Lin Peter H, Chandra Fiona A, Shapiro Fred E, Osman Brian M, Urman Richard D, Ahn Samuel S
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX; Department of Vascular Surgery, University Vascular Associates, Los Angeles, CA.
Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA.
Ann Vasc Surg. 2017 Jan;38:332-338. doi: 10.1016/j.avsg.2016.06.010. Epub 2016 Aug 20.
The rise in office-based interventional vascular laboratories in recent years was prompted in part by expedient ambulatory patient experience and favorable outpatient procedural reimbursement. While studies have shown that clinical safety and treatment efficacy can be achieved in office-based vascular facilities, critics have raised various concerns due to inconsistent patient care standards and lack of organizational oversight to ensure optimal patient outcome. Available literature showed widely varied clinical outcomes which were partly attributable to nonuniform standards in reporting clinical efficacy and adverse events. In this report, various concerns and pitfalls of office-based interventional vascular centers are discussed. Strategies to improve patient care delivery in office-based laboratories including accreditations which serve as external validation of processes to ensure patient care and safety are also mentioned. Finally, the requirements to obtain accreditation in an office-based practice and the differences between these nationally recognized accrediting organizations are discussed herein.
近年来，基于办公室的介入血管实验室数量的增加，部分原因是便捷的门诊患者体验和有利的门诊手术报销政策。虽然研究表明，在基于办公室的血管设施中可以实现临床安全性和治疗效果，但由于患者护理标准不一致以及缺乏组织监督以确保最佳患者预后，批评者提出了各种担忧。现有文献显示临床结果差异很大，部分原因是报告临床疗效和不良事件的标准不统一。在本报告中，讨论了基于办公室的介入血管中心的各种问题和陷阱。还提到了改善基于办公室的实验室患者护理服务的策略，包括作为确保患者护理和安全的流程外部验证的认证。最后，本文讨论了在基于办公室的实践中获得认证的要求以及这些全国认可的认证组织之间的差异。
