Alabama Administrative Code › Title 540 - ALABAMA BOARD OF MEDICAL EXAMINERS › Chapter 540-X-10 - OFFICE-BASED SURGERY › Section 540-X-10-.11 - Reporting Requirement

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
			 Reporting to the Alabama Board of Medical Examiners is required within three
			 (3) business days of the occurrence and will include all surgical related
			 deaths and all events related to a procedure(s) that resulted in an emergency
			 transfer of the surgical patient to the hospital, anesthetic or surgical events
			 requiring CPR, unscheduled hospitalization related to the surgery, and surgical
			 site deep wound infection.
(2)
			 Office Administration. The following summarizes some of the important written
			 documents and polices and procedures that office-based practices are encouraged
			 to develop and implement. The policies and procedures should undergo periodic
			 review and updating. Office-based surgery practices are encouraged to utilize
			 on-site patient safety surveys that are performed by professional trade
			 associations, nationally recognized accrediting agencies and/or other
			 organizations experienced in providing emerging risk-reduction strategies
			 associated with office-based surgery.
(a)
			 Policies and Procedures. Written policies and procedures can assist
			 office-based practices in providing safe and quality surgical care, assure
			 consistent personnel performance, and promote an awareness and understanding of
			 the inherent rights of patients. The following are important aspects of an
			 office-based practice that should benefit from simple policy and procedure
			 statements.
1. Emergency Care and Transfer
			 Plan: A plan shall be developed for the provision of emergency medical care as
			 well as the safe and timely transfer of patients to a nearby hospital should
			 hospitalization be necessary.
(i) Age
			 appropriate emergency supplies, equipment and medication should be provided in
			 accordance with the scope of surgical and anesthesia services provided at the
			 practitioner's office.
(ii) In an
			 office where anesthesia services are provided to infants and children, the
			 required emergency equipment should be appropriately sized for a pediatric
			 population, and personnel should be appropriately trained to handle pediatric
			 emergencies (currently trained in APLS or PALS).
(iii) At least one physician currently
			 trained in ACLS must be immediately and physically available until the last
			 patient is past the first stage of recovery. A practitioner who is qualified in
			 resuscitation techniques and emergency care should be present and available
			 until all patients having more than local anesthesia or minor conductive block
			 anesthesia have been discharged from the office (Advanced adult or pediatric
			 life support certified).
(iv) In
			 the event of untoward anesthetic, medical or surgical emergencies, personnel
			 should be familiar with the procedures and plan to be followed, and able to
			 take the necessary actions. All office personnel should be familiar with a
			 documented plan for the timely and safe transfer of patients to a nearby
			 hospital. This plan should include arrangements for emergency medical services,
			 if necessary, or when appropriate escort of the patient to the hospital by an
			 appropriate practitioner. If advanced cardiac life support is instituted, the
			 plan should include immediate contact with emergency medical
			 services.