|Day Surgery Article|
|Publication Status||3b (Australian Surgeon Winter 1997 vol 21 no 2 pp 35-36)|
|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.)|
Day Surgery – The Past
Lindsay Roberts, FRCS FRACS
Chairman, Australian Day Surgery Council, 1990 â€“ 2000
President Elect, International Association For Ambulatory Surgery 1999
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 16 June 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 20th August 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 Australasian Association of Surgeons, The Faculty of Anaesthetists of the Royal Australasian 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 Party’s publication “Day Surgery” 19 September 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 10 December 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 the 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 Party for the purpose of accreditation of day surgery 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 1986, the Australian Council on Healthcare Standards has taken over responsibility for accreditation of day surgery centres and published standards for this purpose in conjunction with the Working Party.
The Working Party produced a revised edition of its publication “Day Surgery” in January 1987, and at a meeting on 27 June 1987 determined that it be formalised as the National Day Surgery Facility Standards Committee.
On 28 October 1988, recognising the 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 on 9 December 1989, the Committee decided that a Charter should be prepared to govern its future activities.
Over the next four years, the Committee 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 (vida infra). 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 May 1992, and circulated an important Paper entitled “Incentives For The Expansion of Day Surgery”. It is a matter of some concern that the Federal Government has not acted on the incentives which are included in this concise Paper.
During 1994-95 the Committee identified four Clinical Indicators specifically applicable to day surgery centres/units. These Clinical Indicators were accepted by the Australian Council on Healthcare Standards, Care Evaluation Programme and, after a successful 12 month trial, they were introduced into the accreditation programme in January 1996.
In July 1995, following extensive clinical evaluation by many professional and other health care organisations, including the National Day Surgery Committee, the Commonwealth Department of Health and Human Services produced a definitive list of procedures (Type B) considered suitable for day surgery.
There has been a rapid increase in the number of free standing day surgery centres throughout Australia over the past five years. As of December 1996, there were 143 registered free standing day surgery centres, compared with 83 in January 1993. In the same period, many private hospitals and some public hospitals have constructed specific free-functioning day surgery units within their hospitals.
A major International Conference on Day Surgery “Day Surgery 2000”, was held in Adelaide on 31 August – 3 September 1996, and this proved to be very successful.
At a meeting of the Committee on 12 October 1996, a decision was made to change its name to the Australian Day Surgery Council, thereby raising its status and providing greater authority to its activities. At the same meeting Council unanimously supported the concept of extended recovery for day surgery patients.
It was considered essential that all facets of day surgery be defined, and at a meeting on 22 February 1997, a list of definitions for day surgery practice was prepared.
A further revised edition of “Day Surgery” was published in April 1997.