June 2000
Volume 64 |
Number 6
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ASA NEWS
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| In-Office Surgery
Patient Safety Message Reaches 13 Million |
Philip S. Weintraub
Public Relations Manager
Advances that have been nurtured by anesthesiologists for patient
monitoring standards, equipment and methods and improved anesthetic
agents have contributed to one of medicine's greatest achievements:
office-based surgery. This achievement, however, without the implementation
of minimum safety standards, could become one of medicine's greatest
tragedies.
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| ASA President Ronald
A. MacKenzie, D.O., and Kathleen P. Nichols, M.D., Tucson,
Arizona, were featured in the VNR segment, shot primarily
in Tucson at an office-based surgical facility that uses anesthesiologists
as sole anesthesia providers. |
The number of surgeries performed in physicians' offices has
rapidly escalated in the last few years. It is estimated that
within five years, at least 10 million surgical procedures will
be performed each year in doctors' offices. Well-publicized cases
of patient deaths and injuries, mostly in Florida, have demonstrated
that patient safety standards are falling far short of the demand
for in-office surgical procedures.
The Doctors Day observance this year focused on concerns for
patients' safety during in-office surgical procedures. Just as
it did with last year's highly successful video and radio news
releases on herbal medicines, the Committee on Communications
(COC) turned its patient safety message to office-based surgery.
The COC, along with members of the Committee on Ambulatory Surgical
Care and the Anesthesia Patient Safety Foundation, provided guidance
and technical expertise in the video news release's (VNR's) content.
The goal of the VNR and radio release was to educate the public
on the increasing use and popularity of office settings for some
surgical procedures. There remains, however, a huge void in effective
patient safety standards being adopted in most states.
While hospitals and ambulatory surgical centers operate under
strict rules, guidelines and protocols, only a handful of states
(California, Florida, New Jersey and Texas) have adopted patient
safety standards in the office-based setting. Earlier this year,
the District of Columbia adopted ASA's "Guidelines for Office-Based
Anesthesia" as its standard of care.
In the VNR, patients were encouraged to ask questions and find
out prior to surgery who will be providing their anesthesia and
who will be monitoring their vital signs during the procedure.
They were urged to ask if the surgeon is accredited to do the
same procedure in a hospital and to find out if there are written
emergency procedures in place in case the patient needed to be
transferred to the hospital. The VNR also highlighted the need
to confirm that someone in the office is certified in advanced
cardiac life support and will be available during the surgical
procedure.
The VNR was distributed to more than 700 television stations
nationwide. It aired 243 times and reached an audience of more
than 8.5 million television viewers. The radio news release aired
nearly 600 times and reached an audience of 4.7 million listeners.
Within two weeks of the VNR and radio release distribution,
"Dateline NBC" aired its segment on office-based surgery. The
April 11 segment focused on two unrelated in-office procedures
that resulted in tragic consequences for the patients because
of the lack of adequately trained anesthesia personnel and the
failure of the practitioners to follow proper patient safety protocols.
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