Abstract
Admission on the day of surgery for elective cardiac and non-cardiac surgery has been established as a prevalent, critical practice. This approach realizes medical, logistical, psychological and fiscal benefits, and its success is predicated on an effective outpatient pre-operative evaluation. The establishment of a highly functional pre-operative clinic with a comprehensive set-up and efficient logistical pathways is invaluable. This notion has been expanded in recent years to include the entire peri-operative period and the concept of a ‘peri-operative anesthesia/surgical home’ is gaining popularity and support. Evaluating patients prior to admission for surgery, anesthesiologists can place themselves at the forefront of reducing unnecessary pre-operative hospital admissions, excess lab tests, unneeded consultations, and ultimately decrease the cancellations on the day of surgery. Furthermore, by taking a leadership role in the pre-operative clinic, anesthesiologists place themselves squarely at the forefront of the burgeoning movement for the peri-operative surgical home and continue to cement the indispensability of the anesthesiologist during the entire peri-operative course. The authors present this review as a follow-up describing the successful implementation of a pre-operative same-day cardiac surgery clinic and offer these experiences over the last 8 years as a guide to helping other anesthesiologists do the same.
Similar content being viewed by others
References
Silvay G. Day admission for thoracic aortic aneurysm. Heart Lung Vessels. 2010;2:40–2.
Flynn BC, DePerio M, Hughes E, Silvay G. The need for specialized preanesthesia clinics for day admission cardiac and major vascular surgery patients. Sem CTVA. 2009;13:241–8.
Flynn BC, Silvay G. Value of specialized preanesthetic clinic for cardiac and major vascular surgery patients. Mt Sinai J Med. 2012;79:13–24.
Apfelbaum JL, Connis RT, Nickinovich DG, Pasternak IR, Arens JF, Caplan RA. Practice advisory for preanesthetic evaluation. An updated report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology. 2012;116:1–17.
Fleisher LA, Fleischmann K, Auerbach A, Barnason S, Beckman J, Bozkurt B, Davila-Roman V, Gerhard-Herman M, Holly T, Kane G, Marine J, Nelson M, Spancer C, Thompson A, Ting H, Uretskey B, Wijeysundera D. ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery. J Am Coll Cardiol. 2014;64:77–137.
Hepner DL, Bader AM, Hurwitz S, Gustafson M, Tsen LC. Patient satisfaction with preoperative assessment in the preoperative assessment testing clinic. Anesth Analg. 2004;98:1099–105.
Yasny JS, Herlich A. Perioperative dental evaluation. Mount Sinai J Med. 2012;79:34–45.
Wilson W, Taubert K, Gewitz M, Lockhart P, Baddour L, Levison M, Bolger A, Cabell C, Takahashi M, Baltimore R, Newburger J, Strom B, Tani L, Berber M, Bonow R, Pallasch T, Shulman S, Rowley A, Burns J, Ferrieri P, Gardner T, Goff D, Durack T. AHA guideline: prevention of infective endocarditis. Circulation. 2007;11:1736–54.
Gandhi N, Silvay G. How important is dental clearance for elective open heart operation? Ann Thor Surg. 2015;99:377.
Tait AR, Voepel-Lewis T, Munro HM. Cancellation of pediatric outpatient surgery: economic and emotional implications for patients and their families. J Clin Anaesth. 1997;9:213–9.
Ivarsson B, Kimblad PO, Sjöberg T. Patient reactions to cancelled or postponed heart operations. J Nurs Manag. 2002;10:75–81.
Strum DP, Vargas LG, May JH. Surgical subspecialty block utilization and capacity planning: a minimal cost analysis model. Anesthesiology. 1999;90:1176–85.
Squires A. Language barriers and qualitative nursing research: methodological considerations. Int Nurs Rev. 2008;55:265–73.
Bernard AC, Summers A, Thomas J, Ray M, Rockich A, Barnes S, et al. Novel Spanish translators for acute care nurses and physicians: usefulness and effect on practitioners’ stress. Am J Crit Care. 2005;14:545–50.
Denson AC, Mahipal A. Participation of the elderly population in clinical trials: barriers and solutions. Cancer Control. 2014;21:209–14.
Abenstein JP. Letter to the Editor. Anesthesiol News. 2015;41:1, 14.
Ferschl MB, Tung A, Sweitzer B, Huo D, Glick D. Preoperative clinic visits reduce operating room cancellation and delays. Anesthesiology. 2005;103:855–9.
Kain ZN, Vakharia S, Garson L, Engwall S, Schwarzkopf R, Gupta R, Cannesson M. The perioperative surgical home as a future perioperative practice model. Anesth Analg. 2014;118:1126–30.
Silvay G, Zafirova Z (2015) Improving the quality and safety as well as reducing the cost for patients undergoing cardiac surgery: missing some issues? Letter to the Editor. J Cardiothoracic Vasc Anesth (in press).
Kain ZN, Fitch JCK, Kirsch JR, Mets B, Pearl RG. Future of anesthesiology is perioperative medicine: a call for action. Anesthesiology. 2015;122(6):1192–5.
Sigmund AE, Stevens ER, Blitz DJ, Ladapo JA. Use of preoperative testing and physicians response to professional society guidance. JAMA. 2015;175:1352–9.
Kain ZN, Fitch JC, Kirsch JR, Mets B, Pearl RG. Future of anesthesiology is perioperative medicine: a call for action. Anesthesiology. 2015;122:1192–5.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflicts of interest to declare.
About this article
Cite this article
Silvay, G., Goldberg, A., Gutsche, J.T. et al. Same day admission for elective cardiac surgery: how to improve outcome with satisfaction and decrease expenses. J Anesth 30, 444–448 (2016). https://doi.org/10.1007/s00540-016-2139-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00540-016-2139-8