(DAY) SURGERY AMBULATORY - Suggested international terminology and definitions
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BLANKET International Association for Ambulatory Surgery AMBULATORY (DAY) SURGERY Suggested international terminology and definitions Approved by the Executive Committee - Paris 9/27/2003
TABLE OF CONTENTS International Association for Ambulatory Surgery AMBULATORY (DAY) SURGERY Suggested international terminology and definitions Table of contents IAAS official document ..........................................................................................................................................................................3 Preamble ...................................................................................................................................................................................3 Vocabulary ..............................................................................................................................................................................4 Vocabulary and precisions ..........................................................................................................................................5 Vocabulary and traduction ....................................................................................................................................................................7 Denmark ..........................................................................................................................................................................................................14 France ................................................................................................................................................................................................................20 Germany ..........................................................................................................................................................................................................27 Italy ......................................................................................................................................................................................................................33 The Netherlands .........................................................................................................................................................................................39 Norway .............................................................................................................................................................................................................45 Poland ................................................................................................................................................................................................................51 Portugal ............................................................................................................................................................................................................59 Spain ...................................................................................................................................................................................................................66
PREAMBLE International Association for Ambulatory Surgery AMBULATORY (DAY) SURGERY Suggested international terminology and definitions PREAMBLE Ambulatory 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 basic definitions of ambulatory (day) surgery which will enable data to 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 different nations. Fundamentally, ambulatory surgery should expand by the inclusion of operations on patients who are cur- rently admitted into acute bed hospitals as inpatients. Nevertheless, technological 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 for Ambulatory Surgery have been invited to translate. the definitions into their own languages and include any necessary interpretation applicable to their health care systems. An increasing number of operations/procedures, mostly minor but including some intermediate type, are carried 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, however 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 surgery centres/units must remain the responsibility of the attending surgeon and/or anaesthetist. Terminology of the following Ambulatory Surgery definitions may be interpreted and expressed in more appropriate terms to satisfy the specific requirements of healthcare authorities in each nation.
VOCABULARY International Association for Ambulatory Surgery AMBULATORY (DAY) SURGERY VOCABULARY -1- SYNONYMS AND TIME FRAMES 1.1 - Ambulatory 1.2 - Ambulatory Surgery Centre (facility) 1.3 - Extended Recovery 1.4 - Short stay -2- DEFINITIONS - GENERAL 2.1 - Surgery / Office 2.2 - Outpatient Department 2.3 - Outpatient 2.4 - Inpatient -3- DEFINITIONS - SURGERY / OFFICE OR OUTPATIENT 3.1 - Surgery / office Procedure 3.2 - Outpatient Procedure -4- DEFINITIONS - AMBULATORY SURGERY 4.1 - Ambulatory Surgery / Procedure 4.2 - Ambulatory Surgery Procedure Patient 4.3 - Ambulatory Surgery Center (Facility) 4.4 - Ambulatory Surgery / Procedure - Extended Recovery Patient 4.5 - Ambulatory Surgery / Procedure - Extended Recovery Centre / Unit 4.6 - Limited care accomodation 4.7 - Hotel / Hostel Accomodation
VOCABULARY AND PRECISIONS International Association for Ambulatory Surgery AMBULATORY (DAY) SURGERY VOCABULARY & PRECISIONS TERMINOLOGY Precisions -1- SYNONYMS AND TIME FRAMES Ambulatory • Synonyms: Day. Same day. Day only. • Time frame: working day - no overnight stay. Ambulatory Surgery Centre • Synonyms: Day Clinic. Day Surgery Centre / Unit. Ambulatory (facility) Surgery Unit. Extended Recovery • Synonyms: 23 h. Overnight stay. Single night. • Time frame: under 24 hours Short stay • Time frame: 24 - 72 hours -2- DEFINITIONS - GENERAL Surgery / Office A medical practitioner's professional premises. Outpatient Department Section(s) of a hospital or a free standing ambulatory surgery centre, public or private, for the management of outpatients. Outpatient. A patient treated solely in the outpatient department, including such services as ambulatory procedure, interventional radiology, radiotherapy, oncology, renal dialysis, etc.… Inpatient A patient admitted into a hospital, public or private, for a stay of 24 h or more.
6 / 72 -3- DEFINITIONS - SURGERY / OFFICE OR OUTPATIENT Surgery / Office Procedure An operation or procedure carried out in a medical practitioner's professional premises which provides an appropriately designed, equipped and serviced room(s) for its safe performance. Outpatient Procedure An operation or procedure carried out in the outpatient depart- ment of a hospital, public or private. -4- DEFINITIONS - AMBULATORY SURGERY Ambulatory Surgery / Procedure An operation/procedure, excluding an office/surgery or outpa- tient operation/procedure, where the patient is discharged on the same working day. Ambulatory Surgery / Procedure A patient having an operation, procedure excluding an office / Patient surgery or outpatient operation/procedure, who is admitted and discharged on the same working day. Ambulatory Surgery Center (Fa- A centre (facility) designed for the optimum management of an cility) ambulatory surgery/procedure patient. Ambulatory Surgery / Procedure A patient treated in ambulatory surgery / procedure centre/unit, - Extended Recovery Patient free standing or hospital based, who requires extended recovery including overnight stay, before discharge the following day. Ambulatory Surgery / Procedure Purpose constructed / modified patient accommodation, free - Extended Recovery Centre / standing or within an ambulatory surgery centre or hospital, spe- Unit cifically designed for the extended recovery of ambulatory surge- ry / procedure patients. Limited care accomodation Hotel / hostel accomodation for ambulatory surgery / procedure patients where professional health care is avaible on an on-call basis. Hotel / Hostel Accomodation Accomodation without professionnal health care for ambulatory surgery / procedures: required by patients for domestic, social or travel reasons.
