DEPARTMENT OF ANESTHESIOLOGY ANNUAL REPORT

Goals for the Future
The Ambulatory Surgery Center is in
the third year of operation and we continue
to have exciting goals for the
future. Our statistics continue to reveal
that we are achieving excellent patient
satisfaction and that remains our first
and foremost goal.
We are already delivering regional
anesthesia to nearly 60% of our patient
population at the Ambulatory Surgery
Center. It is our goal to continue to offer
a wide variety of anesthesia options
to our patients with special focus on
Regional Anesthesia. Our status as a
Center of Excellence in regional and
ambulatory techniques has allowed us
to offer training to fellow anesthesiologists
throughout the country. We will
continue to develop the Division of
Ambulatory Anesthesia at Duke as a
guiding force in education and training
for Regional Anesthesia both nationally
and internationally.
We continue to integrate our outcomes
data with patient satisfaction
and are expanding it to look at the cost
of care delivery. As we broaden and
hone the outcomes database we are
establishing a model in the field of outcomes
for ambulatory surgical centers.
Our improved technologic enhancement
to our database systems will improve the
deliverance of vital information regarding
ambulatory surgery and patient satisfaction.
The Division of Ambulatory Anesthesia
is working to develop a protocol
for home catheter infusion system for
the management of post-operative pain.
Drs. Susan Steele and Karen Nielsen
have worked collaboratively with this
protocol and have visited in patient’s
home after surgery allowing first hand
investigation of the efficacy of home
catheter infusion. The results have been
overwhelming. The patients who have
participated in this protocol have been
extremely satisfied with their pain con-
00 100%
80 80%
60 60%
40 40%
20 20%
0% 0
Very
Satisfied
trol and with the convenience of managing
their pain at home.
The Ambulatory Surgery Center
is working with a team of surgeons,
administrators and other key personnel
to develop a Breast Care Center of
Excellence at our facility. This would
greatly enhance patient convenience
Ambulatory Surgery Center
CLINICAL ACTIVITIES
TABLE 2
Patient Satisfaction with Anesthesia Techniques
Ambulatory Surgery Center
July 13, 1998–July 13, 2000
Somewhat
Satisfied
Neutral Somewhat
Dissatisfied
Very
Dissatisfied
24 Hours
7 Days
and satisfaction in allowing diagnostic
procedures of the breast as well as surgical
procedures to be accomplished
in one location. This would be a great
improvement to our present protocol
for breast procedures. This is certainly
one of the most promising initiatives
on our horizon. We remain dedicated
to providing the highest level of patient
satisfaction of any ambulatory surgery
in the nation.
Our division is initiating an innovative
pilot study on patients undergoing
total knee arthroplasty. These procedures
will be performed under continuous
peripheral nerve blocks on an ambulatory
basis. Patients will be discharge
from our 23 hour recovery care unit to
a rehabilitation unit. Continuous peripheral
nerve blockade will be used during
the first 72 hours allowing excellent
postoperative analgesia, aggressive
physical therapy, and early recovery.
CLINICAL ACTIVITIES 43