LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Discern the importance of the physician's office administrative structure. 2. Recognize the necessity of a system for quality assessment. 3. Assess which procedures are safe in the office-based setting. 4. Know the basic steps for properly evaluating patients for office-based plastic surgery. SUMMARY: This article reviews the literature on office-based patient safety issues. It places special emphasis on the statements and advisories published by the American Society of Plastic Surgeons' Convened Task Force on Patient Safety in the Office-Based Setting. The article divides patient safety in the health care delivery system into four broad categories. First, patient safety starts with emphasis at the administrative level. The physician or independent governing body must develop a system of quality assessment that functions to minimize preventable errors and report outcomes and errors. Second, the clinical aspects of patient safety require that the physician evaluate whether the procedure(s) and the patient are proper for the office setting. Third, this article gives special attention to liposuction, the most frequently performed office-based plastic surgery procedure. Finally, the article reviews the management of postoperative pain, nausea, and vomiting. Patient safety must be every physician's highest priority, as reflected in the Hippocratic Oath: primum non nocere ("first, do no harm").
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