VOCABULARY AND TRADUCTION International Association for Ambulatory Surgery AMBULATORY (DAY) SURGERY VOCABULARY & TRADUCTION -1- SYNONYMS AND TIME FRAMES Ambulatory Denmark Ambulant France Chirurgie ambulatoire Germany Ambulant, tageschirurgisch Italy Day Surgery Netherlands Ambulant Norway/Scandinavia Dagbehandling Poland Chirurgia ambulatoryjna Portugal Cirurgia Ambulatória; Cirurgia e/ou Anestesia Ambulatória. Spain Cirugía Mayor Ambulatoria (CMA) Ambulatory Surgery Centre (facility) Denmark Ambulant kirurgisk klinik France Unité de chirurgie ambulatoire Germany Ambulantes Operationszentrum (Einrichtung), Tageschirurgie Italy Centro di Day Surgery Netherlands Dagcentrum / kliniek Norway/Scandinavia Dagkirurgisk senter Poland Centrum (Ośrodek) Chirurgii Ambulatoryjnej Portugal Unidade de Cirurgia Ambulatória (UCA) Spain Unidad de Cirugía Mayor Ambulatoria (UCMA)
8 / 72 Extended Recovery Denmark Udvidet opvågning France Séjour d'une nuit (inférieur à 24 heures) Germany Verlängerter Erholungsbedarf Italy Ricovero (osservazione) protratto Netherlands Dagopname Norway/Scandinavia Utvidet Recovery Poland Hospitalizacja “jednego dnia” Portugal Estadia com pernoita hospitalar Spain Recuperación Prolongada. Short stay Denmark France Court séjour (de 24 à 72 heures) Germany Kurzaufenthalt, kurzstationär Italy Netherlands Kort verblijf Norway/Scandinavia Poland Hospitalizacja krótkoterminowa Portugal Curta estadia hospitalar (de 24 a 72 horas) Spain -2- DEFINITIONS - GENERAL Surgery / Office Denmark Kirurgisk speciallæge praksis France Cabinet médical Germany Operationsraum einer Arztpraxis, einer Tages- oder Praxisklinik Italy Studio medico Netherlands Spreekkamer Norway/Scandinavia Kirurgisk kontor Poland Ambulatorium/Gabinet lekarski Portugal Consultório Médico Spain Consulta/Consultorio
9 / 72 Outpatient Department Denmark Ambulatorium France Unité de chirurgie ambulatoire : UCA Germany Poliklinik, Abteilung für Tageschirurgie Italy Dipartimento ambulatoriale (Centro di Servizi Ambulatoriali) Netherlands Polikliniek Norway/Scandinavia Poliklinikk Poland Przychodnia Portugal Departamento de Ambulatório Spain Consulta Externa Outpatient. Denmark Ambulant patient France Patient pris en charge en chirurgie ambulatoire. Germany Ambulanter Patient Italy Paziente ambulatoriale Netherlands Poliklinische patiënt Norway/Scandinavia Poliklinisk Poland Pacjent ambulatoryjny Portugal Doente em Ambulatório Spain Paciente Ambulatorio Inpatient Denmark Indlagt patient France Patient hospitalisé Germany Stationärer Patient Italy Paziente ricoverato in regime ordinario Netherlands Opgenomen patiënt Norway/Scandinavia Innlagt pasient Poland Pacjent hospitalizowany Portugal Doente Internado Spain Paciente ingresado
10 / 72 -3- DEFINITIONS - SURGERY / OFFICE OR OUTPATIENT Surgery / Office Procedure Denmark Speciallæge praksis procedurer France Soins externes, actes réalisés au cabinet médical Prozedur im Operationsraum einer Arztpraxis, Tages- oder Germany Praxisklinik Italy Prestazione chirurgica ambulatoriale Netherlands Spreekkamer verrichting Norway/Scandinavia Kirurgisk kontor operasjon Poland Zabieg ambulatoryjny / procedura ambulatoryjna Portugal Procedimento realizado em Consultório Médico Spain Intervención o procedimiento en consulta Outpatient Procedure Denmark Ambulant procedure Soins externes, actes relevant du cabinet médical mais réalisés dans France le cadre d'une unité de chirurgie ambulatoire Germany Ambulante Prozedur Italy Prestazione ambulatoriale Netherlands Poliklinische (‘kleine’) verrichting Norway/Scandinavia Poliklinisk prosedyre Poland Zabieg ambulatoryjny / procedura ambulatoryjna Portugal Procedimento efectuado a Doente em Ambulatório Spain Procedimiento ambulatorio -4- DEFINITIONS - AMBULATORY SURGERY Ambulatory Surgery / Procedure Denmark Dagkirurgi/procedurer Acte (intervention, exploration) pris en charge en chirurgie ambula- France toire Germany Ambulante Operation / Prozedur, tageschirurgischer Eingriff Italy Intervento chirurgico/Procedura di Day Surgery Netherlands Dagchirurgie Norway/Scandinavia Dagkirurgisk prosedyre Poland Zabieg (procedura) w oddziale dziennym Portugal Procedimento em regime de Cirurgia Ambulatória Spain Cirugía Mayor Ambulatoria (CMA)
11 / 72 Ambulatory Surgery / Procedure Patient Denmark Dagkirurgisk klinik/center France Patient pris en charge en chirurgie ambulatoire. Patient für ambulanten chirurgischen Eingriff, für tageschirur- Germany gischen Eingriff Italy Pazienti arruolati per la Day Surgery Netherlands Dagchirurgie patient Norway/Scandinavia Dagkirurgisk Pasient Poland Pacjent leczony w trybie dziennego pobytu Doente submetido a um procedimento em regime de CirurgiaAmbu- Portugal latória Spain Paciente de CMA Ambulatory Surgery Center (Facility) Denmark Dagkirurgisk Senter France Centre, unité de chirurgie ambulatoire Germany Ambulantes Operationszentrum (Einrichtung), Tagesklinik Italy Centro di Day Surgery Netherlands Dagcentrum / Afdeling voor dagbehandeling / dagverpleging Norway/Scandinavia Dagkirurgisk Senter Poland Centrum (Ośrodek) Chirurgii Ambulatoryjnej Portugal Unidade de Cirurgia Ambulatória (UCA) Spain Unidad de Cirugía Mayor Ambulatoria (UCMA) Ambulatory Surgery / Procedure - Extended Recovery Patient Denmark Dagkirurgisk patient med udvidet opvågning France Ambulante Operation / Prozedur – Patient mit verlängertem Erho- Germany lungsbedarf, Praxisklinik Paziente sottoposto ad una procedura chirurgica di Day Surgery Italy che necessita di osservazione prolungata Netherlands Norway/Scandinavia Dagkirurgisk prosedyre – Utvidet recovery Poland Pacjent leczony w trybie hospitalizacji “jednodniowej” Doente submetido a intervenção em regime de Cirurgia Ambu- Portugal latória com pernoita hospitalar Spain Paciente de Recuperación Prolongada
