New York, S.C. require accreditation of
Office-based surgeries
By George E. Brandon
News Editor/Writer
New York Gov. Eliot Spitzer (D.) on July 18 signed into law legislation (S.6052) requiring that office-based surgeries be performed by physicians in settings that have obtained and maintained accreditation. Under the law, surgeries performed in an unaccredited setting would constitute professional medical misconduct, Gov. Spitzer said.
Earlier, South Carolina’s General Assembly ratified a regulation proposed by the state Board of Medical Examiners that will require office-based practices performing procedures requiring moderate , deep or general anesthesia to become accredited within the first year of operation.
Previously, office-based surgical practices were unregulated in New York state, except for licensing regulations covering physicians and other clinicians. The office facilities were not subject to licensing, credentialing and patient safety reporting requirements that apply to hospitals, diagnostic centers and ambulatory surgery centers. Voluntary guidelines developed in 2000 by a Committee on Quality Assurance in Office-Based Surgery had urged office-based practitioners to consider accreditation.
In addition to imposing accreditation as a requirement for office-based surgery facilities, the new law requires physicians working in them to report adverse office-based events-patients who die within 30 days of a procedure, unplanned transfers to hospitals or other "serious or life-threatening" events-to the state Health Department's Patient Safety Center within 24 hours. Data from such reports won't be subject to public disclosure under state "freedom of information" act requests but can be included in reports that aggregate such outcome data.
The law will take effect in six months, except for the accreditation requirements, which won't come into play until two years after the statute's enactment. In the meantime, the state's Health Commissioner is authorized to develop a list of entities authorized to accredit office-based surgeries. That list is expected to include the three major accrediting agencies already serving the market: The Joint Commission, the Accreditation Association for Ambulatory Health Care and the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF).
AAAASF, which specifically targets office-based surgical settings, already accredits 127 such facilities in New York state, said Theresa J. Griffin, CAE, director-legislative affairs and education. Griffin told AORN Management Connections there's no way of tallying the number of office-based surgery facilities in New York because the practices weren't regulated at all before passage of the legislation. "There are varying numbers on the actual facilities," she said. "I've heard as high as 2,000 and as few as 700 or 800."
Born as an accrediting body for plastic surgery practices, AAAASF adopted its current name and embraced a wider scope of medical specialty practice in the mid80s, Griffin said. In addition to cosmetic surgery, AAAASF's major surgical practice areas now include gastrointestinal, orthopedic, urology, fertility and OB/GYN.
The regulation passed June 7 by the South Carolina General Assembly requires accreditation, registration with the state Board of Medical Examiners and reporting of adverse events requiring resuscitation, emergency transfer, or resulting in death to the state board. It also sets performance and training standards for such office-based surgical facilities.
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