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"The increased awareness of the importance of accreditation in ensuring patient safety has created a need for us to customize our standards to fit that specific niche demand," says Alan Gold, MD, president of AAAASF. "Since physicians working in these types of facilities do not perform surgery in the operating room as we have accredited in the past, we felt compelled to address them directly."

There are 8 basic mandates for procedural facilities included in the 68-page PDF of procedural standards.

1. Patients receiving anesthetic agents other than topical or local anesthesia should be supervised in the immediate post-discharge period by a responsible adult for at least 12 to 24 hours, depending on the procedure and anesthesia used.

2. Changes in facility ownership must be reported to AAAASF within 30 days of the change.

3. Any death occurring in an accredited facility, or any death occurring within 30 days of a procedure performed in an accredited facility, must be reported to AAAASF within five business days after the facility is notified or otherwise becomes aware of that death. The death must also be reported as an unanticipated procedure sequela in the semi-annual peer review report. An unannounced inspection will occur in the event of a death occurring within 30 days of a procedure.

4. The facility director is responsible for establishing and enforcing policies that protect patients, and monitoring all members of the medical and facility staff for compliance with this policy.

5. The AAAASF patient bill of rights should be posted, followed and promoted.

6. All physicians using the facility must be certified or eligible for certification by one of the member boards of the American Board of Medical Specialties, or be certified or eligible for certification by the American Osteopathic Association Bureau of Osteopathic Specialists.

7. All physicians practicing in an AAAASF-accredited facility must hold, or must demonstrate that they have held, unrestricted hospital privileges in their specialty at an accredited and/or licensed acute care hospital located within 30 minutes of the facility for all procedures that they perform within the facility. Only procedures included in those hospital privileges may be performed within the AAAASF-accredited facility. A physician must be present when anesthesia other than strictly local is being administered in Class B, Class C-M or Class C accredited facilities.

8. If pediatric patients are treated in the facility, a minimum of one staff member who is Pediatric Advanced Life Support- certified must be present in the facility until all pediatric patients recovering from anesthesia have met discharge criteria.

"With the enactment of the New York legislation requiring office-based facility accreditation (by July 14, 2009), we have seen an influx of applications originating from that state," says AAAASF. "Also, the high concentration of office-based facilities in the city of New York has led us to review the OR space requirement, which we were able to modify without compromising patient safety."