Seattle Plastic Surgery Center

Ambulatory Surgery Centers More Efficient than Hospitals for Breast Surgery

MammagramA study published in The American Journal of Surgery found that breast surgery patients spent less time at the surgery facility when they had their operation at an ambulatory surgery center (ASC) vs. a hospital. The study found that on average the total time was 69 minutes shorter at the ASC. The authors were able to do the study because they had an ASC that was closed in 2005, and then breast operations were done at a hospital, allowing them to do a complete comparison. Ninety-two patients who underwent breast operations at the ASC were compared with 92 patients who underwent outpatient breast operations at the hospital, and the following factors were analyzed:
  • Anesthetic techniques
  • Recovery room events
  • Duration of stay (pre- through post-op times)
The results found that age and recovery times were similar. Complications were negligible at both the ASC and hospital; most notable, according to the study, was that 10 patients at the hospital has excessive pain, compared with 3 at the ASC (none required hospital admission). However, the preoperative and total facility time increased when breast cases were moved back to the hospital setting. The researchers wrote: Findings support a common perception, namely, that outpatient surgery can be more efficiently performed at a dedicated outpatient center rather than at a hospital setting. Some of the reasons for the efficiency of the ASC include:
  • Nurses at the ASC only prep outpatients, whereas hospital nurses may process both outpatients and critically ill patients.
  • The ASC was limited to a relatively small and uniform set of cases, whereas the hospital has a more varied and complex case mix, which can cause surgery delays.
  • The preoperative area in the ASC was physically closer to the OR compared with the hospital setting.
The study’s authors concluded that the potential efficiency advantage of an ASC over a hospital has implications for patient and staff satisfaction, facility expense, and surgeon productivity. Dr. Grenley was one of the first board-certified plastic surgeons in Seattle to open a state-certified office-based surgery center.