12 / 72 Ambulatory Surgery / Procedure - Extended Recovery Centre / Unit Denmark Dagkirurgisk enhed med udvidet opvågning France Ambulante Operation / Prozedur – Zentrum / Einheit für verlänger- Germany ten Erholungsbedarf, Praxisklinik Struttura destinata ad accogliere i pazienti sottoposti a Interventi in Italy Day Surgery che debbano rimanere sotto osservazione medica pro- lungata (per una notte) Netherlands Norway/Scandinavia Dagkirurgisk utvidet recovery enhet Poland Unidade de Cirurgia Ambulatória com capacidade para recobro Portugal prolongado permitindo a estadia do doente por uma noite Spain UCMA con recuperación prolongada. Limited care accomodation Denmark Begrænset pleje enhed France Germany Unterbringung mit begrenzter Pflegemöglichkeit Italy Struttura di degenza protetta Netherlands Norway/Scandinavia Begrenset overvåking Zakwaterowanie z zapewnieniem opieki medycznej w ograniczonym Poland zakresie Instalações Hoteleiras com cuidados de saúde limitados e específi- Portugal cos Spain Hotel de pacientes Hotel / Hostel Accomodation Denmark Patienthotel France Hôtel Germany Unterbringung in Hotel / Pension Italy Strutture alberghiere convenzionate Netherlands Norway/Scandinavia Sykehotel Poland Zakwaterowanie w hotelu lub hostelu Portugal Instalações Hoteleiras sem cuidados de saúde Spain Hotel
DENMARK International Association for Ambulatory Surgery AMBULATORY (DAY) SURGERY DEFINITIONS Translation for Denmark By the Dansk Selskab for Dag-Kirurgi (DSDK) Correspondence: Danish Association of Day Surgery Dept. of Day Surgery Haderslev hospital DK-6100 Haderselv Denmark
International Association for Ambulatory Surgery Dansk Selskab for Dag-Kirurgi (DSDK) AMBULATORY (DAY) SURGERY DAGKIRURGISKE DEFINITIONS DEFINITINER PREAMBLE FORORD Ambulatory surgery is expanding throughout the Dagkirurgi er i kraftig udvikling over hele verden, world and it is considered that at least 75%, if not og det formodes, at mindst 75 % - og måske mere - more, of all operations/procedures will ultimately af alle operationer/procedurer er mulige at udføre i be carried out in ambulatory surgery centres/units. dagkirurgisk eller ambulant regi. The International Association for Ambulatory Sur- IAAS – den internationale sammenslutning af dag- gery believes that it is important to prepare a list of kirurgiske selskaber – tror på, at det er vigtigt at basic definitions of ambulatory (day) surgery udarbejde en liste over basale definitioner ve- which will enable data to be collected for the com- drørende dagkirurgi. Det vil gøre det muligt at parison of ambulatory surgery practice from one indsamle sammenlignelige data fra den ene nation nation to another A multiplicity of terminology has til den anden. En mangfoldighed af benævnelser gradually developed which is causing confusion har gradvist udviklet sig på området, og det har and problems in comparing ambulatory surgery medført konfusion og problemer i sammenlignin- practice in the different nations. ger af dagkirurgisk aktivitet i forskellige lande. Fundamentally, ambulatory surgery should expand Grundlaget for den fortsatte udvikling af dagkirur- by the inclusion of operations on patients who are gien er en yderligere omlægning af operationer fra currently admitted into acute bed hospitals as inpa- stationære indlæggelser til dagbehandling. Tekno- tients. Nevertheless, technological advances have logisk udvikling har stimuleret denne udvikling stimulated the development of new techniques and gennem udvikling af ny teknik og modificering af modifications of existing techniques, which will eksisterende teknikker, som medvirker til at ud- further increase ambulatory surgery practice. vikle den ambulante praksis. The difficulty in producing a set of definitions Vanskeligheden ved at fremstille et sæt af defini- which will apply to clinical practice and the health tioner, som kan anvendes inden for den kliniske care system of each nation is appreciated. For this hverdag og i sundhedssystemerne i de forskellige reason, member nations of the International As- lande er indlysende. Af denne grund er med- socîation for Ambulatory Surgery have been invi- lemslandene i IAAS blevet inviteret til at oversæt- ted to translate. the definitions into their own lan- te disse definitioner til deres eget sprog og an- guages and include any necessary interpretation vende nødvendig fortolkning så definitionerne kan applicable to their health care systems. anvendes i de respektive landes sundhedsvæsener. An increasing number of operations/procedures, Størstedelen af de dagkirurgiske operationer/pro- mostly minor but including some intermediate cedurer er elektive, dog således at udvalgte akutte type, are carried out as office based/out patient, kirurgiske procedurer såsom traumer også kan surgery. This group should be recognised as a se- udføres i dagkirurgiske enheder/centre. parate entity, distinct from ambulatory surgery. The great majority of ambulatory surgery opera- Det understreges, at det endelige valg af såvel pa- tions/procedures are elective, however appropria- tient som procedure til dagkirurgiske aktiviteter i tely selected acute surgical operations, including de dagkirurgiske enheder/centre er den ansvarlige trauma, can also be carried out in ambulatory sur- kirurgs og anæstesiologs valg. gery centres/units. It is emphasised that the ultimate choice of patient Forhåbningsvis kan de følgende definitioner danne and procedure to be carried out in ambulatory sur- basis for nationale og internationale sammenli- gery centres/units must remain the responsibility gninger af dagkirurgiske aktiviteter. of the attending surgeon and/or anaesthetist.
