1. Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011
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drmgbhat@novamedicalcenters.com
©2009. Nova Medical Centers. Strictly private and confidential
Dr. M G Bhat
MS, FRCS(England), FRCS ( Edinburgh), FICS,
DMLE (Law), DMIRCSEd (Informatics)
Consultant Surgeon, Bangalore
Medical Director, Nova Medical Centers Ltd, India
Greetings From…

2. Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011
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drmgbhat@novamedicalcenters.com
This delivery system is growing in the Europe.
And we in India are in the process of Developing
and Popularizing the Ambulatory Surgery.
The Ambulatory Surgery
(Day Surgery & Short Stay Surgery)
Ambulatory Surgery in USA, in the last two
decades has become the most efficient form of
Surgical Healthcare Delivery.

3. Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011
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drmgbhat@novamedicalcenters.com
•Progress in Anesthesia
•Improved Surgical Techniques
•Fast Tracking Approach
•Post Operative Management
•Pain Management
•Doctors Mindset
•Patients Mindset
Reasons for the Popularity

4. Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011
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drmgbhat@novamedicalcenters.com
From Patient’s Point
• Surgery is a major stressor for all Patients.
• Anxiety and fear are normal.
• Fear of the unknown is the most prevalent
fear prior to surgery and is the fear that is
the easiest for all the staff to help the
patient to overcome.

5. Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011
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drmgbhat@novamedicalcenters.com
Small Stand Alone Centers
With State of the Art Facilities
•Efficient
•Attractive
•Cost Effective
• Financial and organizational Benefits
• Multispecialty Procedures performed
On fit patients (Minor to Supramajor)
• Discharged in a Short Period

6. Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011
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drmgbhat@novamedicalcenters.com
The only way Ambulatory Surgery
will become Popular and Accepted
is if the Healthcare delivery is safe
and effective
Safety is the key for Success

7. Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2 Sept 2011
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drmgbhat@novamedicalcenters.com
803
560
432
378
138 110
42 4
Total Surgeries 2009-11 (2470)

8. Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011
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drmgbhat@novamedicalcenters.com
Experience From One Center
Untoward Events
• Complications
• Transfer to Hospital
• Readmission

9. Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2 Sept 2011
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drmgbhat@novamedicalcenters.com
Patients Requiring Transfer
5 Transfers and One Treatment/2470
• Post Lap Chole – Chest Problems
• Post Adenoidectomy- Bleeding Managed in
center with Blood Transfusion
• Post Septoplasty- Bleed –
• Post Adenoidectomy- Breathing Problem-
• Post TURP- Urinary Retention
• Intestinal Tear during surgery-
shifted for Hospitalization
Compared to 1-2% in USA

10. Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011
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drmgbhat@novamedicalcenters.com
Factors for Safety
• Analyze the Risks and Fears & Solve them
• Qualified and Skilled Doctors & Staff
• Comply with All Regulatory Rules
• Ensure Quality of Service ( Accreditation)
• Comply with All Legal Requirements
• Incident Reporting & Corrective Measures

11. Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011
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drmgbhat@novamedicalcenters.com
• Availability of Continuous Care
• Good Selection of Patient
• Patient well informed
• Good Post Op Care
• Home Support
• Shift Patient if required
Provide Good Care

12. Risks and Fears in Ambulatory Surgery
National Conference Ambulatory Surgery, Bangalore 2/9/2011
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Thank you
drmgbhat@novamedicalcenters.com