As ambulatory surgery facilities perform more complex surgical procedures on more patients with serious medical conditions, a patient safety group in Pennsylvania warns that ASCs need to step up their pre-operative patient assessments to reduce the risk of complications.

The Pennsylvania Patient Safety Authority received 467 reports related to pre-op screenings in ambulatory surgery facilities between June 2004 and December 2008. In a March 2009 advisory, the organization notes that 203, or 43 percent, of those reports described "serious events" where a patient was harmed and, in most cases, had to be transferred to a hospital. Half of the reports involved patients over the age of 65, and 5 percent involved a pediatric patient.

"Our data shows many ambulatory surgical facilities need to improve their screening and assessment processes prior to accepting patients for surgery," says Mike Doering, executive director of the Patient Safety Authority. "Of the total reports, 124, or 27 percent, show a need for an improved process in their facilities."

The advisory lists a number of risk factors surgical facilities should be on the lookout for during pre-op assessments, including obstructive sleep apnea, cardiovascular disease, hyperactive reactive airway disease, obesity and end-stage renal disease. It also outlines strategies for conducting thorough and effective pre-operative screenings, nursing assessments and anesthesia assessments to reduce the risk of complications in patients with complex medical conditions.

—Irene Tsikitas