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August 16, 2017

New Ambulatory Surgery Centers aim...

Emphasis on Atmosphere, Quality Care, Safe Outcomes

At New, Independent Surgical Care Centers

 

By jim richmond

 

     Right before wheeling me into the operating room Tuesday, nurse Karen (who ensured continuity and timeliness of care) leaned over the bed, nudged me to take a wide, black magic marker, and prompted, “Sir, please take this, and mark your initials on the wrist of the hand we’ll be operating on this morning.”

     So, I took the marker, moved the plastic iv drip cord on my left wrist out of the way, and carefully drew the letters: J R smack dab, 100 percent in the middle, in the equivalent of 36-point type, on my right-hand wrist.

     “Very good!” Karen beamed at me. She would stay with us throughout our visit and had been part of a one week before pre-op visit at my surgeon’s office.

     Now as way of brief literary back story, my specialist doctor had sent me to a non-hospital, independent ambulatory surgery center.  And it was about as far from a hospital setup as you could find – even in this day of sometimes startling health care change for many Americans.

      The surgery center was more like the lobby and Palm Court restaurant at New York’s swank, beautiful-people Plaza Hotel, including a BIJOU Theatre to show new flicks while your relatives waited, big palm plants, first class, low back, cushy chairs, a coffee bar and gallery of small shops featuring pricey ties, gold-lettered t-shirts and knick-knacks, just like The Plaza.

     The “back of the shop” was equally as efficient and inviting – 8 to 12 curtained corrals, for each patient in pre-op or recovery, and with more nurses, doctors, family members and traffic than the Meijer’s supermarket shopping aisles on a Sunday afternoon.  Except here everyone smiled, made eye contact and did not bump into your cart. And Karen kept track and us moving ahead to the actual surgery on schedule.

     I was accompanied by my oldest son (the required Responsible Adult), me in the private coral's surgery bed, and watched over by Karen. Over the course of about 1 hr 15 minutes, she hooked me up to the iv and checked my vitals. 

     During that time span, I spent about 7 minutes in a brief repeat here’s-what-to-expect- visit with my engaging, task-focused surgeon, and a 3-minute review with a thin, somewhat jittery anesthesiologist.

     Many of you already know the end of this little story from my last Facebook page. The surgery went well.  I’m home and headed back to work soon.

     But in telling you about Karen the nurse, the black marker, and the “JR” written on my right wrist, I forgot one detail. She also asked my son if I had a (Do Not Resuscitate) on file. “If so, we can’t take him. He’ll have to go to a hospital, instead.  Because we resuscitate everyone here.”

     That positive, optimistic outcome attitude is felt by and encouraging for patients. Of course, it’s also a function of the ambulatory surgery center’s mission within the rapidly, some would say ever changing American health care system.

     The system is striving, struggling to bring down costs and to provide services in the safest, least intrusive setting for patients who do not require more intense and costly inpatient hospital care.

     The new, independent ambulatory surgery center is the same and yet quite different from hospital inpatient facilities. Their relationships with the physicians and other health care providers can be different, and seem more collegial.

     Patients reportedly receive more personal attention, better continuity of care, and patient infection rates are often lower than surgery and care in a large hospital.

     Yet the ambulatory surgical center’s physician specialists may do 6 to 10 operations, each of several days a week.

     As patients, we want them, the total surgical team, to get all our own J Rs right, before reaching the cutting table.

     That certainly proved the case for this guy known as JR.

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The author wrote this blog, voice to text, from a comfortable home bed, 3 a.m. Wednesday morning. His apologies for any typo or grammar oversights.

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