Office-Based Surgery Centers

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Because of the popularity of plastic surgery today, the number of office-based surgical procedures is on the rise. According to The American Society of Anesthesiologists (ASA), approximately 10 million procedures were performed in a doctor's office by 2005 — double the number since 1995. Likewise, the need for accredited facilities and standardized operations has grown.

In 2004, only 14 states had accreditation mandates in place for office-based surgical facilities. Until November 2005, there was not an agreement between healthcare accrediting agencies to define unfavorable medical errors during procedures that occur in office-based surgical centers, according to the American Society of Plastic Surgeons (ASPS). In fact, there is no consistency in definitions at the state level that offer standard mandatory reporting requirements, which should be reported and investigated by an independent third party.

Setting Standards

To help solve this problem, The American Society of Plastic Surgeons sponsored collaboration, announced in November 2005, between The American Association of Accreditation of Ambulatory Surgery Facilities (AAAASF), the Accreditation Association for Ambulatory Health Care (AAAHC), and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), which was facilitated by the American College of Surgeons. Previously, these agencies worked independently to secure the support of the government and to work on legislative initiatives that would help establish standards for patient safety and quality care in office-based surgical facilities.

Doctors, medical associations, and others have helped to create a safeguard movement for office-based surgical procedures. For example, membership requirements for surgeons who participate in the ASPS and the American Society for Aesthetic Plastic Surgery (ASAPS) state those members who perform outpatient surgical procedures under sedation or general anesthesia must be accredited by the AAAASF.

Hospital Privileges and Board Certification

The AAAASF requires that surgeons who perform outpatient surgery in office-based surgical facilities have hospital privileges to perform the same procedure as well. In order for a surgeon to obtain hospital privileges to perform a specific procedure, the surgeon's expertise is reviewed by select peer members. The surgeon must demonstrate excellence in performing the procedure as well as provide the highest possible standard for quality care and patient safety. In addition, accredited facilities use surgeons who are board certified by the American Board of Medical Specialties (ABMS), the governing U.S. medical board. Furthermore, office-based surgical centers that are accredited must agree to follow through on the established standards set by the accrediting agency in order to maintain status.

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Safety Record Reflects Accreditation Efforts

More than 400,000 surgical procedures were performed in "accredited" office-based-surgery facilities. During the 2004 Annual Meeting of the ASAPS, a major study was released to find that the 400,000 office-surgery procedures shared an overall safety record comparable to those performed in hospital surgery facilities. This data, gathered by the AAAASF, utilized an Internet-based Quality Improvement and Peer Review Program, which provided a first ever central data collection system. The system evaluated more than 600 accredited surgery centers in a two-year period.

Consult a Qualified Doctor about the Facility

Be sure to talk with your doctor to ensure that the facility is accredited and that your doctor has privileges to perform the procedure you are interested in at an accredited hospital. (Even though you may have the procedure in an office, you want a doctor who has been granted privileges to do the same procedure in a hospital.)