SAMBA leadership occasionally responds to reports and articles released in the media related to ambulatory anesthesia practice and safety. Click the articles below to view these responses.
Guidelines to be available soon. To view the abstract, click on the image above.
SAMBA, SASM and SOCCA Collaborative Guidelines for Postoperative Management of Patients with Obstructive Sleep Apnea
Mandeep Singh, MBBS, MD, MSc, FRCPC, Ashish Khanna, MD, FCCP, FCCM, FASA, Niraja Rajan, MD, Girish Joshi, MBBS, MD, FFARCSI and Satya Krishna Ramachandran, MD
Obstructive sleep apnea (OSA) is the most common form of sleep-related breathing disorder encountered in the perioperative setting. It is defined by recurrent upper airway collapse, potentially leading to decreased oxygen levels during sleep and an increased risk of long-term cardiovascular illness. While OSA is more prevalent in surgical candidates than in the general population, between 60-90% of patients remain undiagnosed. OSA has been associated with a high risk of perioperative complications and a resultant increase in hospital cost and resource utilization.
Appropriateness for Ambulatory Surgery: No Magic Formula
Kenneth Cummings, MD, MS, FASA
Director, Pre-Anesthesia Consultation Clinics
As the director of a preoperative clinic, one of the recurring challenges I face is the appropriate scheduling of ambulatory versus inpatient procedures. It is remarkable how many patients with significant medical issues may safely undergo ambulatory procedures if carefully selected. Innovative surgical techniques, shorter-acting anesthetic agents, and changes in reimbursement models have increased interest in ambulatory surgery. At the same time, however, an aging population with an increasing disease burden significantly complicates the decision as to who is an appropriate candidate for an outpatient procedure.
To access the article, click on the image above.
To access the survey response, click on the image above.
Society for Ambulatory Anesthesia Response to the Leapfrog Group Survey 12/15/2019
The Society for Ambulatory Anesthesia (SAMBA) is the premier society for ambulatory physician anesthesiologists, with membership available to all physicians and professionals with interest in ambulatory surgical care.
We disagree with some of the negative, unsupported comments made by the Leapfrog group representatives in the preliminary findings of their ASC survey. In response we wish to highlight our organization’s efforts to advance patient safety.
Click here to review Leapfrog’s preliminary findings from their ASC survey.
Pediatric Non-O.R. Anesthesia (NORA)
The need for sedation and anesthesia care for pedi-atric patients in non-O.R. locations has increased significantly during the past decade. It is not uncommon for such children to represent anywhere from 10 to 24 percent of the daily case load, as noted by Campbell and associates.1 Without psychological and other non-pharmacological interventions, pediatric patients are unlikely to cooperate and lay still even for non-painful diagnostic MRI procedures unless the procedures are brief, as during a CT examination.
To access the article, click on the image above.
Manual of Practice Management for Ambulatory Surgery Centers
This key resource provides insight and guidance to managing ambulatory surgery centers (ACSs) from a broad spectrum of expertise. Intended for a wide audience of healthcare professionals, this book covers topics such as regulatory issues, outpatient pediatric anesthesia, inventory management, personnel training, the culture of safety, and sedation standards.
The format found in each chapter is designed intentionally to function as an educational manual. Many chapters are supplemented by high quality figures and tables to aid in visual learning.
This text brings together authors from diverse professions including lawyers, administrators, surgeons, anesthesiologists and architects. Manual of Practice Management for Ambulatory Surgery Centers: An Evidence-Based Guide is a concise and evidence-based guide to successfully operating the modern health care facilities that have transformed the outpatient experience for millions of people.
- Provides a comprehensive guide for medical directors, administrators, anesthesiologists, surgeons, and perioperative leaders in the management of ASCs
- Concise and evidence-based guide to common pitfalls and situations that arise during the running of an ASC or office-based practice
- Resource for ASC and office –based practice leadership in addressing issues that arise during the management of these practices
- Topics covered include ASC construction, anesthesia billing, sedation standards, protocols, and guidelines, the culture of safety, and outpatient pediatric anesthesia
The Manual of Practice Management for Ambulatory Surgery Centers is a SAMBA publication in collaboration with Springer Nature publishing.
Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting
This consensus statement presents a comprehensive and evidence-based set of guidelines for the care of postoperative nausea and vomiting (PONV) in both adult and pediatric populations. The guidelines are established by an international panel of experts under the auspices of the American Society of Enhanced Recovery and Society for Ambulatory Anesthesia based on a comprehensive search and review of literature up to September 2019.
To access the article, click on the image above.
ASA Subspecialty kiosk
Dr. Abdelmalak and Dr. Belani represented SAMBA at the ASA subspecialty kiosk during the ASA Annual Meeting October 19-23.
SAMBA and the Indian College of Anesthesiologists have a common interest to improve patient care and safety within the ambulatory anesthesia medical field. We will be partnering and collaborating through marketing, promotion and communications.
