Ambulatory surgical facilities (ASFs) provide surgical care to patients who do not require hospital admission for their postoperative care. The popularity and growth of ASFs on a national scale has been attributed to an increased throughput of patients, reduction in staff and surgical costs, and more personalized care. Along with the progression in volume, increasingly complex procedures are being performed at ASFs. In addition, patients with more complex medical conditions are having surgery in the ASF setting. Thorough initial assessment of patients is required to identify any concerns or disease processes, such as obstructive sleep apnea or cardiovascular disease, which could potentially cause intraoperative or postoperative problems. From June 2004 to December 2008, the Pennsylvania Patient Safety Authority received 467 reports related to the preoperative screening or assessment process in ASFs. Two hundred three of these reports indicate the patient experienced harm. Risk factors are discussed, as well as processes to ensure a thorough preoperative screening and assessment of patients to identify risk factors.
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