HOMEWARD BOUND? Three-fourths (75%) of the 407 respondents to a recent Outpatient Surgery online reader poll say they wouldn't let an unaccompanied patient leave their facility in a taxi.

CALLING A CAB
Would You Let a Patient Take a Taxi Home Alone?

Would you protest if one of your physicians says it's okay for an unaccompanied patient who received propofol to leave your facility in a taxi? We put this question to a vote of our readers. Most agreed — it's not a good idea. Three-fourths (75%) of the 407 respondents to our online reader poll wouldn't let a patient take a cab home. About one-fifth (18%) would and 7% were unsure.

"Absolutely no. It still takes time for medications including propofol to wear off Imagine if the patient took a taxi home and with [his] slower response time got hit by a car, and was severely injured or died," says Paul Rein, DO, an anesthesiologist in Virginia.

Many note that CMS and accreditation agencies require that all patients who receive any kind of sedation after surgery be released to "a responsible adult." "We follow Joint Commission standards, which state that the patient must be discharged to the care of a responsible adult. The taxi driver is not considered to be that responsible adult," says one facility manager. "I don't know of any cab driver that is willing to sign a discharge sheet saying he is 'responsible' for said patient," says another.

Several respondents warn that discharging a patient via taxicab is a safety risk for the patient as well as the facility, meaning that the provider and facility would be liable if something bad were to happen. "Patients who are altered in any way should be discharged to a person that is willing to be responsible for them while in their supervision. I doubt cab drivers would be willing to assume that responsibility," says a respondent.

One reader says that while the facility does not release patients to taxis, it does use a "medical transport service." Others note that it's important to be sure to make arrangements for escorts before the day of surgery. "This should be ascertained pre-procedure (responsible adult available)," says an anesthesia provider. "If none, then no procedure."

— Kendal Gapinski