Johns Hopkins Health Alerts | Healthy Living After 50 | Outpatient Surgery

Serious complications of outpatient surgery are rare, but it’s important to be prepared.

According to the Federation of Ambulatory Surgery, outpatient surgeries account for 60–70% of all operations. Research shows that most outpatient procedures are safe and effective, but there are important differences among outpatient facilities that may make one type of facility a better -- and safer—option for your surgery.

Simple surgery, like hernia repairs or cataract surgery, are the most common outpatient procedures, but the widespread use of less invasive technologies has resulted in more complicated operations being performed on an outpatient basis. Outpatient hysterectomies, laparoscopic colon surgery, and gastric bypass surgery, for example, are now done through tiny keyhole incisions in the abdomen. With smaller incisions; less operating time, bleeding, and risk of infection; and shorter recovery periods, patients may leave the facility the same day of their surgery.

Outpatient procedures are performed at one of three locations: outpatient hospitals, ambulatory surgery centers, and doctors’ offices. Outpatient hospitals are affiliated with, and usually directly attached to, a major hospital. Surgeons and medical staff are hospital employees and the outpatient facility has access to hospital administrative and medical resources, including the hospital’s wide range of specialists.

In contrast, ambulatory surgery centers are privately owned, freestanding surgical facilities. Many ambulatory surgery centers are dedicated to one surgical specialty, such as eye or orthopedic surgeries. Most are staffed with board-certified surgeons and nursing staff. Although your ambulatory surgery center’s surgeon may also be affiliated with a hospital, the ambulatory surgery centers and hospital may not be directly affiliated.

Your surgeon will help you determine if the ambulatory surgery center or the hospital is a better choice for your procedure. Since 85% of ambulatory surgery centers receive Medicare funds, most are frequently inspected by the federal government and subject to the same stringent federal requirements as any hospital; however, because the ambulatory surgery center is not affiliated with a hospital, the staff may not be “on call.” Moreover, if you develop complications and require emergency services or hospital admittance after your operation, hospital staff may have difficulty getting information from the ambulatory surgery centers as quickly as they could from an affiliated outpatient facility.

Your doctor will also help you determine where to schedule your surgery. Keep in mind that your surgeon’s schedule may impact the decision. You may want to meet with your surgeon beforehand to discuss any health concerns. Finally, you can check the accreditation and safety records of your intended facility at:

• American Association for the Accreditation of Ambulatory Surgery Facilities Phone: (888) 545-5222 www.aaaasf.org
• Joint Commission of Accreditation of Healthcare Organizations Phone: (630) 792-5000 www.jointcommission.org
• Accreditation Association for Ambulatory Health Care Phone: (847) 853-6060 www.aaahc.org

For more Alerts and Special Reports, please visit the Healthy Living Topic page.

Johns Hopkins Health Alerts | Healthy Living After 50 | Outpatient Surgery