SAMBA and the European Society of Anesthesiologists met recently to discuss and explore a partnership moving forward.
August is National ASC Month
For more than forty years, ASCs have provided high-quality, cost-efficient surgical care for millions of Americans. In that time, ASCs have transformed the outpatient experience by offering a convenient and personalized alternative to the hospital outpatient surgical setting.
For the last decade, ASCs have promoted awareness of these contributions by opening their doors to their communities and hosting National ASC Month events. By hosting an event in your community, you can educate key policy and decision makers about the benefits of ASCs and encourage public awareness of your ASC. Effective events include inviting your elected officials to tour your surgery center and hosting an open house to provide more information to patients.
Letter from the President
On behalf of all SAMBA members,
I want to thank Basem Abdelmalak, MD, FASA, SAMBA President 2019-2020, for the excellent service he has provided our society for the past year. Dr. Abdelmalak worked tirelessly executing SAMBA’s mission and vision. During his tenure, we signed cooperation agreements with multiple Anesthesiology organizations from around the world, including, the American Society of Anesthesiologists, European Society of Anesthesiologists, the Croatian Society of Anesthesiology and Intensive Care Medicine, the Brazilian Society of Anesthesiologists, and the Sao Paulo State Society of Anesthesiologists.
A few weeks ago, I was mapping out the projects for the year that I will serve as SAMBA’s President. My main goal is to enhance the business acumen of our members. Based on the interesting interactions in Q/A sessions at the annual meetings, and your feedback, we plan to have a Medical Directors track in future Annual Meetings. We are considering a SAMBA Medical Director education and certification program, open to SAMBA active and associate members.
As Anesthesiology Medical Directors, on the one hand, we provide medical care to our patients. SAMBA provides statements and guidelines to improve medical management:
- Preoperative risk assessment calls, information gathering, and patient selection
- Perioperative pain management, multimodal analgesia, and regional anesthesia
- Consultations and intraoperative care
- Post-operative care, discharge
- Complication management and transfers
On the other hand, Medical Directors are also the Chief Medical Officers of the facility and have different responsibilities:
- Design and implementation with the administrative team the facility’s competitive advantage
- Leadership and team building
- Patient experience and satisfaction
- Surgeon selection and surgeon satisfaction
- Scheduling and blocked time management
- Patient safety and quality management
- Quality measures, benchmarks, SQI
- Help manage staff, scheduling conflicts, and medication management
- Credentialing and recredentialing
- Policies, procedures, medical executive committee, governing board.
The Coronavirus pandemic has shifted our attention. The hardest-hit countries are western nations, including Belgium, Spain, Italy, UK, France Sweden, Netherlands, Ireland and the U.S. As of May 10th, 2020, the U.S. population is 327 million. There have been 78,675 deaths, which represents the mortality of 240.47 per million. Epidemiology has taught us that the most vulnerable people are adults aged ≥60 years, people with severe underlying health conditions, people living in the urban cores of large metropolitan areas and minorities.
Political leaders implemented drastic measures to slow down the spread of COVID-19, including travel restrictions, stay home orders, business closures, social distancing, wearing face masks in public places, and stopping elective surgeries.
During the pandemic, the SAMBABboard of Directors has published a series of statements, as well as webinars with medical and non-medical content to help guide our members through obstacles. As elective surgeries commence again, we must aim to maintain our facilities COVID-19 free, or at least COVID-19 safe. As leaders, we must meet with our facility administrative and nursing leadership to map out the measures that we plan to take to keep our patients, staff and ourselves safe:
- Prevention of human-to-human and equipment-to-human transmission.
- Implementation of checklists to reopen the facilities to ensure an adequate supply of medications and equipment necessary to proceed with procedures safely.
- Maintain excellent communication with patients and staff about measures being taken.
- Let’s not forget about ourselves, and our families – we must stay healthy.
It is our wish that all Ambulatory Surgery Centers take advantage of the SAMBA Ambulatory Surgery Center membership. For a discounted price, Anesthesiologists and non-Anesthesiologists that work at member facilities become SAMBA members and enjoy all the educational opportunities that SAMBA provides. SAMBA will continue to work on behalf of our members, developing content to keep them updated.
We plan to deploy a SAMBA app from which members can access the content on our website. We aim to create an index and pertinent content to serve as reference for ambulatory anesthesiologists. SAMBA recently published a Manual of Practice Management for Ambulatory Surgery Centers, which members can purchase with a 25% discount.
We are working on a combined virtual regional anesthesia meeting/workshop with the European Society of Regional Anesthesia (ESRA). We are planning a virtual Medical Director’s meeting. Many members have visited the membership forum, where you can find additional content related to our webinars, questions and answers by our Board Members, including our Past-Presidents.
Thank you for the opportunity to serve and help enhance our specialty.
Leopoldo V. Rodriguez, MD, MBA, FAAP, FASA
President, Society for Ambulatory Anesthesia 2020 – 2021