title: Same day admission for elective cardiac surgery: how to improve outcome with satisfaction and decrease expenses.
abstract: Admission on the day of surgery for elective cardiac and non-cardiac surgery has been established as a prevalent, critical practice. This approach realizes medical, logistical, psychological and fiscal benefits, and its success is predicated on an effective outpatient pre-operative evaluation. The establishment of a highly functional pre-operative clinic with a comprehensive set-up and efficient logistical pathways is invaluable. This notion has been expanded in recent years to include the entire peri-operative period and the concept of a 'peri-operative anesthesia/surgical home' is gaining popularity and support. Evaluating patients prior to admission for surgery, anesthesiologists can place themselves at the forefront of reducing unnecessary pre-operative hospital admissions, excess lab tests, unneeded consultations, and ultimately decrease the cancellations on the day of surgery. Furthermore, by taking a leadership role in the pre-operative clinic, anesthesiologists place themselves squarely at the forefront of the burgeoning movement for the peri-operative surgical home and continue to cement the indispensability of the anesthesiologist during the entire peri-operative course. The authors present this review as a follow-up describing the successful implementation of a pre-operative same-day cardiac surgery clinic and offer these experiences over the last 8 years as a guide to helping other anesthesiologists do the same.
authors: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, Box 1010, New York, NY, 10029, USA.
authors: George
authors: G
authors: Silvay
authors: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, Box 1010, New York, NY, 10029, USA. andrew.goldberg@mountsinai.org.
authors: Andrew
authors: A
authors: Goldberg
authors: Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104-4283, USA.
authors: Jacob T
authors: JT
authors: Gutsche
authors: Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104-4283, USA.
authors: John G
authors: JG
authors: T Augoustides
mesh_terms: D001071:Appointments and Schedules; D006348:Cardiac Surgical Procedures / Q000191:economics* / Q000379:methods*; D003363:Cost Control; D017558:Elective Surgical Procedures / Q000191:economics / Q000379:methods; D006760:Hospitalization; D006801:Humans; D017060:Patient Satisfaction; D013903:Thoracic Surgery / Q000191:economics* / Q000379:methods*; D016896:Treatment Outcome
keywords: Improvement of outcome and satisfaction; Peri-operative anesthesia and surgical home; Pre-operative evaluation clinic; Same-day admission for cardiac and major vascular surgery