Features  |   May 2015
Examining Trends and Outcomes in Ambulatory Surgery: Looking Into the Future
Author Affiliations
  • Samir R. Jani, M.D., M.P.H.
    Committee on Patient Safety and Education
  • Richard D. Urman, M.D., M.B.A.
    Committee on Surgical and Procedural Anesthesia
  • Fred E. Shapiro, D.O.
    Committee on Patient Safety and Education
Article Information
Ambulatory Anesthesia / Features
Features   |   May 2015
Examining Trends and Outcomes in Ambulatory Surgery: Looking Into the Future
ASA Monitor 05 2015, Vol.79, 18-20.
ASA Monitor 05 2015, Vol.79, 18-20.
Given recent events that have received significant media coverage, there is increased scrutiny and concern over safety and quality in ambulatory anesthesia. As more and more surgeries occur in outpatient settings, regulatory bodies are not the only ones asking questions. Many of our patients share these apprehensions, and our profession has a duty to help allay these fears.
In an effort to further our knowledge and insight regarding the current practice of anesthesiology in the United States, large-scale data regarding patients, procedures, and outcomes is now being collected and analyzed. Currently, there are two national registries gathering data, serving unique roles by providing a snapshot of the current state of ambulatory anesthesia. The first is the Anesthesia Quality Institute (AQI) National Anesthesia Clinical Outcomes Registry (NACOR). Since 2010, NACOR has been amassing case data regarding all aspects of anesthesia care, a subset of which is ambulatory data. NACOR is the largest anesthesia database in the country. It currently stores data on more than 20 percent of all anesthetics administered in the U.S. annually.1  This information is automatically harvested from a combination of clinical programs, including billing records and anesthesia information management systems. The electronic mining system is exceptional at collecting basic case information (patient’s age, patient’s ASA Physical Status, procedural codes, etc.), but outcomes collection is complicated by several issues. First, there is no mandatory reporting. Second, participating institutions may not track all adverse outcomes. Additionally, each institution/practice has a variable definition and follow-up period for detecting these outcomes.
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