Management of outcomes in the ambulatory surgery center: the role of standard work and evidence-based medicine.
OBJECTIVE
Quality and safety in the manufacturing and airline industries have benefited from evidenced-based process-improvement strategies. This review investigates the rationale for application of these same processes in the ambulatory anesthesia setting.


RESULTS
Application of quality methodologies in healthcare and other service industries has yielded similar quality and safety improvements as in the manufacturing and airline industries. Anesthesiologists have embraced the use of some mandated care plans, but many such opportunities have been rejected by the specialty, to the detriment of the safety and quality of patient care. Implementation of such mandates and team work training in healthcare would improve the safety and quality of medical practice as they have so dramatically in the airline and manufacturing industries over the preceding 30 years.


CONCLUSIONS
Ambulatory surgery and anesthesia care is uniquely oriented to the application of repetitive processes in the provision of highly predictable and reproducible surgical services. Ambulatory anesthesiologists should lead the healthcare industry in the much wider adoption of standard practice protocols and team training to maximally improve the safety and quality of patients' experiences.
Merrill
Douglas
D
The Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA. douglas-merrill@uiowa.edu
D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000592:standards; D019317:Evidence-Based Medicine; D017408:Guidelines as Topic; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards; D011787:Quality of Health Care / Q000592:standards*; D017751:Safety Management / Q000592:standards*; D013531:Surgicenters / Q000592:standards*