15 / 72 AMBULATORY SURGERY DAGKIRURGI Suggested international terminology Anbefalede international and definitions terminologi og definitioner Terminology of the following Ambulatory Surgery Terminologien vedr. ambulante/dagkirurgiske de- definitions may be interpreted and expressed in finitioner kan udtrykkes i overensstemmelse med more appropriate terms to satisfy the specific re- de specifikke rekommandationer eller krav fra de quirements of healthcare authorities in each nation. enkelte landes nationale sundhedsmyndigheder. 1) Synonyms and time frames 1) Synonymer og tidsgrænser 2) Definitions - general 2) Generelle definitioner 3) Definitions - surgery / office or outpatient 3) Definitioner – speciallæge praksis og ambula- 4) Definitions - ambulatory surgery torium 4) Definitioner – dagkirurgi TERMINOLOGY Precisions Comments TERMINOLOGI Præcisering Kommentarer -1- SYNONYMS AND TIME FRAMES SYNONYMER OG TIDSGRÆNSER Ambulatory • Synonyms: Day. Same day. Day Ambulant only. Synonymer: Sammedags- , dag-, endags- • Time frame: working day - no overnight stay. Tidsgrænse: Arbejdsdag – ingen overnatning Ambulatory Surgery • Synonyms: Day Clinic. Day Sur- Centre (facility) gery Centre / Unit. Ambulatory Ambulant kirurgisk klinik Surgery Unit. Synonym: Dagklinik, Dagkirur- gisk klinik/center/enhed, ambu- lant kirurgisk klinik/center/enhed Extended Recovery • Synonyms: 23 h. Overnight stay. Udvidet opvågning Single night. Synonym: 23 timers ophold, overnatning, en nats ophold. • Time frame: under 24 hours Tidsgrænse: Mindre end 24 timer. Short stay • Time frame: 24-72 hours
16 / 72 -2- DEFINITIONS - GENERAL GENERELLE DEFINITIONER Surgery / Office A medical practitioner's professio- Kirurgisk speciallæge nal premises. praksis En kirurgs professionelle lokalite- ter. Outpatient Department Section(s) of a hospital or a free Ambulatorium standing ambulatory surgery cen- tre, public or private, for the mana- gement of outpatients. Del(e) af et hospital eller selvstændig dagkirurgisk klinik, of- fentlig eller privat, indrettet til be- handling af ambulante patienter Outpatient. A patient treated solely in the Ambulant patient outpatient department, including such services as ambulatory proce- dure, interventional radiology, ra- diotherapy, oncology, renal dialy- sis, etc… Patient behandlet udelukkende i ambulatoriet, includerende ydelser som ambulante procedurer, inter- ventions radiologi, stråleterapi, onkologi, dialyse, etc. Inpatient A patient admitted into a hospital, Indlagt patient public or private, for a stay of 24 h or more. Patient indlagt i hospital, offentligt eller privat i mere end 24 timer.
17 / 72 -3- DEFINITIONS - SURGERY / OFFICE OR OUTPATIENT DEFINITIONER – SPECCIALLŒGEPRAKSIS OG AMBULATORIUM Surgery / Office Proce- An operation or procedure carried dure out in a medical practitioner's pro- Speciallæge praksis pro- fessional premises which provides cedurer an appropriately designed, equip- ped and serviced room(s) for its safe performance. Operation eller procedure, der udføres i speciallæge praksis, hvor der er et eller flere passende kons- trueret, udstyret og serviceret rum, for at proceduren/operationen kan udføres sikkert. Outpatient Procedure An operation or procedure carried Ambulant procedure out in the outpatient department of a hospital, public or private. Operation eller procedure, der udføres i ambulatorium på et hospi- tal, offentligt eller privat, og som ikke kræver faciliteter til indlæg- gelse eller en dagkirurgisk enheds faciliteter eller overvågning. -4- DEFINITIONS - AMBULATORY SURGERY DEFINITIONER – DAGKIRURGI Ambulatory Surgery / An operation / procedure, exclu- Procedure ding an office / surgery or outpa- Dagkirurgi/procedurer tient operation/procedure, where the patient is discharged on the same working day. Operation/procedure, bortset fra operationer/procedurer i spe- ciallæge praksis eller ambulato- rium, hvor patienten normalt uds- krives samme dag. Ambulatory Surgery / A patient having an operation, pro- Procedure Patient cedure excluding an office / surge- Dagkirurgisk patient ry or outpatient operation/proce- dure, who is admitted and dischar- ged on the same working day. Patient, der får foretaget operation/ procedure bortset fra operationer/ procedurer i speciallæge praksis og ambulatorium, som indskrives og udskrives samme dag
18 / 72 Ambulatory Surgery A centre (facility) designed for the Center (Facility) optimum management of an ambu- Dagkirurgisk klinik/center latory surgery/procedure patient. Klinik/center indrettet til optimal behandling af dagpatienter. Ambulatory Surgery / A patient treated in ambulatory sur- Procedure - Extended gery / procedure centre / unit, free Recovery Patient standing or hospital based, who re- Dagkirurgisk patient med quires extended recovery including udvidet opvågning overnight stay, before discharge the following day. Patient, der behandles i dagkirur- gisk klinik/center, fritstående eller i tilknytning til hospital, som kræver overnatning inden udskrivelse da- gen efter indgrebet. Ambulatory Surgery / Purpose constructed / modified pa- Procedure - Extended tient accommodation, free standing Recovery Centre / Unit or within an ambulatory surgery Dagkirurgisk enhed med centre or hospital, specifically desi- udvidet opvågning gned for the extended recovery of ambulatory surgery / procedure pa- tients. Enhed, fritstående eller i tilslutning til hospital, specielt indrettet til pa- tienter, der har behov for udvidet opvågning. Limited care accomoda- Hotel / hostel accomodation for tion ambulatory surgery / procedure pa- Begrænset pleje enhed tients where professional health care is avaible on an on-call basis. Hotel eller lignende til patienter, der har gennemgået en dagkirur- gisk procedure, hvor der kan tilkal- des sundhedsfaglig assistance. Hotel / Hostel Accomo- Accomodation without profession- dation nal health care for ambulatory sur- Patienthotel gery / procedures: required by pa- tients for domestic, social or travel reasons. Indkvarterings facilitet uden sun- dhedsfaglig assistance til brug for dagkirurgiske patienter, hvor opholdet er begrundet i bolig-, so- ciale – eller afstandsforhold.
