Suggestedinternational terminologyand definitionsAmbulatory surgery is - PDF document

1 PREAMBLE Suggestedinternational terminol
PREAMBLE Suggestedinternational terminologyand definitionsAmbulatory surgery is expanding throughout the world and it is considered that at least 75%, if not more,of all operations/procedures will ultimately be carried out in ambulatory surgery centres/units.The International Association for Ambulatory Surgery believes that it is important to prepare a list of basicdefinitions of ambulatory (day) surgery which will enable data to

2 be collected for the comparison of am-bu
be collected for the comparison of am-bulatory surgery practice from one nation to another A multiplicity of terminology has gradually develo-ped which is causing confusion and problems in comparing ambulatory surgery practice in the differentnations.Fundamentally, ambulatory surgery should expand by the inclusion of operations on patients who are cur-rently admitted into acute bed hospitals as inpatients. Nevertheless, technologi

3 cal advances have stimula-ted the develo
cal advances have stimula-ted the development of new techniques and modifications of existing techniques, which will further in-crease ambulatory surgery practice.The difficulty in producing a set of definitions which will apply to clinical practice and the health care sys-tem of each nation is appreciated. For this reason, member nations of the International Assocîation forAmbulatory Surgery have been invited to translate. the de

4 finitions into their own languages and i
finitions into their own languages and includeany necessary interpretation applicable to their health care systems.An increasing number of operations/procedures, mostly minor but including some intermediate type, arecarried out as office based/out patient, surgery. This group should be recognised as a separate entity, dis-tinct from ambulatory surgery.The great majority of ambulatory surgery operations/procedures are elective, how

5 ever appropriately selec-ted acute surgi
ever appropriately selec-ted acute surgical operations, including trauma, can also be carried out in ambulatory surgery centres/units.It is emphasised that the ultimate choice of patient and procedure to be carried out in ambulatory surgerycentres/units must remain the responsibility of the attending surgeon and/or anaesthetist. Terminology of the following Ambulatory Surgery definitionsmay be interpreted and expressed in more app

6 ropriate terms tosatisfy the specific re
ropriate terms tosatisfy the specific requirements of healthcare authorities ineach nation. VOCABULARY AND PRECISIONS •Time frame: working day - no overnight stay. y •Synonyms: 23 h. Overnight stay. Single night.•Time frame: under 24 hours•Time frame: 24 - 72 hours py , oncolo gy , renal dial y sis, etc.…A patient admitted into a hospital, public or private, for a stay of24 h or more. VOCABULARY AND TRADUCTION VOCABULARY& TRADUCTI

7 ONSYNONYMS AND TIME FRAMESAmbulatoryDenm
ONSYNONYMS AND TIME FRAMESAmbulatoryDenmarkAmbulantChirur g ie ambulatoireGermanyAmbulant, ta g eschirur g ischDa y Sur g er y NetherlandsAmbulantDa g behandlin g PolandPortugalChirurgia ambulatoryjnaCirur g ia Ambulatória; Cirur g ia e/ou Anestesia Ambulatória.SpainCiru g ía Ma y or Ambulatoria ( CMA ) Ambulatory Surgery Centre (facility)DenmarkAmbulant kirur g isk klinikFranceUnité de chirur g ie ambulatoireAmbulantes O p erat

8 ionszentrum ( Einrichtun g) , Ta g esch
ionszentrum ( Einrichtun g) , Ta g eschirur g ieItalyCentro di Da y Sur g er y Da g centrum / kliniekNorway/ScandinaviaDa g kirur g isk senterCentrum (Orodek) Chirurgii AmbulatoryjnejPortugalSpainUnidade de Cirur g ia Ambulatória ( UCA ) Unidad de Ciru g ía Ma y or Ambulatoria ( UCMA ) Outpatient DepartmentDenmarkAmbulatoriumUnité de chirur g ie ambulatoire : UCAGermanyPoliklinik, Abteilun g f ür Ta g eschirur g ieDi p artim

9 ento ambulatoriale ( Centro di Servizi
ento ambulatoriale ( Centro di Servizi Ambulatoriali ) NetherlandsPolikliniekPoliklinikkPolandPortugalPrzychodniaDe p artamento de AmbulatórioOutpatient.SpainConsulta ExternaDenmarkAmbulant p atientFrancePatient p ris en char g e en chirur g ie ambulatoire.Ambulanter PatientItalyPaziente ambulatorialePoliklinische p atiëntNorway/ScandinaviaPolikliniskPacjent ambulatoryjnyPortugalSpainDoente em AmbulatórioPaciente AmbulatorioIn

