The effect of facility characteristics on patient safety, patient experience, and service availability for procedures in non-hospital-affiliated outpatient settings: A systematic review.

<h4>Background</h4>Over recent decades, numerous medical procedures have migrated out of hospitals and into freestanding ambulatory surgery centers (ASCs) and physician offices, with possible implications for patient outcomes. In response, states have passed regulations for office-based...

Full description

Saved in:
Bibliographic Details
Main Authors: Nancy F Berglas, Molly F Battistelli, Wanda K Nicholson, Mindy Sobota, Richard D Urman, Sarah C M Roberts
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0190975&type=printable
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850168737672462336
author Nancy F Berglas
Molly F Battistelli
Wanda K Nicholson
Mindy Sobota
Richard D Urman
Sarah C M Roberts
author_facet Nancy F Berglas
Molly F Battistelli
Wanda K Nicholson
Mindy Sobota
Richard D Urman
Sarah C M Roberts
author_sort Nancy F Berglas
collection DOAJ
description <h4>Background</h4>Over recent decades, numerous medical procedures have migrated out of hospitals and into freestanding ambulatory surgery centers (ASCs) and physician offices, with possible implications for patient outcomes. In response, states have passed regulations for office-based surgeries, private organizations have established standards for facility accreditation, and professional associations have developed clinical guidelines. While abortions have been performed in office setting for decades, states have also enacted laws requiring that facilities that perform abortions meet specific requirements. The extent to which facility requirements have an impact on patient outcomes-for any procedure-is unclear.<h4>Methods and findings</h4>We conducted a systematic review to examine the effect of outpatient facility type (ASC vs. office) and specific facility characteristics (e.g., facility accreditation, emergency response protocols, clinician qualifications, physical plant characteristics, other policies) on patient safety, patient experience and service availability in non-hospital-affiliated outpatient settings. To identify relevant research, we searched databases of the published academic literature (PubMed, EMBASE, Web of Science) and websites of governmental and non-governmental organizations. Two investigators reviewed 3049 abstracts and full-text articles against inclusion/exclusion criteria and assessed the quality of 22 identified articles. Most studies were hampered by methodological challenges, with 12 of 22 not meeting minimum quality criteria. Of 10 studies included in the review, most (6) examined the effect of facility type on patient safety. Existing research appears to indicate no difference in patient safety for outpatient procedures performed in ASCs vs. physician offices. Research about specific facility characteristics is insufficient to draw conclusions.<h4>Conclusions</h4>More and higher quality research is needed to determine if there is a public health problem to be addressed through facility regulation and, if so, which facility characteristics may result in consistent improvements to patient safety while not adversely affecting patient experience or service availability.
format Article
id doaj-art-baf04384b21f47769b88dbdac3cda58d
institution OA Journals
issn 1932-6203
language English
publishDate 2018-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-baf04384b21f47769b88dbdac3cda58d2025-08-20T02:20:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01131e019097510.1371/journal.pone.0190975The effect of facility characteristics on patient safety, patient experience, and service availability for procedures in non-hospital-affiliated outpatient settings: A systematic review.Nancy F BerglasMolly F BattistelliWanda K NicholsonMindy SobotaRichard D UrmanSarah C M Roberts<h4>Background</h4>Over recent decades, numerous medical procedures have migrated out of hospitals and into freestanding ambulatory surgery centers (ASCs) and physician offices, with possible implications for patient outcomes. In response, states have passed regulations for office-based surgeries, private organizations have established standards for facility accreditation, and professional associations have developed clinical guidelines. While abortions have been performed in office setting for decades, states have also enacted laws requiring that facilities that perform abortions meet specific requirements. The extent to which facility requirements have an impact on patient outcomes-for any procedure-is unclear.