The changing rules for office-based surgery

Abstract

Edward S. Truppman, MD, Aventura, FL , is a past president of the American Association for Accreditation of Ambulatory Surgery Facilities. Twenty years ago, the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) was established as a voluntary accreditation organization. The specialty of plastic surgery recognized the need for quality assurance and peer review of surgery performed in the office setting. To seek such review voluntarily was unheard of in 1980, which made the creation of AAAASF a profound tribute to the specialty's dedication to excellence. Among the states that took action to make accreditation mandatory, California and Florida led the way. The various office surgery rules developed by these states were applied to most surgical specialties in which intravenous sedation or general anesthesia is used. Under these rules, the surgeon must maintain complete documentation of each surgical procedure, including anesthesia records, informed consent as to surgical risks, and information on the anesthesia provider. Limits have been set on lipoplasty volumes and the maximum amount of lidocaine (per kg) to be injected. The facility must be registered with the Department of Health, and the surgeon must report any serious adverse incidents within 15 days of …