Patient safety issues in office-based surgery and anaesthesia in Switzerland: a qualitative study.

McLennan, Stuart; Schwappach, David; Harder, Yves; Staender, Sven; Elger, Bernice (2017). Patient safety issues in office-based surgery and anaesthesia in Switzerland: a qualitative study. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen, 125, pp. 23-29. Elsevier, Urban & Fischer 10.1016/j.zefq.2017.06.002

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OBJECTIVES

To identify the spectrum of patient safety issues in office-based surgery and anaesthesia in Switzerland.

METHODS

Purposive sample of 23 experts in surgery and anaesthesia and quality and regulation in Switzerland. Data were collected via individual qualitative interviews using a researcher-developed semi-structured interview guide between March 2016 and September 2016. Interviews were transcribed and analysed using conventional content analysis. Issues were categorised under the headings "structure", "process", and "outcome".

RESULTS

Experts identified two key overarching patient safety and regulatory issues in relation to office-based surgery and anaesthesia in Switzerland. First, experts repeatedly raised the current lack of data and transparency of the setting. It is unknown how many surgeons are operating in offices, how many and what types of operations are being done, and outcomes. Secondly, experts also noted the limited oversight and regulation of the setting. While some standards exists, most experts felt that more minimal safety standards regarding what requirements need to be met to do office-based surgery and what can and cannot be done in the office-based setting are needed, but advocated a self-regulatory approach.

CONCLUSION

There is currently a lack of empirical data regarding the quantity and quality office-based surgery and anaesthesia in Switzerland. Further research is needed to address these research gaps and inform health policy in relation to patient safety in office-based surgery and anaesthesia in Switzerland.

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