<h4>Methods and findings</h4>We conducted a systematic review to examine the effect of outpatient facility type (ASC vs. office) and specific facility characteristics (e.g., facility accreditation, emergency response protocols, clinician qualifications, physical plant characteristics, other policies) on patient safety, patient experience and service availability in non-hospital-affiliated outpatient settings. To identify relevant research, we searched databases of the published academic literature (PubMed, EMBASE, Web of Science) and websites of governmental and non-governmental organizations. Two investigators reviewed 3049 abstracts and full-text articles against inclusion/exclusion criteria and assessed the quality of 22 identified articles. Most studies were hampered by methodological challenges, with 12 of 22 not meeting minimum quality criteria. Of 10 studies included in the review, most (6) examined the effect of facility type on patient safety. Existing research appears to indicate no difference in patient safety for outpatient procedures performed in ASCs vs. physician offices. Research about specific facility characteristics is insufficient to draw conclusions.<h4>Conclusions</h4>More and higher quality research is needed to determine if there is a public health problem to be addressed through facility regulation and, if so, which facility characteristics may result in consistent improvements to patient safety while not adversely affecting patient experience or service availability.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0190975&type=printable
spellingShingle Nancy F Berglas
Molly F Battistelli
Wanda K Nicholson
Mindy Sobota
Richard D Urman
Sarah C M Roberts
The effect of facility characteristics on patient safety, patient experience, and service availability for procedures in non-hospital-affiliated outpatient settings: A systematic review.
PLoS ONE
title The effect of facility characteristics on patient safety, patient experience, and service availability for procedures in non-hospital-affiliated outpatient settings: A systematic review.
title_full The effect of facility characteristics on patient safety, patient experience, and service availability for procedures in non-hospital-affiliated outpatient settings: A systematic review.
title_fullStr The effect of facility characteristics on patient safety, patient experience, and service availability for procedures in non-hospital-affiliated outpatient settings: A systematic review.
title_full_unstemmed The effect of facility characteristics on patient safety, patient experience, and service availability for procedures in non-hospital-affiliated outpatient settings: A systematic review.
title_short The effect of facility characteristics on patient safety, patient experience, and service availability for procedures in non-hospital-affiliated outpatient settings: A systematic review.
title_sort effect of facility characteristics on patient safety patient experience and service availability for procedures in non hospital affiliated outpatient settings a systematic review
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0190975&type=printable
work_keys_str_mv AT nancyfberglas theeffectoffacilitycharacteristicsonpatientsafetypatientexperienceandserviceavailabilityforproceduresinnonhospitalaffiliatedoutpatientsettingsasystematicreview
AT mollyfbattistelli theeffectoffacilitycharacteristicsonpatientsafetypatientexperienceandserviceavailabilityforproceduresinnonhospitalaffiliatedoutpatientsettingsasystematicreview
AT wandaknicholson theeffectoffacilitycharacteristicsonpatientsafetypatientexperienceandserviceavailabilityforproceduresinnonhospitalaffiliatedoutpatientsettingsasystematicreview
AT mindysobota theeffectoffacilitycharacteristicsonpatientsafetypatientexperienceandserviceavailabilityforproceduresinnonhospitalaffiliatedoutpatientsettingsasystematicreview
AT richarddurman theeffectoffacilitycharacteristicsonpatientsafetypatientexperienceandserviceavailabilityforproceduresinnonhospitalaffiliatedoutpatientsettingsasystematicreview
AT sarahcmroberts theeffectoffacilitycharacteristicsonpatientsafetypatientexperienceandserviceavailabilityforproceduresinnonhospitalaffiliatedoutpatientsettingsasystematicreview
AT nancyfberglas effectoffacilitycharacteristicsonpatientsafetypatientexperienceandserviceavailabilityforproceduresinnonhospitalaffiliatedoutpatientsettingsasystematicreview
AT mollyfbattistelli effectoffacilitycharacteristicsonpatientsafetypatientexperienceandserviceavailabilityforproceduresinnonhospitalaffiliatedoutpatientsettingsasystematicreview
AT wandaknicholson effectoffacilitycharacteristicsonpatientsafetypatientexperienceandserviceavailabilityforproceduresinnonhospitalaffiliatedoutpatientsettingsasystematicreview
AT mindysobota effectoffacilitycharacteristicsonpatientsafetypatientexperienceandserviceavailabilityforproceduresinnonhospitalaffiliatedoutpatientsettingsasystematicreview
AT richarddurman effectoffacilitycharacteristicsonpatientsafetypatientexperienceandserviceavailabilityforproceduresinnonhospitalaffiliatedoutpatientsettingsasystematicreview
AT sarahcmroberts effectoffacilitycharacteristicsonpatientsafetypatientexperienceandserviceavailabilityforproceduresinnonhospitalaffiliatedoutpatientsettingsasystematicreview