Procedure times, patient outcomes, indications for the procedure, complications, ASA classification and anesthesia monitoring and prevention of wrong lens insertion and wrong-site surgery were measured by the survey. Of the 77 ambulatory centers that participated, 55 were freestanding, single-specialty ASCs, 17 were multi-specialty ASCs and five were office-based surgery practices. The survey followed around 1,700 cataract extraction with lens insertion procedures performed in 2008.
Procedure times were used as benchmarks as they can be good indicators of patient satisfaction and safety, according to the release. According to the survey, the average total time patients spent in facilities (from check-in to discharge) was 117 minutes. The average time from check-in to the beginning of the procedure (incision) was 81 minutes. The average procedure took 14 minutes, and the average recovery time was 22 minutes.
Around 82 percent of the patients were contacted for the survey within 14 days of their procedure. Although not every patient answered every question, the survey found that 98 percent said they were comfortable during their procedures, and 97 percent reported they were comfortable post-discharge. When asked about their vision, 94 percent said their vision was better, 4 percent said it was the same as it was pre-surgery and 2 percent said it was worse. Most patients were about the return to their normal daily activities within 1-14 days, with 66 percent within two days, 14 percent within three-four days, 12 percent within 5-7 days, 3 percent within 8-10 days and 3 percent within 1-14 days.
Participants in the survey identified many ways they were able to keep times low including:
- Paperwork is done ahead of time, and patients are sent home from scheduling with a packet, including informed consent, anesthesia consent, visual function questionnaire, pre-surgery instructions, eye drop prescription and scheduler's business card;
- One center reported using a special compound dilating solution; if the patient isn't completely dilated, he or she is brought into the OR where the physician uses a numbing solution of 1 percent lidocaine and epinephrine, which completes dilation in a few seconds;
- Local anesthesia and mild IV sedation are used;
- A stretcher that converts to a chair is used for quick transfers;
- A family member is with the patient at pre- or post-procedure to hear discharge instructions, confirm follow-up appointments and address questions;
- Laser surgeries are done when all other surgeries are completed;
- Cases using a phacoemulsifier are scheduled first, and longer cases are scheduled at the end of the day.
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