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门诊关节置换:基于证据、成功经验与失败教训的项目实用指南

Outpatient Joint Replacement: Practical Guidelines for Your Program Based on Evidence, Success, and Failures.

作者信息

Sah Alexander P, DeCook Charles A, Della Valle Craig J, Meneghini R Michael

出版信息

Instr Course Lect. 2020;69:167-182.

Abstract

Joint arthroplasty is increasingly being performed in ambulatory surgery centers (ASCs). Enabled by enhanced recovery protocols and multimodal pain management, and incentivized by the implementation of value-based payment models, this trend is projected to continue, with more than half of total joint replacements predicted to be outpatient by 2026. Like any advance in healthcare, this transition offers both new advantages and new challenges. ASCs provide opportunities to improve patient satisfaction and outcomes while lowering costs, but realizing these advantages requires a new level of presurgery preparation for both surgeons and patients. This chapter outlines key considerations for success when transitioning to performing joint arthroplasty at ASCs. Paramount among these are patient selection and preparation. Additional considerations include protocol optimization through data tracking and iterative refinement. A clear understanding of the differences in performing joints at an ASC versus a hospital outpatient setting enables surgeons to make the transition smoothly, maintain a high-quality patient experience, and deliver optimum outcomes.

摘要

关节置换术越来越多地在门诊手术中心(ASC)进行。在强化康复方案和多模式疼痛管理的推动下,以及在基于价值的支付模式实施的激励下,这一趋势预计将持续下去,预计到2026年,超过一半的全关节置换手术将在门诊进行。与医疗保健领域的任何进步一样,这种转变既带来了新的优势,也带来了新的挑战。门诊手术中心提供了提高患者满意度和治疗效果同时降低成本的机会,但要实现这些优势,需要外科医生和患者在术前准备方面达到一个新的水平。本章概述了在门诊手术中心进行关节置换术时取得成功的关键考虑因素。其中最重要的是患者选择和准备。其他考虑因素包括通过数据跟踪和迭代优化来优化方案。清楚了解在门诊手术中心与医院门诊环境中进行关节手术的差异,有助于外科医生顺利过渡,保持高质量的患者体验,并实现最佳治疗效果。

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