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Ambulatory surgery center profitability, efficiency, and cost containment

  • Tom Archer
  • Steve Mannis
  • Alex Macario

Abstract

Ambulatory surgery and anesthesia should be:
  • Safe and effective

  • Friendly and compassionate

  • Profitable

Unless we are an ambulatory surgery center (ASC) owner, why should we care about the financial aspects of ASC management? Why not just give safe, effective, friendly, and compassionate care and not worry about ASC finances?

Keywords

Operating Room Turnover Time Cost Containment Contribution Margin Block Time 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Archer TL, Mannis S, Macario A. Profit maximization for ambulatory surgery centers. In: Steele SM, Nielsen KC, Klein SM, eds. Ambulatory Anesthesia and Perioperative Analgesia. New York, NY:McGraw-Hill; 2005:123–133.Google Scholar
  2. 2.
    Dexter F, Coffin S, Tinker JH. Decreases in anesthesia-controlled time cannot permit one additional surgical operation to be reliably scheduled during the workday. Anesth Analg. 1995;81:1263–1268.CrossRefPubMedGoogle Scholar
  3. 3.
    Macario A, Dexter F, Traub RD. Hospital profitability per hour of operating room time can vary among surgeons. Anesth Analg. 2001;93:669–675.CrossRefPubMedGoogle Scholar
  4. 4.
    Lynk WJ, Longley CS. The effect of physician-owned surgicenters on hospital outpatient surgery. Health Aff. 2002;21:215–221.CrossRefGoogle Scholar
  5. 5.
    Udelsman R. The operating room: war results in casualties. Anesth Analg. 2003; 97:936–937.CrossRefPubMedGoogle Scholar
  6. 6.
    Dexter F, Epstein RH, Abouleish AE, Whitten CW, Lubarsky DA. Impact of reducing turnover times on staffing costs. Anesth Analg. 2004;98:872.CrossRefPubMedGoogle Scholar
  7. 7.
    Dexter F, Abouleish AE, Epstein RH, Whitten CW, Lubarsky DA. Use of operating room information system data to predict the impact of reducing turnover times on staffing costs. Anesth Analg. 2003;97:1119–1126.CrossRefPubMedGoogle Scholar
  8. 8.
    Sandberg WS, Daily B, Egan M, et al. Deliberate perioperative systems design improves operating room throughput. Anesthesiology. 2005;103:406–418.CrossRefPubMedGoogle Scholar
  9. 9.
    Dexter F, Macario A, Traub RD, Hopwood M, Lubarsky DA. An operating room scheduling strategy to maximize the use of operating room block time: computer simulation of patient scheduling and survey of patients’ preferences for surgical waiting time. Anesth Analg. 1999;89:7–20.CrossRefPubMedGoogle Scholar
  10. 10.
    Strum DP, Vargas LG, May JH. Surgical subspecialty block utilization and capacity planning: a minimal cost analysis model. Anesthesiology. 1999;90:1176–1185.CrossRefPubMedGoogle Scholar
  11. 11.
    Dexter F, Tinker JH. Analysis of strategies to decrease postanesthesia care unit costs. Anesthesiology. 1995;82:94–101.CrossRefPubMedGoogle Scholar
  12. 12.
    Apfelbaum JL, Walawander CA, Grasela TH, et al. Eliminating intensive postoperative care in same-day surgery patients using short-acting anesthetics. Anesthesiology. 2002;97:66–74.CrossRefPubMedGoogle Scholar
  13. 13.
    Song D, Chung F, Ronayne M, Ward B, Yogendran S, Sibbick C. Fast-tracking (bypassing the PACU) does not reduce nursing workload after ambulatory surgery. Br J Anaesth. 2004;93:768–774.CrossRefPubMedGoogle Scholar
  14. 14.
    Jin F, Norris A, Chung F, Ganeshram T. Should adult patients drink fluids before discharge from ambulatory surgery? Anesth Analg. 1998;87:306–311.CrossRefPubMedGoogle Scholar
  15. 15.
    Marshall SI, Chung F. Discharge criteria and complications after ambulatory surgery. Anesth Analg. 1999;88:508–517.CrossRefPubMedGoogle Scholar
  16. 16.
    Archer T, Schmiesing C, Macario A. What is quality improvement in the preoperative period? Int Anesthesiol Clin. 2002;40:1–16.CrossRefPubMedGoogle Scholar
  17. 17.
    Roizen MF. Preoperative evaluation. In: Miller RD, ed. Anesthesia. 6th ed. New York, NY: Churchill Livingstone; 2005:927–997.Google Scholar
  18. 18.
    Fleisher LA. Routine laboratory testing in the elderly: is it indicated? Anesth Analg. 2001;93:249–250.CrossRefPubMedGoogle Scholar
  19. 19.
    Schein OD, Katz J, Bass EB, et al. The value of routine preoperative medical testing before cataract surgery. N Engl J Med. 2000;342:168–175.CrossRefPubMedGoogle Scholar
  20. 20.
    Yuan H, Chung F, Wong D, Edward R. Current preoperative testing practices in ambulatory surgery are widely disparate: a survey of CAS members. Can J Anaesth. 2005;52:675–679.CrossRefPubMedGoogle Scholar
  21. 21.
    Imasogie N, Wong DT, Luk K, Chung F. Elimination of routine testing in patients undergoing cataract surgery allows substantial savings in laboratory costs. A brief report. Can J Anaesth. 2003;50:246–248.CrossRefPubMedGoogle Scholar
  22. 22.
    Kantor GS, Chung F. Anaesthesia drug cost, control and utilization in Canada. Can J Anaesth. 1996;43:9–16.CrossRefPubMedGoogle Scholar
  23. 23.
    Tarazi EM, Philip BK. Friendliness of OR staff is top determinant of patient satisfaction with outpatient surgery. Am J Anesthesiol. 1998;25:154–157.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Tom Archer
    • 1
  • Steve Mannis
    • 2
  • Alex Macario
    • 3
  1. 1.Department of AnesthesiologyUniversity of Texas Health Science CenterSan AntonioUSA
  2. 2.SacramentoUSA
  3. 3.Department of AnesthesiaStanford University Medical CenterStanfordUSA

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