An ambulatory surgery center is a freestanding facility exclusively “providing surgical services to patients not requiring hospitalization, and in which the expected duration of services would not exceed 24 hours following an admission” 1. Today, over 60% of all surgeries are performed either in a hospital outpatient department or an ambulatory surgery center. While patients tend to report positive experiences in both hospitals and ambulatory surgery centers, the latter have been found to perform better as regards multiple aspects of a patient’s health care journey and overall lived experience 2. Indeed, ambulatory surgery centers offer a number of important patient-centric benefits.
Ambulatory surgery centers allow surgeons to perform specific procedures more efficiently and conveniently than in the context of hospital-based operating rooms 3. This translates to less time-intensive procedures carried out at a lower cost. In a system that values population health, this ends up increasing access to and efficiency of care for all patient populations – directly improving general community health and the ability to meet basic community needs.
As regards patient experience, first of all, some data show that adult patients have had more favorable experiences of a same-day surgery in an ambulatory center than of a same-day surgery performed at a hospital, partially given their ability to be more directly involved in decision-making processes and to have a more predictable schedule, contributing to a greater sense of engagement and control.
In addition, more recently, the American Consumer Assessment of Healthcare Providers and Systems surveys, consisting of standardized patient surveys aimed at measuring patients’ experience with the care they receive across a number of health care settings, have assessed the overall experience of patients undergoing same-day surgery in hospitals or ambulatory surgery centers 2. In so doing, patients were asked to assess their experience with regard to facilities and staff, communications about their procedure, provide their overall rating of the facility, and share their willingness to recommend an ambulatory surgery center to family and friends. In all four aspects, ambulatory surgery centers were rated statistically significantly better by patients than were hospital outpatient departments 2. Consistently, other studies have shown that improved patient satisfaction can be linked to additional unique facets of ambulatory surgery centers, including their greater accessibility, more convenient parking, and quieter, less-confusing facilities – translating in the end to a more relaxed environment and experience for patients 4.
Patients form the core of health care delivery; insights on the benefits of ambulatory surgery centers can help patients make informed decisions about where to seek care, as well as guide clinicians in laying out priorities for improvement based on patient feedback. However, as with any major health care investment, a number of financial, legal, and regulatory challenges must be addressed in the creation of an ambulatory surgery center. Honing and incorporating these elements should be made a priority as ambulatory surgery centers are made increasingly prevalent 5.
1. eCFR :: 42 CFR Part 416 — Ambulatory Surgical Services. Available at: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-416#416.2.
2. What Patients Think About Their Hospitals and Ambulatory Surgery Centers: An Analysis of Patient Experience Surveys | Leapfrog. Available at: https://www.leapfroggroup.org/patient-experience-report.
3. Should your health care system invest in an ambulatory surgery center? A decision-making framework | The Bulletin. Available at: https://bulletin.facs.org/2017/11/should-your-health-care-system-invest-in-an-ambulatory-surgery-center-a-decision-making-framework/.
4. Gardner, T. F., Nnadozie, M. U., Davis, B. A. & Kirk, S. Patient anxiety and patient satisfaction in hospital-based and freestanding ambulatory surgery centers. J. Nurs. Care Qual. (2005). doi:10.1097/00001786-200507000-00008
5. ASCs: A Positive Trend in Health Care – Advancing Surgical Care. Available at: https://www.ascassociation.org/advancingsurgicalcare/aboutascs/industryoverview/apositivetrendinhealthcare.