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INAHTA IMPACT STORY: LEGISLATIVE AND ACCREDITATION REQUIREMENTS FOR OFFICE-BASED SURGERY IN AUSTRALIA

Published online by Cambridge University Press:  15 December 2017

David Tivey ,
Ning Ma ,
Joanna Duncan ,
Yasoba Atukorale ,
Robyn Lambert  and
Guy Maddern
David Tivey
Affiliation:
Royal Australasian College of Surgeonsdavid.tivey@surgeons.org
Ning Ma
Affiliation:
Royal Australasian College of Surgeons
Joanna Duncan
Affiliation:
Royal Australasian College of Surgeons
Yasoba Atukorale
Affiliation:
Royal Australasian College of Surgeons
Robyn Lambert
Affiliation:
Royal Australasian College of Surgeons
Guy Maddern
Affiliation:
Royal Australasian College of Surgeons
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Abstract

Background: There is growing trend for some surgical procedures previously performed in hospitals to be done in alternative settings, including office-based facilities. There has been some safety concerns reported in the media, which document serious adverse events following procedures performed in an office-based setting. To understand the current regulatory oversight of surgery in this setting ASERNIP-S conducted a review of the legislative and accreditation process governing these facilities in Australia.

Methods: Using rapid review methodology, internet searches targeted government Web sites for relevant publicly-available documents. Use of consolidated versions of legislative instruments ensured currency of information. Standards were sourced directly from the issuing authorities or those that oversee the accreditation process.

Results: Within Australia, healthcare facilities for surgery and their licensing are defined by each state and territory, which results in significant jurisdictional variation. These variations relate to the need for anesthesia beyond conscious sedation and listing of procedures in legislative instruments. In 2013, Australia adopted National Safety and Quality Health Service standards (NSQHS standards) for the accreditation of hospitals and day surgery centers; however, there is no NSQHS standard for office-based facilities. The main legislative driver for compliance is access to reimbursement schemes for service delivery.

Conclusions: The legislative and accreditation framework creates a situation whereby healthcare facilities that provide services outside the various legal definitions of surgery and those not covered by a reimbursement scheme, can operate without licensing and accreditation oversight. This situation exposes patients to potential increased risk of harm when receiving treatment in such unregulated facilities.

Keywords

Ambulatory surgical servicesLegislationAccreditationOffice surgery
Type
Theme Submissions
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 4: Mini-Theme: Stories of HTA Impact , 2017 , pp. 434 - 441
Copyright
Copyright © Cambridge University Press 2017 

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