10 patientDenmarkIndla g t p atientPatient
patientDenmarkIndla g t p atientPatient hos p italiséGermanyStationärer PatientPaziente ricoverato in re g ime ordinarioNetherlandsO pg enomen p atiëntInnla g t p asientPolandPortugalPacjent hospitalizowanyDoente InternadoSpainPaciente in g resado Ambulatory Surgery / Procedure PatientDenmarkDa g kirur g isk klinik/centerPatient p ris en char g e en chirur g ie ambulatoire.GermanyItalyPatient für ambulanten chirurgischen Eing

11 riff, für tageschirur- g ischen Ein g ri
riff, für tageschirur- g ischen Ein g ri ff Pazienti arruolati p er la Da y Sur g er y NetherlandsNorway/ScandinaviaDa g chirur g ie p atientDa g kirur g isk PasientPolandPortugalPacjent leczony w trybie dziennego pobytuDoente submetido a um procedimento em regime de CirurgiaAmbu-latóriaSpainPaciente de CMAAmbulatory Surgery Center (Facility)DenmarkDa g kirur g isk SenterFranceCentre, unité de chirur g ie ambulatoireAmbulantes

12 O p erationszentrum ( Einrichtun g) , T
O p erationszentrum ( Einrichtun g) , Ta g esklinikItalyCentro di Da y Sur g er y Da g centrum / A f delin g voor da g behandelin g / da g ver p le g in g Norway/ScandinaviaPolandDa g kirur g isk SenterCentrum (Orodek) Chirurgii AmbulatoryjnejAmbulatory Surgery / Procedure - Extended Recovery PatientPortugalSpainUnidade de Cirur g ia Ambulatória ( UCA ) Unidad de Ciru g ía Ma y or Ambulatoria ( UCMA ) DenmarkFranceDa g kiru

13 r g isk p atient med udvidet o p vå g n
r g isk p atient med udvidet o p vå g nin g GermanyItalyAmbulante Operation / Prozedur – Patient mit verlängertem Erho-lun g sbedar f , PraxisklinikPaziente sottoposto ad una procedura chirurgica di Day Surgeryche necessita di osservazione p rolun g ataNetherlandsDa g kirur g isk p rosed y re – Utvidet recover y PolandPortugalPac j ent leczon y w tr y bie hos p italizac j i “ j ednodniowe j ”Doente submetido a intervenção em r

14 egime de Cirurgia Ambu-latória com p er
egime de Cirurgia Ambu-latória com p ernoita hos p italarSpainPaciente de Recu p eración Prolon g ada DENMARK DEFINITIONSDenmarkBy theDansk Selskab for Dag-Kirurgi(DSDK)Danish Association of Day SurgeryDept. of Day SurgeryHaderslev hospitalDK-6100 HaderselvDenmark - 2 -DEFINITIONS - GENERALGENERELLE DEFINITIONERSurgery / OfficeKirurgisk speciallægepraksisA medical practitioner's professio-nal premises. En kirurgs professionelle l

15 okalite-ter.Outpatient DepartmentAmbulat
okalite-ter.Outpatient DepartmentAmbulatoriumOutpatient.Ambulant patientInpatientIndlagt patientSection(s) of a hospital or a freestanding ambulatory surgery cen-tre, public or private, for the mana-gement of outpatients.Del(e) af et hospital ellerselvstændig dagkirurgisk klinik, of-fentlig eller privat, indrettet til be-handling af ambulante patienterA patient treated solely in theoutpatient department, includingsuch services as

16 ambulatory proce-dure, interventional ra
ambulatory proce-dure, interventional radiology, ra-diotherapy, oncology, renal dialy-sis, etc…Patient behandlet udelukkende iambulatoriet, includerende ydelsersom ambulante procedurer, inter-ventions radiologi, stråleterapi,onkologi, dialyse, etc.A patient admitted into a hospital,public or private, for a stay of 24 hor more.Patient indlagt i hospital, offentligteller privat i mere end 24 timer. Ambulatory SurgeryCenter (Facility

17 )Dagkirurgisk klinik/centerAmbulatory Su
)Dagkirurgisk klinik/centerAmbulatory Surgery /Procedure - ExtendedDagkirurgisk patient medudvidet opvågningAmbulatory Surgery /Procedure - ExtendedDagkirurgisk enhed medudvidet opvågningA centre (facility) designed for theoptimum management of an ambu-latory surgery/procedure patient. Klinik/center indrettet til optimalbehandlin g af da gp atienter.A patient treated in ambulatory sur-gery / procedure centre / unit, freestandin

