Executive Report  |   August 2013
Culture and Cost of Outpatient Care: Ambulatory Surgery and the Transformation of our Health System
Article Information
Ambulatory Anesthesia / Executive Report
Executive Report   |   August 2013
Culture and Cost of Outpatient Care: Ambulatory Surgery and the Transformation of our Health System
ASA Monitor 08 2013, Vol.77, 10-11.
ASA Monitor 08 2013, Vol.77, 10-11.
This issue of the NEWSLETTER has given me pause to reflect on experiences early in my career and the impact of the trend toward ambulatory care on the health system. I would argue that this trend is possibly one of the most significant over the last three or more decades in terms of its impact on health policy and the delivery of care.
In 1980, soon after earning my M.B.A., I started a position at Thomas Jefferson University Hospital in Philadelphia as manager of several departments, including what was then termed the “Short Procedure Unit.” At the time, this was considered a major innovation, a place in the hospital where surgery patients would be admitted and discharged on the same day. The SPU (or “spew,” as we called it) was placed in an old section of the hospital. Patients were prepared and recovered in semi-private rooms. There were two staff members dedicated to admission and administrative processing. The nursing staff rotated from among the surgery staff. There were no dedicated O.R.s or anesthesia staff.
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