The AAAHC Institute for Quality Improvement has released a toolkit to prevent intraoperative and postoperative complications for obese patients who might be undergoing ambulatory surgery.
The toolkit, titled Ambulatory Surgery and Obesity in Adults: Preventing Complications, provides information that assists ambulatory providers in determining if surgery should be delayed or if a referral to a hospital is appropriate based on the patient’s body mass index (BMI) and health status prior to surgery.
“It is important for providers to know that while each patient must be evaluated individually, many obese patients can safely undergo surgery in an ambulatory setting,” said Naomi Kuznets, PhD, senior director and general manager for AAAHC Institute. “This new AAAHC Institute toolkit gives providers easily implementable guidelines for when it is advisable to move forward with ambulatory surgery and when a hospital may be a more appropriate setting.”
Literature on the subject shows obese patients are not significantly more likely to be hospitalized after ambulatory surgery than non-obese patients.1 However, obese patients having ambulatory surgery are at a higher risk for several intraoperative complications.
The sample flowchart included in the toolkit gives providers a tool to use based on a patient’s BMI, the level of sedation used in the procedure, and the status of any diseases or disorders the patient might have that co-occur with obesity and could complicate surgery.
Common comorbidities associated with obesity include arthritis and chronic back pain, certain types of cancer, cardiovascular disease, depression, diabetes, gallbladder disease, respiratory issues, and stress incontinence.
“This new tool is intended for quick reference when ambulatory surgery center staff have questions about preventing complications in obese patients,” said Kuznets. “It also can serve as a guide for surgery center clinical committees in developing their own internal guidelines for managing these patients.”
To download the AAAHC Institute toolkits, visit http://www.aaahc.org/en/institute/Resources. (See information about other toolkits from the AAAHC Institute in this SDS Accreditation Update supplement.)
- Joshi GP, Ahmad S, Riad W, et al. Selection of obese patients undergoing ambulatory surgery: A systematic review of the literature. Anesth Analg 2013; 117:1082-1091.