Technical skills in the operating room: Implications for perioperative leadership and patient outcomes

Ambulatory anesthesia: restructuring for success

PURPOSE OF REVIEW

We review current evidence about organizational structures, patient selection criteria, safety measures, economic considerations, quality management, and staffing challenges in ambulatory anesthesia. The focus is on the facilitators and barriers related to the peri-interventional period and the potential concepts and innovations for the future development of ambulatory anesthesia services.

RECENT FINDINGS

Recent findings shed light on organizational structures in ambulatory anesthesia, including hospital-based centers, freestanding ambulatory centers, and office-based practices. Patient selection for ambulatory anesthesia involves a two-step process, considering both surgical and anesthetic factors. Safety measures, such as standardized guidelines and scoring systems, aim to ensure patient well being during the perioperative course. Economic considerations pose challenges due to the complexities of managing operating room efficiency and the variations in reimbursement systems. Quality management in ambulatory anesthesia emphasizes the need for outcome studies and patient-centered quality indicators. Staffing requirements necessitate highly skilled professionals with both technical and nontechnical skills, and structured education and training are essential.

SUMMARY

Ambulatory anesthesia is gaining importance due to advancements in surgical techniques and peri-interventional care. The review highlights the need for addressing challenges related to organizational structures, patient selection, patient safety, economic considerations, quality management, and staffing in ambulatory anesthesia. Understanding and addressing these factors are crucial for promoting the further development and improvement of ambulatory anesthesia services.

Coaching to Improve Individual and Team Performance in Anesthesiology

In addition to medical knowledge and psychomotor skills, anesthesiology practice requires the ability to work within a complex system, navigate social situations, manage conflict, and lead teams. Coaching has foundations in psychology and adult learning theory and uses a process of inquiry, reflection, and shared discernment to discover values, goals, and solutions. There is increasing use and evidence for coaching in medicine and anesthesiology to support personal and professional growth. Individual and group coaching for anesthesiologists may improve anesthesiologists' ability to communicate, collaborate and solve problems, improving well-being, culture, and plausibly, patient outcomes.