Washington, DC -- In an effort to enhance patient safety in the office setting, The American Congress of Obstetricians and Gynecologists (ACOG) has launched the pilot stage of its new Safety Certification for Outpatient Practice Excellence (SCOPE) initiative. SCOPE is the first women's health-focused safety and quality certification program for individual and group ob-gyn practices. Participation in the voluntary review program can help ob-gyns institute new processes based on their individual settings and needs to ensure that their offices are operating in line with current patient safety criteria.

"ACOG strongly believes that safety for our patients is paramount to the care we provide, and we recognize that the majority of the interaction with our patients actually takes place in the ambulatory setting," said William L. Rayburn, MD, member of ACOG's Committee on Patient Safety and Quality Improvement. "With more than 70 million ob-gyn visits occurring each year, the office is a critically important place to maintain safety and quality improvement for our patients."

Patient safety is of particular concern when considering office-based surgery, according to ACOG. Recent advances in minimally-invasive gynecologic surgery techniques have made procedures once only available in a hospital setting—such as tubal sterilization, endometrial ablation for heavy periods, and loop electrosurgical excision procedure (LEEP) for precancerous cervical conditions—a feasible and popular offering at the ob-gyn office. Today, roughly 30 percent of gynecologic surgeries are in-office.

"Adverse events are 10 times more likely to occur in an office setting than in the hospital," said James T. Breeden, MD, president-elect of ACOG. "In many ways, the area of office-based surgery is young, and the checks and balances that have existed for years in hospitals have not been as well-established for the office setting. The SCOPE program is ACOG's effort to improve in-office patient safety procedures," Dr. Breeden added.

"Patients who come to have surgery in the office perceive it to be just as safe as if that procedure was taking place in the hospital, and it's important for us as ob-gyns to make sure that's true," said Sandra Koch, MD, member of ACOG's Committee on Patient Safety and Quality Improvement.

How does SCOPE work?

SCOPE is a voluntary comprehensive review program—available to all ob-gyn and other medical practices devoted to women's health—that looks at practices through a patient safety lens. In order to participate, practices will request a SCOPE survey that collects information on characteristics of the practice, providers, and specific safety measures and processes within the practice. The survey will be reviewed and followed with a site visit. Participants will also receive a report from ACOG that will include suggestions for additional opportunities to improve office patient safety.

"Many aspects of office practice can be reviewed with a SCOPE assessment. In addition to looking at safety measures used for surgery, processes used to assign specialist referrals or to order and retrieve laboratory and radiology reports can also be examined," said John P. Keats, MD, member of the Committee on Patient Safety and Quality Improvement who led the development of the SCOPE initiative. "The goal of the program is to help Fellows ensure that the care they provide is as safe as possible."

Why get a certification?

A SCOPE certification will benefit office staff, physicians, and women alike. "The review gives physicians the chance to identify gaps in office practices and improve patient safety which has been shown to improve quality," said R. Moss Hampton, MD, of the Committee on Patient Safety and Quality Improvement. "SCOPE provides an opportunity for ACOG and our Fellows to work together to advance office safety in women's health," he added.

"It is the goal of every ob-gyn to deliver the best possible care. Addressing patient safety issues early and proactively can help us avoid mistakes and mitigate the blame game that is inevitable if a negative outcome occurs," said Dr. Koch. "We want to promote an environment of safety."