18 g or hospital based, who re-quires exten
g or hospital based, who re-quires extended recovery includingovernight stay, before discharge thefollowing day. Patient, der behandles i dagkirur-gisk klinik/center, fritstående eller itilknytning til hospital, som kræverovernatning inden udskrivelse da- g en efter ind g or within an ambulatory surgery •Synonyms: 23 h. Overnight stay.•Time frame: under 24 hours p italisation ) •Time frame: 24-72 hours ) .Surgery / OfficeCabinet

19 médicalA medical practitioner's professi
médicalA medical practitioner's professio-nal premises. Un local professionnel destiné àune p rofession médicale.Hors du champ réglementaire de lachirurgie ambulatoire en France. tient qui ne nécessite ni hospitali- p italisation.C'est le patient qui est ambulatoireet non l'acte. C'est la prise encharge qui définit l'ambulatoire etnon l'acte. Pourtant cet acte, cetteintervention fait partie de ceux quine peuvent ou ne doivent pa

20 s êtrefaits en cabinet médical. Cette pr
s êtrefaits en cabinet médical. Cette priseen charge est substitutive d'uneprise en charge faite habituellementen hospitalisation. Le patient nepasse pas la nuit dans l'UCA. Lanotion de nuit et de jour se juge parrapport à un cycle quotidien de du-rée de travail.Un patient subissant une opérationou une intervention, non praticableen cabinet médical, qui est admis etqui ressort sur avis médical le jourmême, sans nuit d'hospitalisat

21 ion.A centre (facility) designed for the
ion.A centre (facility) designed for theoptimum management of an ambu-latory surgery/procedure patient. Un centre (une structure) conçupour la gestion optimum d'un pa-tient pris en charge en ambulatoire.Un centre, une unité, une structureconçu pour optimiser la prise encharge d'un patient en chirurgieambulatoire. GERMANY DEFINITIONSGermanyBy theBundesverbandfür Ambulantes Operieren e. V.(BAO)BAO Bundesverband für Ambulantes Operie

22 ren e.V.Sterntorbrücke 153111 BonnTel. 0
ren e.V.Sterntorbrücke 153111 BonnTel. 0228 692423Fax. 631715E mail : BAOBonn@T-Online.de 1)Synonyms and time frames2)Definitions - general3)Definitions - surgery / office or outpatient ) Definitions - ambulator y sur g er y Die ambulanten chirurgischen Eingriffe/Prozedu-ren sind größtenteils elektive Eingriffe, wobei je-doch entsprechend ausgewählte akute chirurgischeEingriffe, einschließlich Traumata, auch in ambu-lanten Opera-

23 tionszentren/-einheiten durchgeführtwerd
tionszentren/-einheiten durchgeführtwerden können.Wir betonen, dass die endgültige Auswahl des Pa-tienten und der in ambulanten Operationszentren/-einheiten durchzuführenden Prozedur auch wei-terhin in der Verantwortung des behandelndenChirur g s und/oder Anästhe-sisten lie g en muss.Die Fachbegriffe für die folgenden Definitionenzum ambulanten Operieren können evtl. mit tref-fenderen Begriffen interpretiert und ausgedrücktwerden,

24 um den jeweiligen Anforderungen derGesu
um den jeweiligen Anforderungen derGesundheitsbehörden eines jeden Landes zuentsprechen. Terminolo g ie- 1 -SYNONYMS AND TIME FRAMESSYNONYME UND ZEITLICHE RAHMENPrecisionsErläuterun g •Time frame: working day - no g Outpatient.Ambulanter PatientInpatientStationärer PatientA patient treated solely in theoutpatient department, includingsuch services as ambulatory proce-dure, interventional radiology, ra-diotherapy, oncology, rena

25 l dialy-sis, etc…Patient, der ausschließ
l dialy-sis, etc…Patient, der ausschließlich in derArztpraxis oder im outpatient De-partment eines Krankenhauses be-handelt wird, einschließlich medi-zinischer Dienstleistungen wiebeispielsweise am-bulante Untersu-chungen , interventionelle Radiolo-gie, Strahlentherapie, On-kologie,Nierendial y se, Kardiolo g ie etc.…A patient admitted into a hospital,public or private, for a stay of 24 hor more.Patient, der für einen mindestens24