FRANCE International Association for Ambulatory Surgery AMBULATORY (DAY) SURGERY DEFINITIONS Translation for France By the Association Française de Chirurgie Ambulatoire (AFCA) Correspondence: Docteur François Venutolo AFCA 25 rue Pierre de Theilley B.P. 71 95503 GONESSE cedex FRANCE Secrétaire : 33 1 34 53 24 47 - Fax : 33 1 34 53 24 49 E-mail : francois.venutolo@ch-gonesse.fr
International Association for Ambulatory Surgery Association Française de Chirurgie Ambulatoire (AFCA) «Dans l'intérêt des patients et de la société, promouvoir en France, le développement, l'enseignement et l'évaluation de la chirurgie ambulatoire.» AMBULATORY (DAY) SURGERY DEFINITIONS RELATIVES A DEFINITIONS LA CHIRURGIE AMBULATOIRE PREAMBLE PREAMBULE Ambulatory surgery is expanding throughout the La chirurgie ambulatoire se développe à travers le world and it is considered that at least 75%, if not monde et on considère qu'au moins 75%, si n'est more, of all operations/procedures will ultimately plus, de toutes les opérations/actes chirurgicaux be carried out in ambulatory surgery centres/units. seront, à terme, réalisés dans des unités/centres de chirurgie ambulatoire. The International Association for Ambulatory Sur- Pour l'Association Internationale de Chirurgie Am- gery believes that it is important to prepare a list of bulatoire (IAAS) il est important d'arrêter une liste basic definitions of ambulatory (day) surgery des définitions de base de ce que recouvre la chi- which will enable data to be collected for the com- rurgie ambulatoire (de jour, d'un jour). Ces défini- parison of ambulatory surgery practice from one tions doivent permettre la constitution des bases de nation to another A multiplicity of terminology has données nécessaires à toute comparaison de prati- gradually developed which is causing confusion que ambulatoire d'un pays à l'autre. Un vocabu- and problems in comparing ambulatory surgery laire diversifié s'est graduellement développé. Il practice in the different nations. est source de confusions et pose problèmes dans les comparaisons internationales. Fundamentally, ambulatory surgery should expand Fondamentalement, la chirurgie ambulatoire de- by the inclusion of operations on patients who are vrait se développer par inclusion de patients opérés currently admitted into acute bed hospitals as inpa- lors d'hospitalisations dans des lits de court séjour. tients. Nevertheless, technological advances have Néanmoins, des progrès techniques ont stimulé stimulated the development of new techniques and l'apparition de nouvelles pratiques et permis la mo- modifications of existing techniques, which will dification des pratiques existantes, ce qui facilitera further increase ambulatory surgery practice. l'extension de la chirurgie ambulatoire. The difficulty in producing a set of definitions L'IAAS a bien compris les difficultés qu'il y avait which will apply to clinical practice and the health à produire un ensemble de définitions adaptées care system of each nation is appreciated. For this aux pratiques et aux systèmes de santé de chaque reason, member nations of the International As- pays. Pour cette raison, les associations nationales socîation for Ambulatory Surgery have been invi- membres de l'Association Internationale de Chirur- ted to translate. the definitions into their own lan- gie Ambulatoire (IAAS) ont été invitées à traduire guages and include any necessary interpretation dans leurs langues les définitions retenues et à y applicable to their health care systems. inclure toute interprétation nécessaire à leur appli- cation dans l'organisation de leurs systèmes de santé. An increasing number of operations/procedures, Un nombre croissant d'opérations ou d'actes chi- mostly minor but including some intermediate rurgicaux, surtout mineurs mais incluant certains type, are carried out as office based/out patient, actes de type intermédiaire, est réalisé en cabinet surgery. This group should be recognised as a se- médical. Ce groupe devrait être reconnu comme parate entity, distinct from ambulatory surgery. une entité séparée, distincte de celle de la chirurgie ambulatoire. The great majority of ambulatory surgery opera- La grande majorité des opérations ou des actes réa- tions/procedures are elective, however appropria- lisés en ambulatoire l'est dans le cadre d'une chi- tely selected acute surgical operations, including rurgie programmée. Cependant, convenablement trauma, can also be carried out in ambulatory sur- sélectionnées, des opérations chirurgicales aigües, gery centres/units. y compris traumatologiques, peuvent aussi être prises en charge dans des unités ou centres de chi- rurgie ambulatoire.
