Death of Joan Rivers a Wake Up Call for Surgical Centers and Patients

At this year’s OR Excellence conference, Kenneth P. Rothfield, M.D., M.B.A. (System Vice President and Chief Medical Officer, St. Vincent’s Healthcare, Jacksonville, FL) will discuss why the death of Joan Rivers is a wake up call for surgical centers and patients.

“The death of Joan Rivers has drawn attention to the safety of outpatient surgery facilities,” said Dr. Rothfield. “Hopefully, the positive from this scrutiny will be a re-evaluation of policies and practices, and safety culture at surgical centers that result in improvements to patient safety.”

Doctor caring for child
Doctor caring for child

One area of improvement is for surgical centers to make sure their standards are at least equal to that of hospitals. As Dr. Rothfield and his colleagues wrote in their article, “Medical standards of care and the Joan Rivers death”:

Although hospitals typically seek accreditation from The Joint Commission, ambulatory centers can receive accreditation from a variety of organizations. For example, The American Association for Accreditation of Ambulatory Surgery Facilities (“AAAASF”) accredits ambulatory surgery facilities like the one in which Joan Rivers underwent her medical procedure.

As discussed in their article, some key differences between the standards set by the American Society of Anesthesiologists (ASA) and AAAASF include:

  • The ASA requires all of the physiological parameters be monitored, while the AAAASF mandates just “one or several” physiological parameters be monitored.
  • Unlike the AAAASF, ASA standards mandate that the patient’s adequacy of ventilation be monitored.

So, what can patients and their loved ones do to protect themselves?

In another article written by Dr. Rothfield and his colleagues, “4 Lessons Learned from the Death of Joan Rivers”, they remind patients and their families:

  1. Even “minor” procedures can have major risks and “hidden harm”
  2. Ask questions to fully understand the medical procedure you are to undergo
  3. Make sure you are monitored electronically, with both pulse oximetry and capnography, if you are to receive sedation, opioids or anesthesia
  4. Equipment and resources at an outpatient clinic may be different than at a hospital

Dr. Rothfield is a member of the Board of Advisors for the Physician-Patient Alliance for Health & Safety (PPAHS), a non-profit 501(c)(3) that advocates that hospitals monitor all patients receiving opioids with capnography and pulse oximetry.

To help prevent adverse events and death due to respiratory compromise, PPAHS has joined with key medical societies to address the growing incidence and burden of inpatient respiratory issues through the Respiratory Compromise Institute.

Organizations that form the Clinical Advisory Committee of the Respiratory Compromise Institute include:

  • American Association for Respiratory Care (AARC)
  • American College of Emergency Physicians (ACEP)
  • American Society of Anesthesiologists (ASA)
  • American Thoracic Society (ATS)
  • American College of Chest Physicians (CHEST)
  • National Association for Medical Direction of Respiratory Care (NAMDRC)
  • Physician-Patient Alliance for Health & Safety (PPAHS)
  • Society of Critical Care Medicine (SCCM)
  • Society of Hospital Medicine (SHM)

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