26 -stündigen Aufenthalt in ein öf-fentlich
-stündigen Aufenthalt in ein öf-fentliches oder privates Kranken-haus auf g enommen wird.Krankenhaus, Klinik, HospitalIn einem Krankenhaus werdenKranke behandelt, untergebrachtund verpflegt.Kurzstationärer AufenthaltStationärer Aufenthalt zwischen 24und 72 Stunden.- 3 -DEFINITIONS - SURGERY / OFFICE OR OUTPATIENTDEFINITIONEN - OPERATIONSRAUM / ARZTPRAXIS ODER AMBULANTSurgery / Office Proce-Prozedur im Operations-raum / in der Arzt

27 praxisAn operation or procedure carriedo
praxisAn operation or procedure carriedout in a medical practitioner's pro-fessional premises which providesan appropriately designed, equip-ped and serviced room(s) for itssafe performance.In den Praxisräumen eines Fa-charztes durchgeführte Operationoder Eingriffe, wobei diePraxisräume über (einen) entspre-chend ge-staltete/n, ausgestattete/nund gewartete/n Raum/Räume fürdie sichere Durchführung einer sol-chen Operation oder Eing

28 riffeverfü g eines öf- or within an amb
riffeverfü g eines öf- or within an ambulatory surgery g t. Q uelle: BAO-Info IV/98, S. 25-26BAO Bundesverband für Ambulantes Operieren e.V.Sterntorbrücke 1 @ T-Online.de AMBULATORY (DAY) SURGERYDEFINITIONSPREAMBLEAmbulatory surgery is expanding throughout theworld and it is considered that at least 75%, if notmore, of all operations/procedures will ultimatelybe carried out in ambulatory surgery centres/units.The International A

29 ssociation for Ambulatory Sur-gery belie
ssociation for Ambulatory Sur-gery believes that it is important to prepare a list ofbasic definitions of ambulatory (day) surgerywhich will enable data to be collected for the com-parison of ambulatory surgery practice from onenation to another A multiplicity of terminology hasgradually developed which is causing confusionand problems in comparing ambulatory surgery p ractice in the different nations.Fundamentally, ambulatory sur

30 gery should expandby the inclusion of op
gery should expandby the inclusion of operations on patients who arecurrently admitted into acute bed hospitals as inpa-tients. Nevertheless, technological advances havestimulated the development of new techniques andmodifications of existing techniques, which willfurther increase ambulator y sur g er y p ractice.The difficulty in producing a set of definitionswhich will apply to clinical practice and the healthcare system of e

31 ach nation is appreciated. For thisreaso
ach nation is appreciated. For thisreason, member nations of the International As-socîation for Ambulatory Surgery have been invi-ted to translate. the definitions into their own lan-guages and include any necessary interpretationa pp licable to their health care s y stems.An increasing number of operations/procedures,mostly minor but including some intermediatetype, are carried out as office based/out patient,surgery. This group

32 should be recognised as a se- p arate en
should be recognised as a se- p arate entit y , distinct from ambulator y sur g er y .The great majority of ambulatory surgery opera-tions/procedures are elective, however appropria-tely selected acute surgical operations, includingtrauma, can also be carried out in ambulatory sur- g er y centres/units.It is emphasised that the ultimate choice of patientand procedure to be carried out in ambulatory sur-gery centres/units must re

33 main the responsibilityof the attendin g
main the responsibilityof the attendin g sur g eon and/or anaesthetist.DEFINIZIONILa Day Surgery si sta espandendo in tutto il mon-do e si considera che almeno il 75%, se non più, ditutti gli interventi chirurgici/procedure invasive sa-ranno a breve termine condotte in centri/unità dichirur g ia ambulatoriale.La IAAS ritiene che sia importante preparare unalista di definizioni di base sulla Day Surgery cherenda possibile raccogli

34 ere dati per il confrontodella pratica d
ere dati per il confrontodella pratica di Day Surgery tra un Paese e l’altro.Una vasta terminologia si è gradualmente svilup-pata e sta creando confusione e problemi nel con-fronto dell’ attività di Day Surgery tra i vari Paesi.La difficoltà nel produrre una serie di definizioniche possano essere applicate alla pratica clinica edal Sistema Sanitario di ciascun Paese è notevole.stato chiesto di tradurre le definizioni nella lorolin

35 gua e di inserire qualsiasi necessaria i
gua e di inserire qualsiasi necessaria interpreta-zione applicabile al loro sistema sanitario.La grande maggioranza di interventi chirurgici/procedure invasive di Day Surgery sono elettive,anche se casi selezionati di particolari operazionichirurgiche, inclusi traumi, possono essere condot-ti in centri/unità di Da y Sur g er y .Va sottolineato che al chirurgo e/o anestesista res-ponsabile rimane la scelta ultima del paziente edel

