Pushes for Quality in Facilities (Feb 1987)

Feb 14, 1997Journal Article

Day Surgery Article
Publication Status 3b (Australian Surgeon December 1994)
Review Status SR
Copyright Copyright of this article is vested in the author. Permissions for reprints or republications must be obtained in writing from the copyright holder. This article has been republished here with permission from the copyright holder. (Scanned from The Australian Surgeon. If there is any discrepancy between this scanned reproduction and the original the original takes precedence.)

Pushes for Quality in Facilities

Lindsay Roberts, FRCS FRACS

Chairman, Australian Day Surgery Council, 1990 – 2000

President Elect, International Association For Ambulatory Surgery 1999

The Chairman of the National Day Surgery Committee, Mr Lindsay Roberts, presented a speech at a national conference on health care delivery organised by I.I.R. Conferences in September, last. The speech was entitled “Day Surgery – The Past, Present and Future”, and the following is an edited version of the address.

The initiative of the medical profession to formalise the establishment and development of high quality day surgery facilities was expressed in a paper entitled “Introduction and Establishment of Day Only Facilities and Services”, and adopted at a meeting of the New South Wales Committee of the Australian Association of Surgeons on June 16, 1980.

The Paper was considered, adopted and expanded by the Council of the Australian Association of Surgeons and its document, entitled “Policy for the Introduction and Establishment of Day Surgery Facilities and Services” was forwarded to the Council of the Royal Australasian College of Surgeons on August 20, 1980, with the suggestion that these two organisations form a Working Party to prepare a manual of standards for day surgery. As a result, a Joint Working Party of the Royal Australasian College of Surgeons, the Australian Association of Surgeons, the Faculty of Anaesthetists of the Royal Australian College of Surgeons, and the Australian Society of Anaesthetists was formed as a quadripartite working party of equal representation with power to co-opt. The working parties publication “Day Surgery” September 19, 1981. was the first manual of standards for organised high quality day surgery in Australia.

There was little interest from Federal and State Governments for the next five years, however construction of several high standard Day Surgery Facilities, the first at Dandenong Victoria and several others in Sydney, stimulated formation of the New South Wales Day Surgery Facility Professional standards Advisory Committee on December 10, 1985 and this Committee published the first Manual for the Accreditation of Day Surgery Facilities in June 1986. It was also a quadripartite committee of New South Wales branches of the same four organisations which constituted the Working Party. The New South Wales Committee was granted imprimatur status by the Working Group for the purpose of accreditation of facilities in that State and two successful accreditation surveys were completed – the first Accreditation process by the medical profession, applying its own standards in Australia.

Since l986 the Australian Council on Health Care Standards has taken over responsibility for accreditation of day surgery centres and has published standards for this purpose in conjunction with the National Day Surgery Committee

The Working Party produced a revised edition of its publication “Day Surgery” in January 1987 and at a meeting on June 27, 1987 determined that it be formalised as the National Day Surgery Facility Standards Committee. On October 28 1988, recognising a necessity for the Committee to advise on all aspects of day surgery and day surgery facilities, the decision was made to change its name and therefore the scope of its determinations to the National Day Surgery Committee. At a meeting December 9, 1989, the Committee decided that a Charter should be prepared to govern its future activities.

Over the past four years the Committee has consolidated its activities and developed two Expanded Groups, the first to include representatives of all surgical specialities together with a nurses representative, and the second to include the Australian Medical Association, representatives of private and public hospitals together with free-standing day surgery centres, representatives of private health insurers and a representative of gastro-intestinal endoscopy (see opposite). As such, the Committee has the widest possible representation from the medical profession and all other major organisations involved in the delivery of health care, and is the most informed body on day surgery in Australia.

The Committee held a successful national seminar on day surgery in March 1992, and circulated an important Paper entitled “Incentives for The Expansion Of Day Surgery” (copies available from the AAS Secretariat). It is a matter of some concern that the Federal Government has not acted on the incentives which are included in this concise Paper.

History of the International Association for Ambulatory Surgery

Over the past four years there have been two European Congresses on Ambulatory Surgery, both held in Brussels (March 1991 and March 1993). A group of representatives from interested nations held a meeting during the Second European Congress on Ambulatory Surgery, (March 29-30, 1993) to consider the formation of an international association. The proposal was unanimously supported and a further meeting of this interested group was held in London, September 17 and 18, 1993. The Convener of these meetings was Dr Claude de Lathouwer MD (Belgium), who was also the Convener of the two European Congresses.

At the second meeting, (September 17-18, 1993) a formal decision was made, with unanimous support, that an International Association for Ambulatory Surgery be formed with the group of interested national representatives becoming the Foundation Committee. Some progress was made in drawing up a constitution for the new Association and it was decided that the next conference should also be held in Brussels, as the First International (Third European) Congress on Ambulatory Surgery, March 17-18, 1995

An information journal, “Ambulatory Surgery” (Butterworth Heinemann) was successfully launched in early 1993.

A third meeting of the Foundation Committee was held in Orlando Florida, on May 10, 1994 and the following nations we represented

Australia Belgium Great Britain
Germany Italy South Africa
Sweden Switzerland United States of America


At the previous meetings there were also representatives from France, Holland and Portugal. There was further discussion on the constitution and the Convener, Dr Claude de Lathouwer, is to prepare a Draft Constitution for consideration at the next meeting of the Foundation Committee, which is to be held in Brussels immediately prior to the Conference. It is hoped that a formal announcement of the formation of the International Association for Ambulatory Surgery will be made during the Conference.

Day Surgery – The Future

The following conceptual changes and developments for day surgery were mentioned and briefly discussed:

(a) Fundamental conceptual change.

  • Recognition of the large group of patients who need an operation/ procedure but who do not require the highly sophisticated services of traditional acute bed overnight stay hospitals.
  • The development of multidisciplinary “Day Hospitals”.
  • The provision of hotel (minimal serviced) type accommodation in existing hospitals.

(b) Expansion of day surgery/ procedure to reach its maximum potential.

(c) World wide expansion of day surgery/procedure to those countries where this service is not as yet established.

National Day Surgery Committee

National Day Surgery Central Committee

  • Australian Association of Surgeons
  • Royal Australian College of Surgeons
  • Australian & New Zealand College of Anaesthetists
  • Australian Society of Anaesthetists

National Day Surgery Expanded Committee

  • Royal Australian College of Obstetrics and Gynaecology
  • Australian Society of Otolaryngology Head and Neck Surgery Ltd
  • Royal Australian College of Ophthalmologists
  • Neurosurgical Society of Australasia Inc.
  • Australian Society for Plastic Surgeons
  • Australian and New Zealand Association of Urological Surgeons
  • Australian Orthopaedic Association
  • Australian Association of Paediatric Surgeons
  • Australian Nursing Federation
  • Australian Dental Association
  • Australian Medical Association
  • Australian Private Hospitals Association
  • Australian Health Insurance Association
  • Health Insurance Commission
  • Australian Hospital Association
  • Gastroenterology Society of Australia
  • Australian Association of Day Surgery Centres