Which criteria support that a patient is ready for discharge from an ambulatory surgery center?

Reception and Family Waiting Area

During registration, you will be asked to:

• Review demographic information to ensure it is correct and complete
• Pay any outstanding deductible, coinsurance or copayment
• Sign a statement acknowledging that you have read and understand the following legal considerations before your surgery:
  • Patient’s Rights and Responsibilities
  • Notice of Privacy Practices
  • Ownership Disclosure
  • Advanced Care Planning
  • Health Care Proxy
  • Living Will
  • Do Not Resuscitate

Preoperative Area

On admission to the clinical floor, the Preoperative Nurse will:

• Review your medical history
• Review the Consent for Procedure
• Ask you to change into the hospital gown
• Prepare you for surgery (e.g., start an intravenous line, prepare the surgical site)
• Review the discharge plans and care at home.

Be sure to advise the nursing staff of any medical problems you have and any medications you are taking including prescription, over-the-counter and herbal medications.

Please use this opportunity to ask any questions you may have.

An anesthesiologist will review your medical history and discuss the options for anesthesia.  The type of anesthesia you will receive depends on your general health, the type of surgical procedure and your preferences, when possible.

Your surgeon will meet with you in the Preoperative Area to answer any last-minute questions before you go into the Operating Room.

After the nurse has admitted you to the Preoperative Area, you may choose to have a family member/companion to be with you until you are taken into the Operating Room.

The family member may then wait in the Family Waiting Room or, if the family member leaves the Center, we ask that we have a cell phone number available to contact them if the need arises.

At least one parent of a pediatric patient must remain at the Center.

The anesthesiologist may administer a light sedative before you are taken into the Operating Room (OR).

Once in the OR, the anesthesiologist will continually monitor your vital signs, including your blood pressure, heart rhythm and oxygen saturation throughout the procedure.

Your privacy is very important to us:

• Only designated staff members are allowed in the OR during your procedure.
• On occasion, other individuals (e.g., students, sales representatives) may request to observe procedures in the OR.  You must give specific permission on the Consent for Procedure to allow non-ASCW staff members to be present in the OR during your procedure.

Recovery Room

• Patients who have had general anesthesia will recover in the Phase I Recovery Area with intensive nursing care.
• Your vital signs will be monitored frequently and you may receive oxygen during your emergence from anesthesia.
• Medication for pain and nausea may be administered to keep you comfortable.
• Parents of pediatric patients may be with their child while he/she is awakening from anesthesia.
• Family members of adult patients must wait until the patient is in the Phase II Recovery Area.

• Patients who have recovered from general anesthesia, and those patients who received only sedation in the Operating Room, will complete their recovery in the Phase II Recovery Area.
• Family members may visit the patient at the patient’s discretion.
• Patients are encouraged to drink clear fluids in the Phase II Recovery Area before being discharged to home.
• Most patients are in the Recovery Area 1-2 hours after surgery.  However, some patients may be ready for discharge after 20-30 minutes and others may require 3-4 hours to recover from anesthesia and surgery.
• The duration of recovery depends on many factors such as the type of procedure and anesthetic, and the age and underlying medical condition of the patient.

• The Recovery Room Nurse will review your surgeon’s Discharge Instructions regarding diet, activity, medications and follow up care with you and your family member/companion.
• You will receive a written copy of the Discharge Instructions to take home.
• Total pain relief may not be achieved prior to discharge though it should be tolerable.

• It is very important for you to have a responsible adult to take you home and remain with you for the first 24 hours after surgery to provide assistance.
• Postop complications are rare but they are more easily addressed if you have someone to assist you during your time of need.
• If you have questions or problems after discharge from the Center, please contact your surgeon’s office.

• The patient’s surgery may be canceled if the patient does not have a responsible adult to escort him/her home after receiving sedation or general anesthesia.
• The responsible adult must be at least 18 years of age and willing to assume responsibility for your care.  The responsible adult is usually a family member or friend.
• A taxi or limousine driver does not qualify as a responsible adult because he/she cannot assume responsibility for your care.

• Plan to rest and relax at home with a family member/companion.
• Do not attempt any skill based activities; e.g. swimming, cycling.
• Do not drink alcoholic beverages.
• Do not drive or operate any other type of machinery or heavy equipment.
• Do not sign any legal documents or make any major life-changing decisions.

Postoperative infections are rare but may occur.

Please follow these guidelines to decrease your chance of a postoperative infection:

• Keep the dressing dry and intact
• If your surgeon prescribed an oral antibiotic, make sure you take this as directed.
• Notify surgeon if any redness, swelling or drainage is noted at the incision site.

An ASCW Administrator is available after hours for your assistance.

• If you are having medical issues, you should either call your surgeon’s office or, if it is an emergency, call 911.
• The Administrator-on-Call can assist you with non-medical issues and will contact an anesthesiologist if you have specific questions about your anesthesia care.
• To contact the Administrator-on-Call, please call the answering service at (914) 241-1050 and ask to speak specifically to the “ASCW Administrator on Call” .
• The contact information for the ASCW Administrator-on-Call is also available on the Center’s voice mail after hours.