21 / 72 It is emphasised that the ultimate choice of patient Il est important de souligner que le choix ultime en and procedure to be carried out in ambulatory sur- matière d'éligibilité d'un patient, d'une opération gery centres/units must remain the responsibility ou d'un acte à une prise en charge en chirurgie am- of the attending surgeon and/or anaesthetist. bulatoire doit rester de la responsabilité du chirur- gien et/ou de l'anesthésiste concerné. AMBULATORY SURGERY CHIRURGIE AMBULATOIRE Suggested international terminology Suggestions pour des définitions et and definitions une terminologie internationale Terminology of the following Ambulatory Surgery Les termes retenus pour les définitions relatives à definitions may be interpreted and expressed in la Chirurgie Ambulatoire peuvent être interprétés more appropriate terms to satisfy the specific re- et exprimés de façon plus appropriée afin de satis- quirements of healthcare authorities in each nation. faire aux exigences spécifiques des autorités sani- 1) Synonyms and time frames taires de chaque pays. 2) Definitions - general 1) Synonymes et durée 3) Definitions - surgery / office or outpatient 2) Définitions générales 4) Definitions - ambulatory surgery 3) Définitions - soins externes, actes de cabinet 4) Définitions - chirurgie ambulatoire. TERMINOLOGY Precisions Comments TERMINOLOGIE Précisions Commentaires -1- SYNONYMS AND TIME FRAMES SYNONYMES ET DURÉE Ambulatory • Synonyms: Day. Same day. Day • Synonymes : Chirurgie ambula- Chirurgie ambulatoire only. toire ; Chirurgie et/ou anesthésie Synonymes: de jour, sur le même ambulatoire ; radiologie interven- jour, d'un seul jour. tionnelle en ambulatoire. • Time frame: working day - no • Horaires : sans hospitalisation de overnight stay. nuit. Cadre de durée : horaires de tra- La réglementation française de vail, sans séjour de nuit. 1992 prévoit un maximum de 12 heures
22 / 72 Ambulatory Surgery • Synonyms: Day Clinic. Day Sur- Synonymes : La réglementaion Centre (facility) gery Centre / Unit. Ambulatory française englobe les «structures Unité de chirurgie ambu- Surgery Unit. pratiquant l'anesthésie ou la chirur- latoire Synonymes : Clinique de jour. gie ambulatoire» dans les «structu- Centre ou unité de chirurgie d'un res de soins alternatives à l'hospita- jour. Unité de chirurgie ambula- lisation». Elles sont pourvues de toire. «places» et non de lits. «Les places relevant des structures pratiquant l'anesthésie ou la chi- rurgie ambulatoires sont comprises dans la carte sanitaire des installa- tions de chirurgie» (Décret n° 92/ 1101 du 2 octobre 1992 sur les structures de soins alternatives à l’hospitalisation). Extended Recovery • Synonyms: 23 h. Overnight stay. Hors du champ réglementaire de la Séjour d'une nuit (infé- Single night. chirurgie ambulatoire en France. rieur à 24 heures) Synonymes : 23 heures, séjour d'une nuit. • Time frame: under 24 hours Cadre de durée : moins de 24 heures Short stay • Time frame: 24-72 hours En 2004, lors de la mise en place Court séjour (de 24 à 72 Cadre de durée : de 24 heures à de la T2A, la France a choisi de heures) 72 heures. porter la durée des GHM de la CM 24 à une nuit d'hospitalisation, afin de soulager les séjours d'hospitali- sation classique des séjours d'une nuit. En conséquence, elle n'a pas choisi de distinguer les séjours am- bulatoires des "courts séjours" de "24 à 72" heures ni des séjours d'hospitalisation traditionnelle comme le préconisait l'AFCA. Pour cette dernière il y a pourtant bien deux logiques organisationnelles (ambulatoire / hospitalisé) et trois logiques de coûts (Ambulatoire, court séjour hospitalisé, hospitali- sation traditionnelle). -2- DEFINITIONS - GENERAL DEFINITIONS GENERALES Surgery / Office A medical practitioner's professio- Hors du champ réglementaire de la Cabinet médical nal premises. chirurgie ambulatoire en France. Un local professionnel destiné à une profession médicale.
23 / 72 Outpatient Department Section(s) of a hospital or a free Local (locaux) d'un hôpital, d'une Unité de chirurgie ambu- standing ambulatory surgery cen- clinique ou d'un centre autonome, latoire : UCA tre, public or private, for the mana- public ou privé, dévolu aux pa- gement of outpatients. tients pris en charge en chirurgie Local (locaux) d'un hôpital ou d'un ambulatoire. centre autonome, public ou privé, dévolu aux patients pris en charge en chirurgie ambulatoire. Outpatient. A patient treated solely in the Le vocable général qui englobe, en Patient pris en charge en outpatient department, including France, la chirurgie ambulatoire est chirurgie ambulatoire. such services as ambulatory proce- celui «d'alternative à l'hospitalisa- dure, interventional radiology, ra- tion». diotherapy, oncology, renal dialy- Selon la réglementation française sis, etc.…. cette prise en charge a lieu dans Un patient pris en charge exclusi- une unité de chirurgie ambulatoire vement dans l'unité de chirurgie préalablement reconnue, autorisée ambulatoire. Cette unité est conçue par l'autorité de Tutelle. pour prendre en charge dea patients relevant de la chirurgie ambula- toire, de la radiologie intervention- nelle, d'un traitement de radiothéra- pie, d'une prise en charge oncologi- que, de dialyse, etc… Inpatient A patient admitted into a hospital, Un patient admis dans un établisse- Patient hospitalisé public or private, for a stay of 24 h ment de santé, hôpital ou clinique, or more. quel que soit son statut public ou Un patient admis dans un hôpital privé, pour un séjour de 24 h. ou public ou privé, pour un séjour de plus. 24 h. ou plus. -3- DEFINITIONS - SURGERY / OFFICE OR OUTPATIENT DEFINITIONS - SOINS EXTERNES, ACTES DE CABINET Surgery / Office Proce- An operation or procedure carried Ces actes, soins, interventions ou dure out in a medical practitioner's pro- opérations ne relèvent pas du Soins externes, actes réa- fessional premises which provides champ réglementaire de la chirur- lisés au cabinet médical an appropriately designed, equip- gie ambulatoire en France. ped and serviced room(s) for its safe performance. Une opération, une intervention pratiquée dans un cabinet médical qui possède un local conçu, équipé et organisé de façon appropriée pour en assurer la sécurité.
