Anesthesiology clinics
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Anesthesiology clinics · Jun 2014
ReviewInitial results from the National Anesthesia Clinical Outcomes Registry and overview of office-based anesthesia.
Safe office-based anesthesia practices dictate proper patient and procedure selection, appropriate provider qualifications, adequately equipped facilities, and effective administrative infrastructure. Analysis of patient outcomes can help reduce mortality and morbidity by identifying high-risk patients and procedures. ⋯ Increased regulation and standardization of care, such as the use of checklists and professional guidelines, can advance safe practices. There is increasing emphasis on continuous quality improvement, electronic health records, and outcomes data reporting.
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In this article, recent literature related to airway management in the ambulatory surgery setting is reviewed. Practical pointers to improve clinical success and avoid complications of newer airway management techniques are provided.
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Anesthesiology clinics · Jun 2014
ReviewPerioperative consideration of obstructive sleep apnea in ambulatory surgery.
The prevalence of obstructive sleep apnea (OSA) is increasing and a significant number of patients with OSA are undiagnosed. The suitability of ambulatory surgery in patients with OSA remains controversial, and the evidence regarding the safety of ambulatory surgery for patients with OSA is limited. Preoperative screening and careful selection of patients for ambulatory surgery is the most important step. Patients diagnosed and suspected of having OSA should be managed with a systematic algorithm to improve outcomes.
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This article provides a review of key concepts in quality management (QM) for ambulatory anesthesia. The importance of collecting data from every case is emphasized, and important outcome measures are recommended. The use of specific data collection tools and methodologies is discussed, including the national registry projects of the Society for Ambulatory Anesthesia and the Anesthesia Quality Institute. A brief overview is provided of how to use QM data to improve patient outcomes within an anesthesia practice.
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This article informs anesthesiologists of some of the legal issues they may encounter in connection with ambulatory surgical center-based or office-based practice. The primary legal issues that anesthesiologists face in connection with practice in such settings can be broken down into practice-related issues and ownership-related issues. Given the complexity of legal issues relating to ambulatory anesthesia, anesthesiologists are advised to consult counsel at an early stage so as to understand the issues that may apply to their practices.