>> AMBULATORY SURGERY IS BASICALLY THE IDEA OF HAVING
YOUR SURGERY AND GOING HOME THE SAME DAY.
>> THINGS IN AN AMBULATORY SURGICAL CENTER ARE PREDICTABLE.
>> WE TRY TO SELECT CASES THAT WE CAN START AND END
AT A REASONABLY PREDICTABLE TIME.
>> THERE ARE NO EMERGENCIES.
THERE ARE NO ADD-ONS.
EVERYBODY IS FOCUSED ON WHAT'S BEING DONE THAT DAY
AND THE PATIENTS THERE ARE THERE THAT DAY,
SO IT MAKES A REAL PLEASURE.
>> IT'S CONVENIENT.
IT'S NEXT DOOR TO YOUR HOUSE.
IT'S RIGHT IN YOUR COMMUNITY.
OKAY.
THE PARKING ISSUE-- THERE ARE NONE.
YOU PARK UNDER A TREE HERE.
YOU GET TO WALK 10 FEET, AND YOU'RE IN THE BUILDING.
>> WE'RE AS ABOUT AS FAR SOUTH IN JERSEY AS YOU CAN GET.
AND TO HAVE SOMETHING THIS CLOSE, THIS EASY TO GET TO...
>> MAIN ROADS ALL THE WAY.
>> AND I THINK IT'S EASIER ON THE KIDS NOT HAVING TO WALK
INTO THAT BIG HOSPITAL.
>> THE PRIMARY BENEFIT IS THE ENVIRONMENT,
THE CALMING AND SOOTHING NATURE OF THE ENVIRONMENT.
>> THE LITTLE THINGS THAT WE TRY TO DO FOR THE FAMILIES--
WE TRY TO OFFER THEM TO TOUR, TO MAKE THEM AND THEIR CHILDREN
FEEL MORE COMFORTABLE.
>> THEY'RE LESS STRESSED.
THEY'RE MORE CALM.
THEY CAN CONCENTRATE ON THE EXPLANATION OF WHAT'S GOING
TO BE DONE AND, WITH ADEQUATE PREPARATION,
IT'S JUST A MUCH MORE PLEASANT ENVIRONMENT FOR THE FAMILY
AND FOR THE CHILD.
>> WE'RE TRYING TO SET THE TIMES UP SO THAT FAMILIES COME IN,
AND THEY'RE NOT WAITING LONG.
>> WE WANT PATIENTS READY.
WE WANT SURGICAL TEAMS READY.
AND WE DON'T WANT PATIENTS TO HAVE TO WAIT.
>> THERE'S A WIDE RANGE OF SURGICAL PROCEDURES
THAT ARE DONE AT THE AMBULATORY CENTERS.
>> FROM AS SIMPLE AS AN EAR TUBE TO AS BIG AS AN ACL RECONSTRUCTION.
JUST ABOUT ANY PROCEDURE THAT YOU CAN HAVE AND GO HOME
THE SAME DAY, WE DO HERE AT THE SURGICAL CENTERS.
>> THERE ARE A VARIETY OF SPECIALISTS WHO PERFORM
PROCEDURES AT THE AMBULATORY CENTERS, THE EAR, NOSE, AND THROAT SPECIALISTS,
EYE DOCTORS, ORTHOPEDISTS, UROLOGISTS, PLASTIC SURGEONS, GENERAL SURGEONS,
AND GASTROENTEROLOGISTS.
>> EVERY ONE OF THE EMPLOYEES HERE ARE EMPLOYED BY CHOP.
>> THE NURSES ARE FULLY TRAINED, FULLY CERTIFIED,
AND CHOP-QUALITY NURSES.
>> ALL OF THE ANESTHESIOLOGISTS AND SURGEONS WHO WORK
AT THE SURGERY CENTERS ARE CHOP PHYSICIANS AS WELL.
THE BEAUTY OF THE SATELLITES IS THAT THEY'RE INTERCHANGEABLE.
YOU CAN AIRLIFT A SATELLITE AND ATTACH IT TO CHOP,
AND YOU WOULDN'T NOTICE ANY DIFFERENCE.
>> IT'S ALL THE SAME STAFF.
THEY'RE JUST IN DIFFERENT PLACES.
DR. KAZAHAYA-- I THINK THEY'RE CLONING HIM.
HE JUST POPS UP THERE.
AND POPS UP HERE AND POPS UP.
WE'VE THE SAME ANESTHESIOLOGIST, SO IT'S THE SAME STAFF THAT YOU
WOULD HAVE IN PHILADELPHIA.
>> WE KNOW EACH OTHER WELL, AND WE ARE ACCUSTOMED TO WORKING
WITH EACH OTHER IN ALL DIFFERENT TYPES OF CIRCUMSTANCES
AND UNDER ALL DIFFERENT TYPES OF CONDITIONS.
>> EACH OF THE SURGICAL CENTERS IS ALSO ATTACHED TO A SPECIALTY CENTER.
THAT'S BASICALLY AN AREA WHERE CONSULTATIONS ARE DONE,
PATIENTS ARE EXAMINED AND SEEN.
DECISIONS ARE MADE AS TO WHETHER THEY NEED ADDITIONAL CARE.
AND IT'S NOT JUST SURGICAL CARE IN THOSE SPECIALTY CENTERS,
IT'S ALSO SPECIALTY PEDIATRIC MEDICAL CARE.
USUALLY, THE CHILD WILL SEE THEIR OWN PEDIATRICIAN
AND THEN BE REFERRED TO ONE OF THE CHOP SURGEONS.
>> REFERRING PHYSICIANS ARE OUR EYES AND EARS.
THEY'RE THE ONES THAT IDENTIFY THE PROBLEMS IN THEIR PATIENTS,
IN THEIR GENERAL PEDIATRIC FAMILY PRACTICE,
AND THEY SEND THE PATIENTS TO US.
>> DEPENDING ON WHAT THE MEDICAL ISSUE IS,
WE MAKE A DECISION WHETHER OR NOT SURGERY IS INDICATED.
AND THEN ONCE A DECISION TO GO THROUGH A SURGICAL PROCEDURE
IS MADE, THE NEXT LEVEL OF DECISION MAKING IS,
"IS THE CHILD APPROPRIATE FOR A PROCEDURE TO BE DONE AS
AN OUTPATIENT AT A CENTER SUCH AS THIS, AN AMBULATORY CENTER
WHICH IS OFF CAMPUS?"
>> WE'RE VERY SELECTIVE ABOUT THE PATIENTS THAT WE BRING OUT.
THE CHILDREN HAVE TO BE BASICALLY HEALTHY.
IF THEY HAVE A SIGNIFICANT CARDIAC HISTORY,
IF THEY HAVE A SIGNIFICANT NEUROLOGICAL HISTORY,
IF THEY HAVE AN AIRWAY HISTORY THAT WOULD MAKE IT DIFFICULT
FOR AN INTUBATION, THOSE PATIENTS THAT HAVE THOSE KNOWN PROBLEMS
DON'T COME TO THE SATELLITES.