Patients go from "before" to "after" in less than an hour on reality TV makeover shows, and while patients are often shown shopping for smaller jeans or larger bras after recovery, they're rarely seen signing an informed consent form before surgery. So when a high-profile patient experiences a negative outcome or worse — such as the recent death of Donda West, mother of hip-hop singer Kanye West — consumers are forced to acknowledge what American Society of Plastic Surgery (ASPS) President Richard D'Amico, M.D., stated following the news of Ms. West's death, "No-risk surgery doesn't exist."
THE LITMUS TEST Vito Quatela, M.D., president of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), says that surgeons who practice in accredited facilities convey the message that standardization and safety are very important to them. "Accreditation is equated with patient safety and in today's world of highly publicized deaths during plastic surgery, patient safety is first and foremost on the minds of both surgeons and patients alike," says Dr. Quatela.To that end, AAFPRS has recently instituted a new rule. The mandatory accreditation bylaw amendment states that members using Level II or higher sedation must be accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Accreditation Association for Ambulatory Healthcare (AAAHC), the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) or another third-party entity qualified to issue (similar) accreditation or be in the process of gaining that accreditation. Members have two years after the amendment's effective date of July 7, 2007 to come into compliance with its provision.
AAAHC REQUIREMENTS The requirements for AAAHC accreditation are widely known to be rigorous and ongoing. John E. Burke, Ph.D., Executive Director and C.E.O. of AAAHC, describes the certificate of accreditation as a symbol to others that an organization is committed to providing high-quality care and that it has demonstrated that commitment by measuring up to the AAAHC's high standards. "However," says Dr. Burke, "the real value of accreditation lies in the consultative and educational process that precedes the awarding of the certificate. It is this self-analysis, peer review and consultation that ultimately help an organization improve its care and services."
In order to achieve AAAHC accreditation, cosmetic surgery centers must meet the same core standards in eight areas with which all AAAHC accredited organizations must be compliant. These include rights of patients, governance, administration, quality of care provided, quality management and improvement, clinical records and health information, and facilities and environment. The standards, published in the AAAHC's Accreditation Handbook for Ambulatory Health Care, describe organizational characteristics that the Accreditation Association has determined to be essential to providing high-quality patient care. The standards are divided into core standards that apply to all organizations seeking accreditation, and adjunct standards that apply to organizations based on the services they provide. In total, there are approximately 250 core and 375 adjunct standards listed in the handbook. Adjunct standards include anesthesia services, surgical and related services, overnight care and services, dental services, emergency services, immediate care/urgent care services, pharmaceutical services, pathology and medical lab services, and diagnostic and other imaging services, among others.
KEEPING CURRENT Each year, the Accreditation Association Standards and Survey Procedures Committee reviews and revises Accreditation Association standards to ensure that they remain relevant to the ambulatory care community. These revisions are released for a 30-day comment period in order to allow interested parties an opportunity to comment on the proposed standards. The revisions are then sent to the Accreditation Association Board of Directors for final approval.