24 / 72 Outpatient Procedure An operation or procedure carried Une opération, une intervention Soins externes, actes rele- out in the outpatient department of pratiquée dans l'unité de chirurgie vant du cabinet médical a hospital, public or private. ambulatoire d'un établissement de mais réalisés dans le ca- Une opération, une intervention santé, public ou privé, sur un pa- dre d'une unité de chirur- pratiquée dans l'unité de chirurgie tient qui ne nécessite ni hospitali- gie ambulatoire ambulatoire d'un établissement de sation ni prise en charge dans une santé, public ou privé. unité de chirurgie ambulatoire ou selon une organisation de type chi- rurgie ambualtoire. Il ne s'agit pas de "chirurgie ambu- latoire" proprement dite, mais il faut distinguer ici les pratiques et le droit, la réglementation (sécurité, organisation), l'allocation de res- source ou la tarification relatives à la chirurgie ambulatoire qui, selon les cas, peuvent s'appliquer. -4- DEFINITIONS - AMBULATORY SURGERY DEFINITIONS - CHIRURGIE AMBULATOIRE Ambulatory Surgery / An operation/procedure, excluding C'est le patient qui est ambulatoire Procedure an office/surgery or outpatient ope- et non l'acte. C'est la prise en Acte (intervention, explo- ration/procedure, where the patient charge qui définit l'ambulatoire et ration) pris en charge en is discharged on the same working non l'acte. Pourtant cet acte, cette chirurgie ambulatoire day. intervention fait partie de ceux qui Une opération ou une intervention, ne peuvent ou ne doivent pas être non praticable en cabinet médical, faits en cabinet médical. Cette prise pour laquelle le patient est libéré le en charge est substitutive d'une jour même de l'intervention. prise en charge faite habituellement en hospitalisation. Le patient ne passe pas la nuit dans l'UCA. La notion de nuit et de jour se juge par rapport à un cycle quotidien de du- rée de travail. Ambulatory Surgery / A patient having an operation, pro- Un patient subissant une opération Procedure Patient cedure excluding an office / surge- ou une intervention, non praticable Patient pris en charge en ry or outpatient operation/proce- en cabinet médical, qui est admis et chirurgie ambulatoire. dure, who is admitted and dischar- qui ressort sur avis médical le jour ged on the same working day. même, sans nuit d'hospitalisation. Un patient subissant une opération ou une intervention, non praticable en cabinet médical, qui est admis et qui ressort le jour même, sans nuit d'hospitalisation. Ambulatory Surgery A centre (facility) designed for the Un centre, une unité, une structure Center (Facility) optimum management of an ambu- conçu pour optimiser la prise en Centre, unité de chirurgie latory surgery/procedure patient. charge d'un patient en chirurgie ambulatoire Un centre (une structure) conçu ambulatoire. pour la gestion optimum d'un pa- tient pris en charge en ambulatoire.
25 / 72 Ambulatory Surgery / A patient treated in ambulatory sur- Patient ambulatoire qui nécessite Procedure - Extended gery / procedure centre / unit, free une nuit d'hospitalisation. Recovery Patient standing or hospital based, who re- Hors du champ réglementaire de la quires extended recovery including chirurgie ambulatoire en France overnight stay, before discharge the dans la mesure où cette nuit d'hos- following day. pitalisation est programmée. Seul Un patient pris en charge en ambu- est prévu par la réglementation le latoire dans une centre / une unité, cas d'un échec de la chirurgie am- autonome ou située dans un établis- bulatoire : l'hospitalisation, alors sement de santé qui nécessite pour rendue nécessaire, doit être prévue se rétablir un séjour d'une nuit afin et organisée par l'unité de chirurgie d'être libéré le lendemain. ambulatoire, au sein de l'établisse- ment ou par convention. Ambulatory Surgery / Purpose constructed / modified pa- Equipement hôtelier destiné aux Procedure - Extended tient accommodation, free standing patients pris en charge en ambula- Recovery Centre / Unit or within an ambulatory surgery toire, nécessitant une nuit sous sur- centre or hospital, specifically desi- veillance médicale. gned for the extended recovery of Hors du champ réglementaire de la ambulatory surgery / procedure pa- chirurgie ambulatoire en France. tients. Ou alors, il s'agit d'un établisse- Un équipement hôtelier, autonome ment de santé pourvu de lits de chi- ou situé à l'intérieur d'un établisse- rurgie autorisés pour une hospitali- ment de santé, construit spécifique- sation classique. ment ou modifié à dessein, afin d'accueillir des patients en cours de rétablissement après une opération ou une intervention chirurgicale faite en ambulatoire. Limited care accomoda- Hotel / hostel accomodation for Hôtel médicalisé, foyer habilité, tion ambulatory surgery / procedure pa- conventionné. Il est destiné à rece- tients where professional health voir des patients pris en charge en care is avaible on an on-call basis. chirurgie ambulatoire à leur sor- Hôtel, foyer destiné à des patients tie : l'intervention de professionnels ayant subi une opération, une inter- de santé y est organisée, sur simple vention en ambulatoire où le re- appel. cours à des médecins ou à des pro- Hors du champ réglementaire de la fesionnels de santé est possible sur chirurgie ambulatoire en France. simple appel. Hotel / Hostel Accomo- Accomodation without profession- Permet de loger des patients pris en dation nal health care for ambulatory sur- charge en chirurgie ambulatoire Hôtel gery / procedures: required by pa- mais qui y ont recours pour des rai- tients for domestic, social or travel sons familiales, sociales ou de reasons. transport. Equipement hôtelier ne disposant Hors du champ réglementaire de la pas de possibilités spécifiques de chirurgie ambulatoire en France. recours à des professionels de santé mais destiné à répondre à la de- mande des patients pris en charge en ambulatoire qui en ont besoin pour des raisons familiales, socia- les ou de transport. G. Parmentier ; Chirurgie Ambulatoire : Définitions et terminologie internationale - IAAS - AFCA et In- troduction à la version Française - Juin 2000 ; Lettre de l'AFCA N° 6 Octobre 2000, p. 5-11, sauf la re- marque sur les courts séjours qui date de 2004
GERMANY International Association for Ambulatory Surgery AMBULATORY (DAY) SURGERY DEFINITIONS Translation for Germany By the Bundesverband für Ambulantes Operieren e. V. (BAO) Correspondence: BAO Bundesverband für Ambulantes Operieren e.V. Sterntorbrücke 1 53111 Bonn Tel. 0228 692423 Fax. 631715 E mail : BAOBonn@T-Online.de
