Inahta Impact Story: Legislative and Accreditation Requirements for Office-Based Surgery in Australia

Tivey, David; Ma, Ning; Duncan, Joanna; Atukorale, Yasoba N.; Lambert, Robyn; Maddern, Guy J.

doi:10.1017/s0266462317001052

Cited by 4 publications

(2 citation statements)

References 2 publications

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“…Various professional colleges have called for quality assurance processes to be instituted in all surgical areas of OBA 27 . In a recent review article examining the regulations for office-based procedures, it was determined that currently there were no national safety and quality service standards for office-based facilities encompassing the provision of surgical and anaesthetic care 28 . The authors found that this situation exposes patients to potential increased risk of harm when receiving treatment in such unregulated facilities.…”

Section: Discussionmentioning

confidence: 99%

A Clinical Audit of An Office-Based Anaesthesia Service for Dental Procedures in Victoria

Silvers

Licina²,

Jolevska³

2018

Anaesth Intensive Care

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There is an increasing number of specialties performing office-based procedures, with many different providers practising in this field. Office Based Anaesthesia Solutions is a private enterprise designed to be a high-quality general anaesthesia and sedation service delivering care across 18 dental practices in Victoria. We undertook a criterion-based audit of our practice standards and outcomes. Following ethics approval, we retrospectively reviewed consecutive patients managed by our service between March 2014 and July 2017. We collected demographic data, information about anaesthesia technique, and surgical features. We assessed our findings against the Australian and New Zealand College of Anaesthetists (ANZCA) day surgery policy documents. During the specified period, we provided anaesthesia or sedation for 1,323 patients. Their ages ranged from two to 93 years (mean [standard deviation] 33.3 [18.6] years). Ninety-three percent of patients were American Society of Anesthesiologists (ASA) physical status classification 1 or 2. Patient demographics were in line with ANZCA day surgical policy documents. Total intravenous anaesthesia was used in 1,054 of the 1,096 documented general anaesthesia cases. There were three unplanned hospital transfers (annual incidence 0.07%). As this was the first Australian criteria-based audit of officebased anaesthesia (OBA) for dental procedures, we cannot compare our findings directly to previous studies. However, we feel that our patient demographics fell within acceptable ANZCA day procedure standards and our adverse event rate was both very low and similar to other published international adverse event rates. Our audit indicates that with careful screening processes, patient selection and medical governance, OBA is a viable model of care for patients undergoing dental procedures.

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Section: Discussionmentioning

confidence: 99%

A Clinical Audit of An Office-Based Anaesthesia Service for Dental Procedures in Victoria

Silvers

Licina²,

Jolevska³

2018

Anaesth Intensive Care

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“…Their story brings to light the role that organizational culture can have in the transfer and application of new knowledge in clinical practice. From the Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S) comes a story by Tivey et al (12) about their application of rapid review HTA methods to assess the legislative and accreditation requirements for office-based surgery in Australia. Their results show that loopholes exist where higher-risk surgeries could occur without the necessary clinical practice safeguards.…”

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confidence: 99%

Insights From the Front Lines: A Collection of Stories of Hta Impact From Inahta Member Agencies

Schuller¹,

Werkö

2017

Int J Technol Assess Health Care

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This mini-theme contains six stories of health technology assessment (HTA) impact from member agencies of The International Network of Agencies for Health Technology Assessment (INAHTA), which were originally shared at the 2015 and 2016 INAHTA Congresses. The INAHTA impact story sharing is an innovative network activity where member agency representatives share experiences of HTA impact in a loosely structured story format. Through this process, members gain insights from other agencies on new ways of thinking about and approaching HTA impact assessment. A guide is provided to members to prepare their story, and the best story receives the David Hailey Award for Best Impact Story. This mini-theme contains stories of HTA impact from six member agencies in different parts of the world: the Health Assessment Division of the Ministry of Public Health (Uruguay), the Institute of Quality and Efficiency in Health Care (Germany), the Health Information and Quality Authority (Ireland), the Finnish Office for Health Technology Assessment (Finland), the Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (Australia), and the Institut national d'excellence en santé et en services sociaux (Canada). Across the papers, common themes emerge about the importance of appropriate engagement of stakeholders and the broadening scope of HTA beyond reimbursement decision making.

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Procedural sedation in ambulatory anaesthesia: what's new?

Ræder

2019

Current Opinion in Anaesthesiology

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Purpose of review Although sedation traditionally has been regarded as an easy, straight forward and simple variety of general anaesthesia; the trends are to make sedation more sophisticated and dedicated. Also to have a critical look at old dogmas, as they are usually derived from the practice of general anaesthesia. Safety always has to be first priority, especially as the practice grows out of traditional theatres and frequently are being practiced by nonanaesthetic personnel. Recent findings Safety comes from learning of rare cases with severe problems as well as better guidelines and rules of accreditation. Further, there is a growing quest for evidence on pragmatic, high-quality, cost-effective practice; in terms of logistics, monitoring, choice of drugs and quality assurance. The traditional drugs, such as propofol, midazolam and remifentanil, are still defending their dominant position but are being challenged by ketamine and etomidate. Remimazolam and dexmedetomidine are new promising drugs in this area, whereas metoxyflurane may have a revival in some situations. Further, there is growing evidence into specific protocols, practice for special procedures and for patients with special challenges. Summary Procedural sedation deserves to have high degree of attention for further developments, both from a scientific and pragmatic point of view, as the practice is very diversified and growing.

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Inahta Impact Story: Legislative and Accreditation Requirements for Office-Based Surgery in Australia

Cited by 4 publications

References 2 publications

A Clinical Audit of An Office-Based Anaesthesia Service for Dental Procedures in Victoria

A Clinical Audit of An Office-Based Anaesthesia Service for Dental Procedures in Victoria

Insights From the Front Lines: A Collection of Stories of Hta Impact From Inahta Member Agencies

Procedural sedation in ambulatory anaesthesia: what's new?

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