Human Resources Impact on Office-Based Surgery Practices

Introduction

Office-based surgery is defined within legislation as any surgical or invasive procedure performed outside of a hospital or diagnostic and treatment center in which moderate to deep sedation or general anesthesia is used (Patel et al., 2008). The use of office-based surgery is currently increasing due to the recognized benefits associated with it — 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 across many areas of 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, patient and staff safety, and employee and labor relations.

Accreditation Issues

Amid concerns for patient safety arising from 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 maintain 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 setting that is not accredited, this is considered professional misconduct (Patel et al., 2008). The introduction of the Joint Commission accreditation scheme is aimed at promoting a recognized standard in the delivery of care, thereby supporting a high level of patient safety (Palmer & McIver, 2008).

Human resources has a significant role to play in the accreditation process, particularly in ensuring that eligibility requirements are met. For example, standards set by the Joint Commission state that four or fewer licensed practitioners must be operating within the surgery to be eligible; this must therefore be accounted for in recruitment planning.

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 when they do occur. The clinical aspects of patient safety include appropriate evaluation of the patient to ensure that both the patient and the chosen procedure are suitable for the office-based surgical setting. The final area of patient safety is the surgical procedure itself.

Human resources clearly plays a crucial role in the administrative elements of patient safety. Staff members handling patient notes need to be appropriately trained and experienced to minimize the risk of errors during administrative procedures. This may be achieved through recruitment and selection processes that ensure staff are suitably qualified. It may also require significant training investment with existing staff at all levels, from administrative personnel to clinicians. For example, training clinicians in quality assurance has been shown to have a significant positive impact on patient safety (Boonyasai et al., 2007).

Such training may also play a crucial role in improving the clinical elements of patient safety, as raising clinician awareness of quality improvements and safety protocols can further improve attitudes toward patient assessment. This, in turn, addresses 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 a hospital-based setting. 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).