Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Privileging of Emerging Procedures for Gynecologic Surgery

Obstet Gynecol; ePub 2016 Sep; ACOG Committee on Patient Safety

Guiding principles for privileging of innovative procedures in gynecologic surgery should include cognitive and technical assessment to ensure appropriate patient selection and performance of the new procedure, and implementation should also include pertinent institutional and staff support as needed. This according to new guiding principles issued by the American College of Obstetricians and Gynecologists (ACOG) regarding privileging for emerging procedures in gynecologic surgery. ACOG recommendations include:

• New or emerging surgical procedures and technologies must be implemented safely into clinical practice.

• Additional privileging may be required if substantively new technical or cognitive skills are required to implement an innovative procedure or technology.

• Guiding principles for privileging should include cognitive and technical assessment to ensure appropriate patient selection and performance of the new procedure.

• As with all facility privileging, systems to ensure current and ongoing clinical competence and, thus, patient safety, should be developed and implemented.

• Proctoring should be conducted to evaluate the skill set of individual surgeons to determine their ability to perform new procedures or use new technologies independently.

• Criteria for determining competency should be established in advance of the proctoring. The number of cases needed to demonstrate cognitive and technical proficiency will vary depending on many factors, including the health care provider’s baseline expertise and technical acumen.

Citation: American College of Obstetricians and Gynecologists. Guiding principles for privileging of innovative procedures in gynecologic surgery. Committee Opinion No. 674. Obstet Gynecol. 2016;128:e85–8.