The Role of the Pharmacist in Ambulatory Surgery

1995 more than 60 % of patients requiring surgery will be treated in an outpatient (ambulatory) setting.' Compared with 10 years ago, the types of surgical procedures performed on an outpatient basis have greatly expanded. This can be attributed to a change in the guidelines used for determining patients suitable for outpatient surgery, which has mainly occurred secondary to changes in technology and the introduc-HE ESCALATING COST of medical care T has made it necessary to curtail spending, while at the same time insuring a safe, high level of patient care. This applies to all aspects of medical care including surgery. Many surgeries formerly performed on an inpatient basis are now being done in the ambulatory setting. Ambulatory surgery settings can be divided into two types: the department within a hospital, and the free-standing ambulatory surgery center (ASC). The types of surgeries performed on an outpatient basis will vary from institution to institution, depending on the patient selection criteria used by the institution. Most patients undergoing surgery in the ambulatory setting are classified as ASA I or I1 (Table l), but class 111 patients who have been medically cleared by their primary care provider are also candidates for the ambulatory setting. The ambulatory surgery setting provides new:pportunities for the pharmacist. While the types of cases performed in the ambulatory setting are not as intensive as the inpatient setting, there is often more opportunity for direct patient contact. Furthermore, by becom-ing totally integrated in the team approach used in these settings, the pharmacist can help to insure the best possible outcome for the ambu-latory surgery patient