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Define terms to meet anesthesia standards

Ambulatory Safety Monitor, June 16, 2005

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The AAAHC revised some of the anesthesia standards in 2005 to clarify providers' availability requirements during the care of patients.

Standards 9.L.1, 9.M, and 10.I speak to this topic specifically. When members of the Standards and Survey Procedures Committee, such as Chair Bev Philip, MD, updated the standards for this year, they wanted to help facilities drill down on the definitions in the policies they create. Understanding the AAAHC's language will help your organization meet compliance.

Following are some definitions:

• Present: In standards 9.L.1 and 9.M, a physician or personnel qualified in advanced resuscitative techniques (ACLS or PALS) must be present. Present, in this context, means in the facility. "You can't resuscitate a patient from a mile away," Philip says.

• Medical discharge: In 9.L.1 the physician or dentist must be present until medical discharge of the patient. Here, medical discharge means until the patient doesn't need medical care and meets discharge criteria.

• Physical discharge: Standard 9.M and 10.I require that appropriate personnel remain present until the patient is physically discharged. Physical discharge translates to the patient leaving the building after medical discharge. Sometimes the two discharges can mean the same thing, but medical discharge may happen before a physical discharge. For example, patients may be medically, but not physically, discharged while they wait for a ride home.

The AAAHC encourages each facility to modify its policies on anesthesia services to include further specifics for that organization. The revised standards aim to help facilities meet a higher level of patient safety.

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