Single-visit surgery: An evaluation from an institutional perspective.

BACKGROUND/PURPOSE: Elective ambulatory surgical care traditionally involves three independent visits. Single-Visit Surgery (SVS) is an alternative surgical model that consolidates care into one visit. Evaluation of the effect of this novel program on hospital operations is limited. The objective of this study was to analyze SVS from an institutional perspective. METHODS: We retrospectively reviewed patients scheduled for SVS at a freestanding children's hospital between January 2016 and August 2017. Data collected included clinic "no show" rates, operating room (OR) utilization, reimbursement rates, and postoperative visits. RESULTS: There were 89 patients scheduled for SVS, of which 63% (n=56) were male, and the median age was 6 years [IQR, 4-9]. The SVS clinic "no show" rate was 2% (n=2) compared to the pediatric surgery clinic "no show" rate of 11% (p=0.01). The SVS OR block utilization rate was 90%. Payment was received from third-party payors for 92% of consultations and 100% of operative procedures without securing prior authorization. Postoperatively 25% (n=17) of patients presented to clinic for follow-up, and one child presented to the emergency department for vomiting. There were no hospital admissions. CONCLUSION: Single-Visit Surgery is an alternative model of ambulatory surgical care that improves institutional efficiency while also enhancing the patient experience. TYPE OF STUDY: Retrospective cohort review LEVEL OF EVIDENCE: III.

Single-Visit Surgery Offers Added Convenience and Excellent Family Satisfaction.

BACKGROUND: The traditional model for elective ambulatory surgical care includes three separate visits to the surgeon: an initial consultation, a second for outpatient surgery, and a third for postoperative follow-up. Single-Visit Surgery (SVS) is an alternative model of ambulatory surgical care that consolidates care into a single appointment where patients with straightforward surgical problems are evaluated in the morning and undergo a surgical procedure later that same afternoon. In April 2016, SVS was introduced at a tertiary-care freestanding children's hospital. Our objective for this study was to evaluate our early experience and conduct a survey of our patient's caregivers to evaluate their satisfaction with SVS. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients that were seen as part of SVS from April 2016 through December 2016. Data collected included demographics, diagnoses, procedures performed, clinical outcomes, and distance traveled to the hospital. In addition, adult caregivers of SVS patients were asked to participate in a telephone survey. RESULTS: There were 43 patients seen through SVS during the study period. The median age was 7 y. Of the 43 patients evaluated through SVS, 40 (93%) of them underwent surgery. Of the 40 patients that had surgery, 27 (68%) of the families participated in the telephone survey. Of those responding, 93% were strongly satisfied, and 7% were satisfied with the care through SVS. All families said they would recommend the SVS program to a friend. CONCLUSIONS: SVS is an alternative model of ambulatory surgical care that adds convenience to the patient experience and results in excellent family satisfaction.