Office-Based Surgery Practices
Impact of Human Resources on Office-Based Surgery Practices
Office-based surgery is defined within the legislation as that in which any surgical or invasive procedure is performed outside of a hospital or diagnostic and treatment centre, in which moderate to deep sedation or general anaesthesia is used (Patel et al., 2008). The use of office-based surgery is currently increasing, due to the recognized benefits with which it is associated, for example shorter waiting times, greater convenience and lower costs (Dalton et al., 2006). The role of human resources in office-based surgery is an important concern as it may have a significant impact in many areas of the practice, including critical aspects such as patient and staff safety. This essay examines the impact of human resources on office-based surgery, including accreditation issues, the impact on patient and staff safety, and employee and labor relations.
Accreditation Issues
Amid concerns for patient safety which arose, related to the use of office-based surgical procedures, legislators have sought to introduce various measures to better regulate this practice and improve safety. Under recently passed legislation, all office-based surgery practices must now maintain a full accredited status with one of the nationally recognized accrediting agencies. This legislation applies regardless of the size or specialty of the practice. If any physician practices in an office-based practice not accredited, this is considered to constitute professional misconduct (Patel et al., 2008). The introduction of this Joint Commission accreditation scheme is aimed at promoting a recognized standard in the delivery of care, thereby promoting a high level of patient safety (Palmer & McIver, 2008).
Human resources has a significant role to play in the accreditation process, especially in ensuring that the eligibility requirements for accreditation are met. For example there are standards set by the Joint Commission which state that four or fewer licensed practitioners must be operating from within the surgery to be eligible, therefore this must be accounted for in recruitment.
Safety and Health of Employees and Patients
Patient Safety
Horton et al. (2006) divide the issue of patient safety into three separate areas: administrative safety, clinical safety and procedural safety.
They suggest that patient safety begins at the administrative level, which involves putting procedures in place to minimize preventable errors associated with record keeping. This also incorporates appropriate processes for monitoring and reporting errors which do occur. The clinical aspects of patient safety then include appropriate evaluation of the patient to ensure that both the patient and the chosen procedure are appropriate for the office-based surgical setting. The final area of patient safety is then the surgical procedure itself.
Human resources clearly play a crucial role in the administrative elements of patient safety. Staff members dealing with the administration of patient notes clearly need to be appropriately trained and experienced to minimize the risk of errors being introduced during administrative procedures. This may be achieved through the recruitment and selection procedures, employing staff members who are suitably qualified and experienced. It may also however require a significant training input with existing staff members, across all levels from administrative staff members to clinicians. For example training with clinicians in quality assurance has been shown to have a significant positive impact on patient safety (Boonyasai et al., 2007).
This training may also play a crucial role in improving the clinical elements of patient safety, as improving clinician awareness of quality improvements and safety may further improve attitudes towards this in patient assessment. This then would leave the procedural element of patient safety. There is a possibility of adverse patient events occurring in an office-based surgery, just as there would be in the case of hospital-based surgery. Legislation states that these should be reported to the Department of Health's Patient Safety Center within one business day of occurrence (Patel et al., 2008).
One concern in the office-based surgery may be that there are less staff...
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