SURGICAL MEDICAL SERVICES
Category: General Surgery
Abstract : Most hospitals have extensive surgical services that include preoperative testing, which may include x-rays, CT scans, ultrasonography, blood tests, urinalysis, and/or an EKG. Medication counseling is offered for current patient prescriptions and how they should be taken during and after surgery. Informed consent forms are made available to patients, as well as patient advocate services for questi
Most hospitals have extensive surgical services that include preoperative testing, which may include x-rays, CT scans, ultrasonography, blood tests, urinalysis, and/or an EKG. Medication counseling is offered for current patient prescriptions and how they should be taken during and after surgery.
Informed consent forms are made available to patients, as well as patient advocate services for questions and assistance in understanding the consent form and similar documents. An anesthesiologist or an assistant discuss with the patient the patients history of allergies, previous reactions to anesthesia and special precautions that will be taken. Intravenous medications are usually begun in the patients room before surgery to relax the patient, with general anesthesia administered in the operating room. Aftercare
According to the National Center for Health Statistics of the Centers for Disease Control and Prevention (CDC), 40 million inpatient surgical procedures wereperformed in the United States in 2000, followed closely by 31.5 million outpatient surgeries. The procedures that were performed most frequently included:
• digestive system: 12 million procedures
• musculoskeletal system: 7.4 million procedures
• cardiovascular system: 6.8 million procedures
• eye: 5.4 million procedures
Inpatient aftercare
After inpatient surgery, most patients are taken to a recovery room and monitored by nursing staff until they regain full consciousness. If there are complications or if the patient develops respiratory or cardiac problems, he or she is transferred to a surgical intensive care unit equipped to deal with acute needs. Intensive care units (ICU) are highly advanced facilities in which patients are monitored by special equipment that measures their heart rate, breathing, blood pressure, and blood oxygen level. Some patients require a respirator to breathe for them and additional intravenous lines to deliver medication and fluids. Once stabilized, patients are transferred to their hospital room.
After returning to the room, the patient is encouraged to sit up, start walking, and do as much as possible to return to a normal level of activity. Special diets may be provided, as well as pain-killing medications and antibiotics if needed. A respiratory therapist will usually visit the patient with breathing equipment intended to help the patients lung function return to normal. A physical therapist may introduce the patient to an exercise program or to skills needed to manage with temporary or permanent physical limitations.
Discharge personnel help the patient plan to go home. Some hospitals follow up with an outpatient nurse or social worker service. Pharmaceutical services may be offered to fill take-home prescriptions without the requirement of visiting an outside pharmacy. Medical equipment, like wheelchairs or crutches and other durable equipment, may be provided by the hospital and then purchased by the patient for use at home.
Outpatient aftercare
Outpatient or ambulatory surgery services make up almost half of all surgeries in the United States as a result of advances in surgical equipment and technique that allow for laser treatments and other minimally invasive procedures. Outpatient procedures require comparatively little aftercare for the patient due to both the nature of the surgical procedure and the advantages of being able to use regional or local anesthesia. Aftercare in hospital outpatient clinics, ambulatory surgery centers, or office- based practices requires that patients recover from anesthetics in the facility. After the anesthetic has worn off, the patient is briefly monitored for complications and released to go home. Many surgical procedures now allow patients to go home after a short recovery period on the same day as the surgery, and benefit from minimal pain and a speedier recovery.
Morbidity and mortality rates
According to a health consumer organization, 98,000 people die each year in Americas hospitals as a result of medical errors. In recent years, many hospitals have introduced special safeguards to cut down on the number of mistakes in medication and surgical services. Two new practices have been adopted by quality hospitals. Computerized order entries for medications cut down drastically on the number of misread prescriptions. The other innovation reduces the number of medical errors in intensive care units by using specially trained physicians intensivists in the unit. Hospitals that have introduced these patient safety features can be found on the Internet at conssumer health sites.
Proprietary hospitals generally offer more services and high end care than government or community hospitals, with teaching hospitals offering the most highly developed new procedures and techniques along with services for the poor and special populations. For-profit hospitals, however, do not have lower rates of morbidity or mortality in their delivery of hospital services. One study in 2000 published by General Internal Medicine found that patients at for-profit hospitals suffered two to four times more complications from surgery as well as delays in diagnosing and treating illness than did patients in nonprofit hospitals. Previous research has shown that death rates are 25% higher in proprietary hospitals than in teaching hospitals, and 6 - 7% higher in proprietary hospitals than in nonprofit institutions.
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