36 la procedura da effettuare in centri/uni
la procedura da effettuare in centri/unità di DaySurgery.Ci auguriamo che le seguenti definizioni fornisca-no una base per il confronto nazionale ed interna-zionale dell’ attività di Day Surgery. (F.I.D.S.) mente strutturato e attrezzato per Ambulatory Surgery /Procedure - ExtendedPaziente sottoposto aduna procedura chirurgicadi Day Surgery che neces-sita di osservazione pro-lungataA patient treated in ambulatory sur-gery / proc

37 edure centre / unit, freestanding or hos
edure centre / unit, freestanding or hospital based, who re-quires extended recovery includingovernight stay, before discharge thefollowing day. Paziente sottoposto a procedura/chirurgia ambulatoriale in un cen-tro/unità, autonoma o ospedaliera,che richiede un prolungamentodell’osservazione e/o cura che in-cluda la notte, per essere dimesso il g iorno se g or within an ambulatory surgery y sur g@ uni p d.it •Synonyms: 23 h. Overn

38 ight stay.•Time frame: under 24 hours•Ti
ight stay.•Time frame: under 24 hours•Time frame: 24-72 hours Ambulatory SurgeryCenter (Facility)Dagcentrum / Afdelingvoor dagbehandeling /dagverplegingAmbulatory Surgery /Procedure - ExtendedAmbulatory Surgery /Procedure - ExtendedLimited care accomoda-tionA centre (facility) designed for theoptimum management of an ambu-latory surgery/procedure patient. Een afdeling (gebouw) bestemdvoor de optimale behandeling vaneen dagchirur

39 gie patiëntA patient treated in ambulato
gie patiëntA patient treated in ambulatory sur-gery / procedure centre / unit, freestanding or hospital based, who re-quires extended recovery includingovernight stay, before discharge thefollowing day. Een patiënt die is behandeld in eendagcentrum, zelfstandig gevestigdof in een ziekenhuis, waarna op-name noodzakelijk is gedurende 1nacht, met ontslag de volgendeda g or within an ambulatory surgeryHotel/ziekenhuishotel waar pro

40 fes- g rote reisafstand. AMBULATORY (DAY
fes- g rote reisafstand. AMBULATORY (DAY) SURGERYDEFINITIONSPREAMBLEAmbulatory surgery is expanding throughout theworld and it is considered that at least 75%, if notmore, of all operations/procedures will ultimatelybe carried out in ambulator y sur g er y centres/units.The International Association for Ambulatory Sur-gery believes that it is important to prepare a list ofbasic definitions of ambulatory (day) surgerywhich will e

41 nable data to be collected for the com-p
nable data to be collected for the com-parison of ambulatory surgery practice from onenation to another A multiplicity of terminology hasgradually developed which is causing confusionand problems in comparing ambulatory surgery p ractice in the different nations.Fundamentally, ambulatory surgery should expandby the inclusion of operations on patients who arecurrently admitted into acute bed hospitals as inpa-tients. Nevertheless,

42 technological advances havestimulated th
technological advances havestimulated the development of new techniques andmodifications of existing techniques, which willfurther increase ambulator y sur g er y p ractice.The difficulty in producing a set of definitionswhich will apply to clinical practice and the healthcare system of each nation is appreciated. For thisreason, member nations of the International As-socîation for Ambulatory Surgery have been invi-ted to trans

43 late. the definitions into their own lan
late. the definitions into their own lan-guages and include any necessary interpretationa pp licable to their health care s y stems.An increasing number of operations/procedures,mostly minor but including some intermediatetype, are carried out as office based/out patient,surgery. This group should be recognised as a se- p arate entit y , distinct from ambulator y sur g er y .The great majority of ambulatory surgery opera-tions/pr

44 ocedures are elective, however appropria
ocedures are elective, however appropria-tely selected acute surgical operations, includingtrauma, can also be carried out in ambulatory sur- g er y centres/units.It is emphasised that the ultimate choice of patientand procedure to be carried out in ambulatory sur-gery centres/units must remain the responsibilityof the attendin g sur g eon and/or anaesthetist. (NDF) - 2 -DEFINITIONS - GENERALSurgery / OfficeKirurgisk kontorA med

45 ical practitioner's professio-nal premis
ical practitioner's professio-nal premises. En kirurgs arbeidsplass for admi-nistrasjon, pasientmottak, diagnos-tikk o g enklere behandlin g .Outpatient DepartmentPoliklinikkOutpatient.PolikliniskInpatientInnlagt pasientSection(s) of a hospital or a freestanding ambulatory surgery cen-tre, public or private, for the mana-gement of outpatients.Del av et sykehus eller dagkirurgisenter/enhet, offentlig eller privat,for håndtering av

