Patient safety in office-based surgery facilities: I. Procedures in the office-based surgery setting.

At the ASPS Annual Meeting in October of 2000, the ASPS Board of Directors convened the Task Force on Patient Safety in Officebased Surgery Facilities. The task force was assembled in the wake of several highly publicized patient deaths, increasing state legislative/regulatory activity, and a moratorium on all level II and level III office-based surgery in the State of Florida. The task force faced a daunting task. The first area the task force focused on was collecting, evaluating, and reporting the health policies, accreditation standards, state legislation/regulation activities, and publications that influence the delivery of health care in office-based surgery facilities. With the information gathered, the task force produced several documents, starting with an accreditation crosswalk table that contrasted the office-based surgery standards of the three nationally recognized accrediting agencies. The task force also built a database to track state office-based surgery regulations, which was used as a resource to draft office-based surgery model legislation/regulation. The accreditation crosswalk and model legislation/regulation were placed on-line for members and have been widely distributed to national, state, and specialty medical organizations and state medical boards. The second area the task force tackled was the development of office-based surgery guidelines. After an extensive review of the existing guidelines and scientific literature, it was determined that few materials met the scientific rigor necessary to establish clear standards of practice. Therefore, the task force determined that it would be more appropriate to develop office-based surgery practice advisories, which are defined as systematically developed reports intended to assist decision-making in areas of patient care in which scientific evidence is insufficient.1 The advisory is based on the best information available and largely reflects the collective opinion of the members of the task force. The task force included representatives from related plastic surgery organizations and the American Society of Anesthesiologists and included Ronald E. Iverson, M.D., chair; Jeffery L. Apfelbaum, M.D., American Society of Anesthesiologists representative; Jack G. Bruner, M.D., ASPS Liposuction Task Force representative; Bruce L. Cunningham, M.D., ASPS/ PSEF Joint Outcomes Task Force representative; Richard A. D’Amico, M.D., ASPS representative; Thomas Joas, M.D., American Society of Anesthesiologists representative; Victor L. Lewis, Jr., M.D., ASPS Health Policy Analysis Committee representative; Dennis J. Lynch, M.D., ASPS representative; Noel B. McDevitt, M.D., ASPS Deep Vein Thrombosis Task Force representative; Michael F. McGuire, M.D., ASAPS representative; Calvin R. Peters, M.D., Florida Ad Hoc Commission on Patient Safety representative; Robert Singer, M.D., American Association for Accreditation of Ambulatory Surgery Facilities, Inc. representative; Rebecca S. Twersky, M.D.,