May 2021 Volume LVI Number 3


AAPD-AAAASF Collaboration Emphasizes Patient Safety In Uncertain Times

November 2020 Volume LV Number 6

Outpatient Pediatric Dentistry
Of course you make safety a priority in your practice. But do your patient fami- lies truly understand that? An excellent way to enhance a sense of trust between providers and families seeking care in pediatric dental facilities is a voluntary accreditation program. That’s why the American Academy of Pediatric Dentistry (AAPD) partnered with the American Association for Accreditation of Ambu- latory Surgery Facilities (AAAASF) to develop a voluntary sedation/general anesthesia accreditation model for pedi- atric dental practices. This program is in response to the commitment by pediat- ric dentists to continue to provide safe environments in which to treat children, and is designed for practices interested in demonstrating that commitment to their patient families. As we find our- selves in the middle of the COVID-19 pandemic this has become even more important.
In 2017, the American Academy of Pedi- atric Dentistry (AAPD) and the American Association for Accreditation of Ambu- latory Surgery Facilities (AAAASF) first began exploring an accreditation program specifically designed to meet the needs of pediatric dentists. Three years later and amid a global health pandemic, accreditation has become an even more important concept and a commitment to a culture of patient safety that requires diligence and protects not just the patient receiving care but the staff and entire community. Such a cultural com- mitment can help wage the wars against the coronavirus and future pandemics.
When AAPD’s Safety Committee and AAAASF began collaborating about a pe- diatric dentistry accreditation program, the primary objective was to ensure the safest possible delivery of anesthesia, pa- tient monitoring, and ability to respond to emergencies for children. The pro- gram was intended to offer facilities the opportunity to demonstrate their com- pliance with best practices and clinical practice guidelines of the AAPD related to sedation and general anesthesia in the dental office via review and accredi- tation by a well-recognized independent organization.
For nearly 40 years, the AAAASF’s mission has been patient safety in the outpatient surgical area. Pediatric Dentistry accredi- tation intended to aid safety measures
in ambulatory facilities performing the following dental procedures on pediat- ric patients under sedation or general anesthesia: Dentoalveolar, Simple and Complex Extractions, Dental Restora- tions, Pulpal Treatment, Soft Tissue Graft, Frenuloplasty, Frenectomy, Space Main- tenance, Trauma (Hard and Soft Tissue Trauma, Lacerations, Hard Tissue Dental Fractures including Alveolus, Pathology (Hard and Soft Tissue, Management of Odontogenic Infection, Soft and Hard Tissue Biopsy).
Our goal is to establish and maintain the highest level of safety and prepared- ness in pediatric dental facilities. This is achieved, in part, by proper credential-
ing and training of dental and anesthesia providers and focusing on training and education in additional areas including emergency equipment and medications. This process sends a clear message to patients and regulators that AAPD and the individual facility is fully committed to the safety of its patients.
To learn more about the Pediatric Dentistry accreditation program, please visit programs/outpatient-pediatric-dentistry/.
Frequently Asked Questions
  1. Why is the AAPD involved in this collaborative effort? The AAPD supports accreditation through AAAASF because it promotes pa- tient safety in the outpatient surgical area, the highest level of safety and preparedness in pediatric dental facilities, proper credentialing and training of dental and anesthesia providers, and a focus on training and education in additional areas including emergency equipment and medications. The AAPD sees the proactive value of an accreditation opportunity for pediatric dental offices. Three years ago, the AAPD evaluated several existing accredita- tion organizations and ultimately selected AAAASF because they were willing to include: 1) the AAPD’s in- put to establish the dental accredita- tion standards., 2) pediatric dentists on the evaluation teams that go into offices and 3) pediatric dentists on their advisory board
  2. Why AAAASF? AAAASF’s Stan- dards, viewed by many as the Gold Standard, may be considered the strongest of any agency that ac- credits ambulatory surgery facilities. Credentialing requires 100% compli- ance with each standard to become and remain accredited. AAPD had significant input in coordination with AAAASF to develop the adopt- ed Pediatric Dental Standards. There is no other independent accredita- tion organization that has standards tailored for pediatric dentistry.
  3. Is it mandatory to become accred- ited? NO, this voluntary accredita- tion process by an independent organization is part of a safety effort by the AAPD since 2017. Pediatric dentistry has seen a significant shift toward general anesthesia and deep sedation services offered in dental offices. State regulatory agencies/ boards have increasingly required further oversight for these anesthe- sia services. The intent is to establish an accreditation process developed specifically for pediatric dentistry.
  4. Is this a new collaboration? AAPD is in the third year of this collabora- tion with AAAASF. For example, AAAASF had an exhibit booth at the 2019 AAPD Annual Session in Chicago and at the Fall 2019 Safety Symposium in Chicago. Initial work required the training of a cadre of pediatric dentists to serve as evalu- ators/site visitors. With the training of initial pediatric dentist evaluators/ site visitors completed, the AAPD had planned a "hard launch" of the program at the 2020 Annual Session in Nashville. However, due to the COVID-19 pandemic and transition of the 2020 Annual Session to a virtual format, the official launch of the program was postponed until the fall of 2020.
  5. Is the AAPD benefiting monetarily from this collaboration with the AAAASF? NO. The AAPD receives no royalties or any other payments from this program. The biggest benefit is the potential of increased safety for its members, their employees, and the patients they serve.
  6. How often are participating practices inspected? Every three years, and self-evaluation occurs yearly.
  7. My state doesn’t require accredi- tation. Why should I consider it? General Anesthesia and deep seda- tion are increasingly transitioning into dental offices as operating room access in hospitals and ambulatory surgery centers is becoming more limited. Practitioners and the public demand greater demonstrations of safety by independent facility ac- creditation. State agencies/boards in many cases are applying their hos- pital/surgery center model require- ments and not making modifications applicable to dentistry. States Health Boards and State Dental Boards across the U.S. are increasingly re- quiring independent accreditation/ permitting for general anesthesia, deep sedation and moderate seda- tion services provided in offices and outside of hospitals/ surgery centers. Here is an opportunity to become accredited within a structure created for pediatric dentistry.
  8. Who can apply? Any outpatient pediatric dentistry facility interested in standing out as a practice that exhibits the highest standard of care for their patients.
  9. If I don’t pursue this accreditation, is my risk of liability increased? The standard of patient care in a pe- diatric dental practice is determined by several factors, including adher- ence to AAPD best practices and clinical practice guidelines. Accredi- tation does not change the standard of care, but may prove helpful for a pediatric dental practice to demon- strate to the public and regulators that an independent agency has reviewed your practice as meeting the very highest standard of safety.
  10. Will all pediatric dental offices need to be accredited in order to be reimbursed by third-party payers? No, and the AAPD would strongly oppose any such proposal.
  11. How to apply? Review the Outpa- tient Pediatric Dentistry Standards and Manual and submit the new applicant materials to AAAASF at 7500 Grand Ave, Suite 200, Gurnee, IL 60031 or fax to (847) 775-1985 or alternatively scan and send to recep- Your documenta- tion will be reviewed within 10 days. Application materials: Standards Manual and Checklist V1, HIPAA Business Agreement, Random Case Review Form, Authorization to Release Form, Facility Identifica-tion Form, Staff Identification Form, Director Attestation Form.

Click here for a PDF version of this article.