46 polikliniske pa-sienter. Prosedyrer hvo
polikliniske pa-sienter. Prosedyrer hvor det ikkekreves profesjonell observasjon el-ler behandling når prosedyren eravsluttet, og hvor pasienten ikkeoppholder seg i lengre tid ellerovernatter i helse-enhet i forbindel-se med prosedyren.A patient treated solely in theoutpatient department, includingsuch services as ambulatory proce-dure, interventional radiology, ra-diotherapy, oncology, renal dialy-sis, etc…Pasient som utelukkend

47 e behandlesved poliklinikk.A patient adm
e behandlesved poliklinikk.A patient admitted into a hospital,public or private, for a stay of 24 hor more.Pasient som overnatter i sykehus,privat eller offentlig; vanligvisopphold på 24 timer eller mer.Innleggelse: Overnatting i sykehus,dvs. enhet med kontinuerlig vak-thold av helsepersonell Ambulatory Surgery /Procedure - ExtendedDagkirurgisk prosedyre –Utvidet recoveryAmbulatory Surgery /Procedure - ExtendedDagkirurgisk utvid

48 et reco-very enhetA patient treated in a
et reco-very enhetA patient treated in ambulatory sur-gery / procedure centre / unit, freestanding or hospital based, who re-quires extended recovery includingovernight stay, before discharge thefollowing day. En dagkirurgisk pasient som kreverutvidet recovery, inkludert overnat-tin g , før utskrivelse p åføl g ende da g or within an ambulatory surgery p raksis i norsk helsevesen, derfor innebærer oversettelse til norsk en viss

49 bearbeidelse. Hotel / hostel accomodatio
bearbeidelse. Hotel / hostel accomodation forambulatory surgery / procedure pa-tients where professional healthcare is avaible on an on-call basis.Hotel eller lignende for dagkirurgipasienter hvor helsepersonell kantilkalles.Accomodation without profession-nal health care for ambulatory sur-gery / procedures: required by pa-tients for domestic, social or travelreasons.Losji for pasienter og/ellerpårørende, med normal (dvs. re-seps

50 jonsbasert) beredskap for åbistå los j e
jonsbasert) beredskap for åbistå los j erende med p roblemer. AMBULATORY (DAY) SURGERYDEFINITIONSPREAMBLEAmbulatory surgery is expanding throughout theworld and it is considered that at least 75%, if notmore, of all operations/procedures will ultimatelybe carried out in ambulatory surgery centres/units.The International Association for Ambulatory Sur-gery believes that it is important to prepare a list ofbasic definitions of amb

51 ulatory (day) surgerywhich will enable d
ulatory (day) surgerywhich will enable data to be collected for the com-parison of ambulatory surgery practice from onenation to another A multiplicity of terminology hasgradually developed which is causing confusionand problems in comparing ambulatory surgerypractice in the different nations.Fundamentally, ambulatory surgery should expandby the inclusion of operations on patients who arecurrently admitted into acute bed hospitals

52 as inpa-tients. Nevertheless, technolog
as inpa-tients. Nevertheless, technological advances havestimulated the development of new techniques andmodifications of existing techniques, which willfurther increase ambulatory surgery practice.The difficulty in producing a set of definitionswhich will apply to clinical practice and the healthcare system of each nation is appreciated. For thisreason, member nations of the International As-socîation for Ambulatory Surgery have

53 been invi-ted to translate. the definit
been invi-ted to translate. the definitions into their own lan-guages and include any necessary interpretationapplicable to their health care systems.An increasing number of operations/procedures,mostly minor but including some intermediatetype, are carried out as office based/out patient,surgery. This group should be recognised as a se-parate entity, distinct from ambulatory surgery.CHIRURGIA AMBULATORYJNAPODSTAWOWE DEFINICJEWST

54 P Rozwój chirurgii ambulatoryjnej na cay
P Rozwój chirurgii ambulatoryjnej na caym w o do mi praktyki prowadzonej w tej dziedzinie. terminów i spowodowa si dzi do leczenia stacjonarnego ist- trudno dotyczy praktyki kli- nieco w gabi- uznane grup si chirurgii Medycyny i Chirurgii Ambulatoryjnej(PAAMS) •Time frame: working day - no Chi-•Synonyms: 23 h. Overnight stay.•Time frame: under 24 hours obejmuje: okres przy- potrzebnej opieki•Time frame: 24-72 hours odpo- sta

