MOC-PS(SM) CME Article: Patient Safety in the Office-Based Setting

Learning Objectives: After studying this article, the participant should be able to: 1. Discern the importance of the physician's office administrative structure. 2. Recognize the necessity of a system for quality assessment. 3. Assess which procedures are safe in the office-based setting. 4. Know the basic steps for properly evaluating patients for office-based plastic surgery. Summary: This article reviews the literature on office-based patient safety issues. It places special emphasis on the statements and advisories published by the American Society of Plastic Surgeons' Convened Task Force on Patient Safety in the Office-Based Setting. The article divides patient safety in the health care delivery system into four broad categories. First, patient safety starts with emphasis at the administrative level. The physician or independent governing body must develop a system of quality assessment that functions to minimize preventable errors and report outcomes and errors. Second, the clinical aspects of patient safety require that the physician evaluate whether the procedure(s) and the patient are proper for the office setting. Third, this article gives special attention to liposuction, the most frequently performed office-based plastic surgery procedure. Finally, the article reviews the management of postoperative pain, nausea, and vomiting. Patient safety must be every physician's highest priority, as reflected in the Hippocratic Oath: primum non nocere (“first, do no harm”). The Maintenance of Certification module series is designed to help the clinician structure his or her study in specific areas appropriate to his or her clinical practice. This article is prepared to accompany practice-based assessment of preoperative assessment, anesthesia, surgical treatment plan, perioperative management, and outcomes. In this format, the clinician is invited to compare his or her methods of patient assessment and treatment, outcomes, and complications with authoritative, information-based references. This information base is then used for self-assessment and benchmarking in parts II and IV of the Maintenance of Certification process of the American Board of Plastic Surgery. This article is not intended to be an exhaustive treatise on the subject. Rather, it is designed to serve as a reference point for further in-depth study by review of the reference articles presented.