Discharge instructions, level of pain improve
Discharge instructions, level of pain improve
Knee arthroscopy study yield benchmarks
In the fifth annual Knee Arthroscopy with Meniscectomy study performed by the Wilmette, IL-based Accreditation Association for Ambulatory Health Care’s (AAAHC) Institute for Quality Improvement (IQI), all organizations indicated they had standing procedures to prevent wrong-site surgery, and in 60% of the cases, the physician and patient initialed the surgery site.
This initialing conforms to the policy of the American Academy of Orthopedic Surgeons (AAOS) that calls for surgeons to initial the site, as well as the patient. "This response is up from 43% in 2003," says Naomi Kuznets, PhD, director of IQI.
Organizations that don’t have a physician initialing the site are having a nurse do so, she adds.
Another indication that same-day surgery programs are focusing on patient safety issues is that 82% of the organizations indicated that they had an advanced cardiac life support (ACLS)-certified person monitoring the patient during anesthesia.
While this represents a drop from the 95% response to a similar question in the 2003 study, there was a slight difference in the way the question was asked and could be interpreted, says Kuznets.
"Participants may have an ACLS-certified staff member in the recovery area, but that person was not specifically designated as a monitor for the patient in the study," she says.
More than 98% of patients indicated that their discharge instructions were clear, up from the 48% of patients who had indicated their discharge instructions were clear in 2002 — a marked improvement that also reduced post-procedure calls to their physicians.
The IQI collected real-time data from June through September 2004 from 43 ambulatory surgery organizations representing approximately 20,200 knee arthroscopies performed annually.
The IQI study also found that the number of knee arthroscopies performed annually at participating organizations ranged from 45 to 2,200.
Yet the data suggested there was no meaningful association between case volume and actual procedure time. The median procedure time overall was 27.5 minutes with an average time of 28.4 minutes.
The median, and average, overall pre-procedure ("waiting") time was 77.2 minutes. "Waiting time is defined as the time at which the patient arrives in the facility to the time the patient enters the operating or procedure room," Kuznets explains.
Pre-op education visits save time
The study found that organizations that had reduced their pre-procedure times attributed the performance to giving patients an in-depth education of the procedure during a preoperative visit and providing patients with pre-procedure packets that could be completed prior to the operating day.
The median setup time for the operating room was 18.61 minutes. Organizations with reduced setup times attributed their performance to having the recovery area and operating room in close proximity and scheduling like cases together.
The median discharge time overall was 82.84 minutes; the average was 87.64 minutes.
Discharge times were associated with anesthesia options, with an average discharge time of 120 minutes for patients receiving epidural/ spinal anesthesia and 59 minutes for patients who received local anesthesia and intravenous sedation.
To obtain a copy of the 2004 Knee Arthroscopy with Meniscectomy study or for information on other AAAHC Institute studies, visit the AAAHC Institute web site at www.aaahc.org, then choose "Institute for Quality Improvement" in the top navigational bar. Or contact the AAAHC Institute at (847) 853-6078.
The cost of the study is $85 plus $12 for shipping and handling.
In the fifth annual Knee Arthroscopy with Meniscectomy study performed by the Wilmette, IL-based Accreditation Association for Ambulatory Health Cares (AAAHC) Institute for Quality Improvement (IQI), all organizations indicated they had standing procedures to prevent wrong-site surgery, and in 60% of the cases, the physician and patient initialed the surgery site.Subscribe Now for Access
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