Recent findings have suggested that surgeons may pressure anesthesiologists into performing inappropriate procedures or accepting ill-suited patients at ambulatory surgery centers. This practice may greatly increase the risk of mortality for patients and could reduce the quality of medical services. It is important that anesthesiologists hold their ground and properly assess patients in order to prevent undue injuries or fatalities. Ignoring patient risk factors when recommending or proceeding with surgical procedures is a common cause of medical malpractice; many cases that could have been prevented had patients been properly selected for procedures.

Valuable Data May Allow Anesthesiologists to Turn Away High-Risk Patients

Studies have revealed links between increased risk of mortality and hospital readmission with factors such as age, medical history and medical conditions. Those with certain health concerns or who were older displayed a greater chance of experiencing postoperative complications or being readmitted to the hospital than younger patients with fewer health complications. Certain health complications were more likely to increase risk than others.

Other factors that influence risk include the type of surgical procedure, the type of anesthetic medications used, the surgical facility and the availability of caregivers. It was determined when reviewing these factors that some patients were more suited to procedures at ambulatory surgery centers while others needed care in a hospital outpatient department or office based environment.

Aftercare Considerations are Being Neglected

One of the most overlooked and critical considerations that is impacting readmission rates is the access patients have to caregivers after their surgical procedures. Ambulatory surgery centers focus on procedures that allow patients to return home quickly without a hospital stay, but there are questions being raised regarding who will ensure the patient’s recovery is going according to plan. If the patient does not have access to a family member or caregiver at home, it is possible for complications to arise which can result in a hospital stay.

The current system in place for evaluating risk is highly subjective and two doctors can have conflicting opinions over whether the same patient is fit for an ambulatory procedure. Older patients are normally considered to be higher risk, but new data is revealing that age is not the only factor to consider. Ambulatory procedures may be appropriate for older patients who need to avoid major disruptions to their sleep schedule and daily routine while being inappropriate for younger patients who may not have access to family members to supervise them throughout their recoveries.

Patients with heart problems or heart failure are at greater risk of being readmitted to the hospital and diseases such as diabetes, cerebrovascular disease and kidney disease all elevate risk levels. More careful assessment is required for these patients and anesthesiologists are often pressured by surgeons to accept patients at ambulatory surgery centers that may not be qualified upon more thorough evaluation.

Patients with Stents Require Careful Assessment

There have been considerable changes in recent history to the materials and medications used in stenting, and these changes have a marked impact on the risks patients face when undergoing surgical procedures. Any patient requiring general anesthesia who has received a stent needs to be vetted before an anesthesiologist consents to an ambulatory procedure. Depending on the type of stent and when it was inserted, the patient may be at a much greater risk of complication than those without stents. Older DES stents are associated with much greater risk, for example, than the newer DES stents and bare-metal stents.

Taking the time to review the type of stent involved along with other risk factors can prevent serious injuries.

We Need to Assess Patients Earlier and More Thoroughly

The failure to commit the appropriate time and resources to patient selection is the cause of many injuries and readmissions to the hospital. It has also contributed to preventable deaths. While surgeons are often expeditious to recommend procedures, it is up to anesthesiologists to push back when an ambulatory procedure is ill-advised due to age, health considerations or concerns over supervision during recovery. Failing to consider these factors can be constituted as negligent when it results in an injury or fatality.