Office-based anesthesia: new frontiers, better outcomes, and emphasis on safety.
OBJECTIVE
Office-based anesthesia has grown and continues to grow very rapidly in the ever-changing medical environment. The demand of patients, surgeons and the evolving economic environment has set off a dynamic growth explosion. This explosion has created aggressive and tumultuous enhancements, some of which have been adapted well and some of which have led to disastrous results.


RESULTS
As we institute rules and regulations to govern this 'wild west' of anesthesia, the landscape is set with some new guidelines that continue to evolve.Practice recommendations have been outlined for fire safety especially on patient fires. Closed claim studies offer valuable recommendations for MAC claims in the office based setting. Anesthesia Patient Safety Foundation and the ASA have outlined valuable information regarding the nonsilencing of equipment alarms.New equipment enhancements have generated successful mobile general anesthesia platforms. Finally, as we forge ahead we must construct measurements of our safety and success as outcome parameters are developed.


CONCLUSIONS
The review of recent literature and technological advances has provided some valuable lessons in the evolution of patient safety and office based technology for the surgical office-based environment. As this specialty grows, measures of its outcome parameters will allow a gauge of performance.
Desai
Meena S
MS
Nova Anesthesia Professionals, Villanova, Pennsylvania, USA. meenasdesai@yahoo.com
D000556:Ambulatory Surgical Procedures / Q000592:standards*; D000758:Anesthesia / Q000592:standards*; D000776:Anesthesiology / Q000295:instrumentation*; D005390:Fires / Q000517:prevention & control*; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D017751:Safety Management / Q000592:standards*; D020246:Venous Thrombosis / Q000517:prevention & control*