatory extended recovery 25 ambulatory surgery centers industry grown since 2017 11 per year reached market size 312 billion according ambulatory surgery center association potential save 576 billion medicare costs next decade httpswwwibisworldcomindustrystatisticsmarketsizeambulatorysurgerycentersunitedstates data suggest expected rise volume ambulatory day extended ambulatory 23 h surgeries coming years similar increases also observed countries example 75 elective surgeries performed sameday surgery united kingdom 6 reduce costs improve quality care complex procedures ambulatory surgery centers started implementing patientcentered highquality valuebased practices achieve goals enhanced recovery surgery eras protocols implemented reduce length stay decrease costs increase patients satisfaction transform clinical practices eras fundamentals ambulatory surgery based five pillars including 1 preoperative patient counseling education optimization 2 multimodal opioidsparing analgesia 3 nausea vomiting wound infection venous thromboembolism prophylaxis 4 maintenance euvolemia 5 encouragement early mobility pillars rely interdisciplinary teamwork led anesthesiologists surgeryspecific workgroups safety culture 2 research shows team ambulatory anesthesiologists crucial improving postoperative nausea vomiting ponv pain control 7 review summarize current evidence elements clinical importance implementing eras protocol ambulatory surgery