For The Public

What Does SCOPE Certification Mean to You the Patient?

In an effort to enhance patient safety in the office setting, The American Congress of Obstetricians and Gynecologists (ACOG) launched Safety Certification for Outpatient Practice Excellence (SCOPE) initiative. SCOPE is the first women's health-focused safety certification program for offices that provide women’s health care, particularly Ob/Gyn practices. Participation in the voluntary review program can help ob-gyns and other women’s health providers institute new safety 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 offices through a patient safety lens. In order to participate, offices complete an application that collects information on characteristics of the office, providers, and specific safety measures and processes within the office. The application will be reviewed and followed with a site visit to review the responses and observe the processes. Participants will also receive a report from ACOG that will include suggestions for additional opportunities to improve office patient safety and to continue to reduce patient risks.

"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 would your health provider’s office get a certification?

Certification benefits office staff, health providers, 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."

How do I know if a practice has gone through this process?

The SCOPE for women’s health website lists all currently certified offices.  Since the process just started May of 2012, many offices are in process but are not listed until all the requirements have been completed and reviewed.  Certification is for 3 years, so the dates of certification are included with the listing.  At three years an office must “re certify” or repeat this process to maintain their certification.  This allows the SCOPE for Women’s Health program to continually add new areas of safety processes and quality improvements that impact the care of women.

Click the links below to see what ACOG Fellows are saying about Patient Safety:

SCOPE: ACOG’s Commitment to Patient Safety—James T. Breeden, MD

How the SCOPE Program Works—John P. Keats, MD

Safety in the Office Setting—William L. Rayburn, MD

A Safe Move from the Hospital to the Office--Sandra Koch, MD