Archive May 2018 XIX, No. 5

Overnight Stays for ASCs

Surgical centers in a handful of states can admit patients for multiple-night stays.

Outpatient Surgery Editors

BIO

Overnight Stay
STAY THE NIGHT A few states let surgery centers keep patients overnight.

Same-day surgery can be stay-the-night surgery in the few states that let ASCs keep patients overnight to recover from complex cases. Rather than shuttle its total joints and spinal fusion patients to a hotel across town to spend the night, these surgical centers can admit patients to a "recovery" or a "convalescence" center that's usually a cove of private rooms attached to their facility. Depending on state law, patients can stay 24, 48 or 72 hours.

"We call it a recovery center, which makes it sound like it's in a separate building, but it's through 2 sets of doors and down a hallway," says Jennifer Arellano, CASC, the director of operations at Pinnacle 3, which manages the Orthopedic & Spine Center of Southern Colorado in Pueblo, 1 of 11 Colorado ASCs licensed as a convalescence center that can admit patients for multiple-night stays.

Though it can keep patients for up to 72 hours, the average length of stay is 1 overnight, says Ms. Arellano. Roughly 30 patients a month stay over in 1 of 9 private rooms Monday through Wednesday (closed on weekends) under the supervision of at least 2 members of a dedicated recovery center nursing staff: a registered nurse, always present, joined by either a certified nurse aide or medical assistant.

Surgeons inform the ASC when they want a patient kept overnight and how long they anticipate the patient staying. "The ability to send patients to the recovery center does not lower our ASC's standards for patient selection criteria," says Ms. Arellano. "We do not risk patient safety solely to increase volume."

On this day, 3 overnight cases are on the schedule, a couple of total knees, but first an 8:30 a.m. spinal fusion. If all goes as planned, the patient will be home by lunchtime tomorrow. She'll spend about 3 hours in surgery and 2 hours in recovery. After she's discharged from PACU, she'll be wheeled to the recovery center (which must have a license, entrance, waiting room, and medical records system separate from the ASC) and admitted around 1 p.m. to her room.

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