International Association for Ambulatory Surgery Bundesverband für Ambulantes Operieren e. V. (BAO) AMBULANTES (TAGESCHIRURGISCHES) OPERIEREN Internationale Terminologie und Definitionen AMBULATORY (DAY) SURGERY DEFINITIONEN DEN BEREICH DEFINITIONS DES AMBULANTEN OPERIERENS PREAMBLE PRÄAMBEL Ambulatory surgery is expanding throughout the Weltweit werden immer mehr ambulante Opera- world and it is considered that at least 75%, if not tionen durchgeführt, und es ist davon auszugehen, more, of all operations/procedures will ultimately dass letzten Endes mindestens 75% aller Operatio- be carried out in ambulatory surgery centres/units. nen/Prozeduren, wenn nicht mehr, in ambulanten Operationenzentren / Operationseinheiten dur- chgeführt werden. The International Association for Ambulatory Sur- Die International Association for Ambulatory Sur- gery believes that it is important to prepare a list of gery findet es wichtig, dass eine Auflistung der basic definitions of ambulatory (day) surgery grundlegenden Definitionen für ambulantes (tages- which will enable data to be collected for the com- chirurgisches) Operieren erstellt wird, anhand de- parison of ambulatory surgery practice from one rer es möglich ist, Ver-gleichsdaten für die ambu- nation to another A multiplicity of terminology has lante Operationspraxis aus verschiedenen Ländern gradually developed which is causing confusion zu erfassen. Nach und nach hat sich eine Fülle von and problems in comparing ambulatory surgery Fachbegriffen herausgebildet, die für Verwirrung practice in the different nations. und Probleme beim Vergleich der ambulanten Operationspraxis in den verschiedenen Ländern sorgt. Fundamentally, ambulatory surgery should expand Grundsätzlich sollten ambulante Operationen by the inclusion of operations on patients who are durch die Einbeziehung von Operationen an Pa- currently admitted into acute bed hospitals as inpa- tienten erweitert werden, die gegenwärtig stationär tients. Nevertheless, technological advances have in Krankenhäusern mit Akutbetten aufgenommen stimulated the development of new techniques and werden, wobei jedoch die Entwicklung neuer, die modifications of existing techniques, which will ambulante Operationspraxis unterstützender Ver- further increase ambulatory surgery practice. fahrenstechniken und Abwandlungen bestehender Verfahrenstechniken durch die technischen Fortschritte gefördert wird. The difficulty in producing a set of definitions Wir wissen um die Schwierigkeit, Definitionen which will apply to clinical practice and the health festzulegen, die auf die klinische Praxis und das care system of each nation is appreciated. For this Gesundheits-wesen eines jeden Landes zutreffen. reason, member nations of the International As- Aus diesem Grunde wurden die Mitgliedsländer socîation for Ambulatory Surgery have been invi- der International Associa-tion for Ambulatory Sur- ted to translate. the definitions into their own lan- gery gebeten, die Definitionen in ihre jeweilige guages and include any necessary interpretation Landessprache zu übersetzen und et-waige applicable to their health care systems. notwendige, für ihr Gesundheitswesen zutreffende Interpretationen mit einzufügen. An increasing number of operations/procedures, Immer mehr Operationen/Prozeduren, mostly minor but including some intermediate hauptsächlich kleinere Operationen/Prozeduren, type, are carried out as office based/out patient, jedoch einschließlich einiger mittelschwerer Ope- surgery. This group should be recognised as a se- rationen/Prozeduren, werden als Operationen in parate entity, distinct from ambulatory surgery. Arztpraxen ambulant durchgeführt. Diese Gruppe sollte als gesonderte Einheit betrachtet werden, die sich von den ambulanten Operationen unter-schei- det.
28 / 72 The great majority of ambulatory surgery opera- Die ambulanten chirurgischen Eingriffe/Prozedu- tions/procedures are elective, however appropria- ren sind größtenteils elektive Eingriffe, wobei je- tely selected acute surgical operations, including doch entsprechend ausgewählte akute chirurgische trauma, can also be carried out in ambulatory sur- Eingriffe, einschließlich Traumata, auch in ambu- gery centres/units. lanten Opera-tionszentren/-einheiten durchgeführt werden können. It is emphasised that the ultimate choice of patient Wir betonen, dass die endgültige Auswahl des Pa- and procedure to be carried out in ambulatory sur- tienten und der in ambulanten Operationszentren/- gery centres/units must remain the responsibility einheiten durchzuführenden Prozedur auch wei- of the attending surgeon and/or anaesthetist. terhin in der Verantwortung des behandelnden Chirurgs und/oder Anästhe-sisten liegen muss. AMBULATORY SURGERY Suggested international terminology and definitions Terminology of the following Ambulatory Surgery Die Fachbegriffe für die folgenden Definitionen definitions may be interpreted and expressed in zum ambulanten Operieren können evtl. mit tref- more appropriate terms to satisfy the specific re- fenderen Begriffen interpretiert und ausgedrückt quirements of healthcare authorities in each nation. werden, um den jeweiligen Anforderungen der 1) Synonyms and time frames Gesundheitsbehörden eines jeden Landes zu entsprechen. 2) Definitions - general 3) Definitions - surgery / office or outpatient 4) Definitions - ambulatory surgery TERMINOLOGY Precisions Comments Terminologie Erläuterungen -1- SYNONYMS AND TIME FRAMES SYNONYME UND ZEITLICHE RAHMEN Ambulatory • Synonyms: Day. Same day. Day Ambulant only. Synonyme : Tages-, am selben Tag, nur tagsüber. • Time frame: working day - no overnight stay. Zeitlicher Rahmen: Arbeitstag – geplanter Aufenthalt ohne Über- nachtung
29 / 72 Ambulatory Surgery • Synonyms: Day Clinic. Day Sur- Centre (facility) gery Centre / Unit. Ambulatory ambulantes Opera- Surgery Unit. tionszentrum Synonyme: Tagesklinik, (Einrichtung) Praxisklinik, tageschirurgisches Operationszentrum / tageschirur- gische Operationseinheit, ambu- lante Operationseinheit, ambulan- tes Operationszentrum. Extended Recovery • Synonyms: 23 h. Overnight stay. Verlängerter Erholungs- Single night. bedarf Synonyme : 23 Stundenaufen- thalt, Aufenthalt mit einer Über- nachtung • Time frame: under 24 hours Zeitlicher Rahmen : unter 24 Stunden Short stay • Time frame: 24-72 hours Kurzaufenthalt Zeitlicher Rahmen: 24 - 72 Stun- den, kurzstationär -2- DEFINITIONS - GENERAL DEFINITIONEN - ALLGEMEIN Surgery / Office A medical practitioner's professio- Operationsraum / nal premises. Arztpraxis Praxisräume eines Facharztes Outpatient Department Section(s) of a hospital or a free Poliklinik, Tageschirur- standing ambulatory surgery cen- gische Abteilung tre, public or private, for the mana- gement of outpatients. Bereich(e) eines öffentlichen oder privaten Krankenhauses oder frei- stehenden ambulanten Opera- tionszentrums für die Behandlung von am-bulanten Patienten.
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