55 cjonarny lub oddzia pozosta- odbycia po
cjonarny lub oddzia pozosta- odbycia podró* W Polsce nie rozró zabiegów (procedur) ambulatoryjnych wykonywanych w gabine- (MZiOS, Warszawa 1999)*** Forma pobytu wykorzystywana w Polsce g**** Forma pobytu nie wyst miennictwo:Staniszewski A.: Koncepcja szpitalnej opieki dziennej i chirurgii "jednego dnia" (ambulatoryjnej) [Theconcept of hospital day care and one-day (ambulatory) surgery]. Polska Medycyna Rodzinna (Polish Fa-mily Me

56 dicine) 2002; 4(3): 377-380.Staniszewski
dicine) 2002; 4(3): 377-380.Staniszewski A.: Chirurgia “jednego dnia” – organizacja, funcjonowanie i strategia rozwoju. Wyd. Con-tinuo, Wrocaw 2004 [w druku].PAAMSul. Syrokomli 151-141 WROCLAWPoland •Synonyms: 23 h. Overnight stay.•Time frame: under 24 hours p ernoita hos p italar.Horários: a legislação portuguesapermite hospitalização superior a12 horas, até um máximo de 23 ho-ras, com pernoita hospitalar.Short stayCurta estadia

57 hospitalar ( de 24 a 72 horas ) - 2 -DE
hospitalar ( de 24 a 72 horas ) - 2 -DEFINITIONS - GENERALDEFINI Ç •Time frame: 24-72 hours p ou privado, destinado ao tratamen-to de doentes em regime ambu-de um hospital, público ou priva-público ou privado, para uma hos-pitalização igual ou superior a 24 Procedimento em regime p italiza ç ão nocturna.Procedimento (intervenção, explo-ração) realizado em regime de Ci-rurgia Ambulatória, numa Unidadede Cirurgia Ambulatória,

58 tendo odoente alta no mesmo dia sem per
tendo odoente alta no mesmo dia sem per-noita hospitalar.É o regime utilizado e não o actoque define Cirurgia Ambulatória, jáque o mesmo procedimento podeser feito em regime de internamen-to.Doente submetido a uma interven-ção ou procedimento realizado emregime de Cirurgia Ambulatória,numa Unidade de Cirurgia Ambu-latória, cuja admissão e alta ocor-rem no mesmo dia, sem pernoitahospitalar.A centre (facility) designed for theoptim

59 um management of an ambu-latory surgery/
um management of an ambu-latory surgery/procedure patient. Centro ou unidade (estrutura) pla-neada para tratamento optimizadode um doente em regime de Cirur-gia Ambulatória.A patient treated in ambulatory sur-gery / procedure centre / unit, freestanding or hospital based, who re-quires extended recovery includingovernight stay, before discharge thefollowing day. Doente submetido a intervenção/procedimento numa Unidade deCirurgia A

60 mbulatória, pública ouprivada, com perno
mbulatória, pública ouprivada, com pernoita hospitalar,antes da alta no dia se g ção numa Unidade de Cirurgia SPAIN DEFINITIONSSpainBy theAsociacion Españolade Cirugía Mayor Ambulatoria(ASECMA)Asociacion Española de Cirugia Mayor Ambulatoria (ASECMA)Apartado de Correos 9191,28080 Madrid�http://www.asecma.org AMBULATORY (DAY) SURGERYDEFINITIONSPREAMBLEAmbulatory surgery is expanding throughout theworld and it is considered

61 that at least 75%, if notmore, of all o
that at least 75%, if notmore, of all operations/procedures will ultimatelybe carried out in ambulator y sur g er y centres/units.The International Association for Ambulatory Sur-gery believes that it is important to prepare a list ofbasic definitions of ambulatory (day) surgerywhich will enable data to be collected for the com-parison of ambulatory surgery practice from onenation to another A multiplicity of terminology hasgra

62 dually developed which is causing confus
dually developed which is causing confusionand problems in comparing ambulatory surgery p ractice in the different nations.Fundamentally, ambulatory surgery should expandby the inclusion of operations on patients who arecurrently admitted into acute bed hospitals as inpa-tients. Nevertheless, technological advances havestimulated the development of new techniques andmodifications of existing techniques, which willfurther increase

63 ambulator y sur g er y p ractice.The
ambulator y sur g er y p ractice.The difficulty in producing a set of definitionswhich will apply to clinical practice and the healthcare system of each nation is appreciated. For thisreason, member nations of the International As-socîation for Ambulatory Surgery have been invi-ted to translate. the definitions into their own lan-guages and include any necessary interpretationa pp licable to their health care s y stems.An incre

