Does your facility have a clearly defined framework for the length of surgery allowable in the office? If not, you may want to look more closely at that portion of your program.
As your Accreditor, QUAD A does not dictate the length of surgery that can be performed in the office. However, you must have policies and procedures that outline procedure length and how that time is determined. The general recommendations for safe outpatient surgery involve surgical time limits of four to six hours for a general anesthesia case. If the procedure exceeds this time limit, it may be more appropriate to perform the surgery in a hospital setting. Some states do put a time limit on surgery length for the outpatient setting.
A facility policy should outline the types of procedures and length of procedures to be performed within the facility. There are several suggestions of times that may be used to define in procedure length in the policy;
- Admission to the facility
- Time in time out
- Open–close
- Total anesthesia time
Whichever time you use, remember the patient’s recovery time must be considered to stay under 23 hours and 59 minutes. Also keep in mind that the required staff, including a physician, must be available to monitor the patient’s recovery.
The required standards are listed below.
1-C-2 The facility should have a specific scheduling policy that includes only those procedures and/or combination of procedures of duration and degree that permit the safe recovery and discharge from the facility.
11-G-1 specifies a physician must be immediately available in the facility until the last patient is discharged.
The following links may help guide the development of facility policies and procedures.
The ASA Physical Status Classification System | American Society of Anesthesiologists (ASA) (asahq.org) is an additional source to use as a reference.
We appreciate your commitment to patient safety. If you have any questions, feel free to reach out to QUAD A.
Since 1980, QUAD A (a non-profit, physician-founded and led global accreditation organization) has worked with thousands of healthcare facilities to standardize and improve the quality of healthcare they provide – believing that patient safety should always come first.