64 asing number of operations/procedures,mo
asing number of operations/procedures,mostly minor but including some intermediatetype, are carried out as office based/out patient,surgery. This group should be recognised as a se-parate entity, distinct from ambulatory surgery.The great majority of ambulatory surgery opera-tions/procedures are elective, however appropria-tely selected acute surgical operations, includingtrauma, can also be carried out in ambulatory sur- g er y

65 centres/units.It is emphasised that the
centres/units.It is emphasised that the ultimate choice of patientand procedure to be carried out in ambulatory sur-gery centres/units must remain the responsibilityof the attendin g sur g La Cirugía Ambulatoria se esta extendiendo y se g imen de CMA.La IAAS considera importante preparar una listade definiciones básicas en CMA que permita reco-ger datos para establecer comparaciones entre unpaís y otro. Progresivamente se han de

66 sarrolladomúltiples terminologías, crean
sarrolladomúltiples terminologías, creando confusión y pro-blemas al comparar la practica de la CMA entrelos diferentes países.Fundamentalmente, la CMA se expandiría con lainclusión de operaciones en pacientes que actual-mente son ingresados en camas de agudos de loshospitales. Sin embargo, los avances tecnológicoshan favorecido el desarrollo de nuevas técnicas ymodificaciones de las técnicas existentes, que in-crementaran los p

67 rocedimientos de CMA.Se aprecia la dific
rocedimientos de CMA.Se aprecia la dificultad para producir un conjuntode definiciones que se apliquen a la practica clíni-ca y a los sistemas sanitarios de cada país. Por estarazón, los miembros de la IAAS han sido invitadosa traducir las definiciones a su propia lengua e in-cluir cualquier interpretación aplicable a su propiosistema sanitario.Un numero cada vez mayor de operaciones / pro-cedimientos, principalmente menores pero

68 in-cluyendo algunos intermedios, se llev
in-cluyendo algunos intermedios, se llevan acabocomo cirugía en consulta. Este grupo debe ser con-siderado como una entidad separada, diferente a laCMA.La gran mayoría de operaciones / procedimientosde CMA son electivos, aunque algunas operacio-nes urgentes, por ejemplo, en traumatología, pue-den también realizarse en los centros y unidades deCMA.De cualquier manera la decisión ultima sobre si unpaciente o procedimiento es selecci

69 onado paraCMA debe ser responsabilidad d
onado paraCMA debe ser responsabilidad del cirujano y/oanestesiólo g o. (ASECMA) 1)Synonyms and time frames2)Definitions - general3)Definitions - surgery / office or outpatient4)Definitions - ambulatory surgery ) Definitiones cirur g ia ambulatoria PrecisionsComments•Time frame: working day - no p ital •Synonyms: Day Clinic. Day Sur-gery Centre / Unit. AmbulatorySurgery Unit.Sinónimos: Unidad de Cirugía sinIngreso (UCSI). Unidad

70 de Ci-ru g ía de Día. Hos p •Synonyms: 2
de Ci-ru g ía de Día. Hos p •Synonyms: 23 h. Overnight stay.•Time frame: under 24 hours•Time frame: 24-72 hours - 3 -DEFINITIONS - SURGERY / OFFICE OR OUTPATIENTDEFINICIONES - CIRUGIA EN CONSULTASSurgery / Office Proce-dureIntervención o procedi-miento en consultaAn operation or procedure carriedout in a medical practitioner's pro-fessional premises which providesan appropriately designed, equip-ped and serviced room(s) for itssaf

71 e performance.Intervención o procedimien
e performance.Intervención o procedimiento reali-zado en una consulta medica quereúna las condiciones adecuadas dediseño, e q ui p amiento y se g zado en la Consulta de un hospital p ernocta en el hos p ital.A patient having an operation, pro-cedure excluding an office / surge-ry or outpatient operation/proce-dure, who is admitted and dischar-ged on the same working day. Paciente que es intervenido, ex-cluyendo un procedimiento

72 de con-sulta, y que es admitido y dado
de con-sulta, y que es admitido y dado dealta en el mismo día.A centre (facility) designed for theoptimum management of an ambu-latory surgery/procedure patient. Un centro dedicado al tratamientooptimo de pacientes ambulatorios International Association for Ambulatory Surgeryc/o BADS - Royal College or Surgeons35-43 Lincoln’s Inn FieldsWC2A 3PE LONDONENGLANDPhone: 44 20 7973 0308 - Fax: 44 20 7973 0314E-mail: bads@bads.co.uk BLAN