Learning Center For Providers


ISOBS is dedicated to educating medical professionals and the public about office-based practices to promote a safe, pleasant experience for all. The Institute fulfills its mission by:

  1. Providing OBS-related information to patients
  2. Providing OBS-related information to healthcare professionals
  3. Sponsoring Educational Activities such as Forums, Panels and Courses
  4. Recognizing individuals and organizations for their efforts to improve OBS safety

Below you will find useful resources for the practitioner that help address many aspects of safety in the office-based setting. Many resources are still under development, so expect many more in the near future. If you are interested in contributing any new resources to be posted on our website, please contact the Institute.

General and Specialty Topics

Surgical Safety Checklist Resources

Helpful Resources for Physicians

  1. Bhananker SM, Posner KL, Cheney FW et al. Injury and liability associated with monitored anesthesia care: A Closed Claims analysis. Anesthesiology 2006; 104:228–34.
  2. Domino KB: Office-Based Anesthesia: Lessons Learned from the Closed Claims Project. ASA Newsletter 65(6): 9-11, 15, 2001.
  3. Iverson RE, Lynch DJ, Twersky RS and the ASPS Task Force on Patient Safety in Office-Based Surgery Facilities. Patient safety in office-based surgery facilities. II: Patient Selection. Plast Reconstr Surg 2002; 110: 1785-90.
  4. Vila H, Soto R, Cantor AB, Mackey D.: Comparative Outcomes Analysis of Procedures Performed in Physician Offices and Ambulatory Surgery Centers. Arch Surg. 2003; 138: 991-995.
  5. Morello D. C., Colon, G. A., Fredricks S, et al. Patient safety in accredited office surgical facilities. Plast. Reconstr. Surg. 1997; 99: 1496–1500.
  6. Hoefflin SM, Bornstein JB, Gordon M: General anesthesia in an office-based plastic surgery facility: a report on more than 23,000 consecutive office-based procedures under general anesthesia with no significant complications. Plast Reconstrc Surg 2001; 107 : 243-51.
  7. Perrott DH, Yuen JP, Andresen RV, et al. Office-based ambulatory anesthesia: Outcomes of clinical practice of oral and maxillofacial surgeons. J Oral Maxillofac Surg. 2003;61(9):983–995.
  8.  Bitar G, Mullis W, Jacobs W, et al. Safety and efficacy of office-based surgery with monitored anesthesia care/sedation in 4778 consecutive plastic surgery procedures. Plast Reconstr Surg. 2003;111(1):150–156.
  9. Shapiro FE, Anesthesia for outpatient cosmetic surgery. In: Joshi G, editor. Current Opinions in Anesthesiology. London: Lippincott, Williams, and Wilkins; 2008; 21:704-11.
  10. Kryger ZB, Dumanina GA, Howard MA. Safety issues in combined gynecologic and plastic surgical procedures. International Journal of Gynecology and Obstetrics 2007; 99: 257-263.
  11. Clayman MA, Seagle BM. Office Surgery Safety: The Myths and Truths behind the Florida Moratoria—Six Years of Florida Data Plast. Reconstr. Surg 2006; 118: 777-785.
  12. Hancox JG, Venkat A, Coldiron B, et al. The safety of office-based surgery: Review of recent literature form several disciplines. Arch Dermatol. 2004;140(11):1379–1382.
  13. Horton JB, Reece EM, Broughton G, et al. Patient safety in the office-based setting. Plast. Reconstr. Surg. 117: 61e, 2006.
  14. Keyes GR, Singer R, Iverson RE, McGuire M, Yates J, Gold A, Thompson D. Analysis of outpatient surgery center safety using an internet-based quality improvement and peer review program. Plast Reconstr Surg. 2004 May; 113(6):1760-70. doi: 10.1097/01.prs.0000124743.75839.11. PMID: 15114143.
  15. Twersky RS, Philip BK, Shapiro FE (eds): Office-Based Anesthesia: Considerations for Anesthesiologists in Setting Up and Maintaining a Safe Office Anesthesia Environment. American Society of Anesthesiologists, 2008.
  16. Young S, Shapiro FE, Urman RD. Office-based surgery and patient outcomes. Curr Opin Anaesthesiol. 2018 Dec;31(6):707-712. doi: 10.1097/ACO.0000000000000655. PMID: 30148715.
  17. Seligson E, Beutler SS, Urman RD. Office-based anesthesia: an update on safety and outcomes (2017-2019). Curr Opin Anaesthesiol. 2019 Dec;32(6):756-761. doi: 10.1097/ACO.0000000000000789. PMID: 31483329.
  18. Urman RD, Punwani N, Shapiro FE. Patient safety and office-based anesthesia. Curr Opin Anaesthesiol. 2012 Dec;25(6):648-53. doi: 10.1097/ACO.0b013e3283593094. PMID: 23026805.
  19. Shapiro FE, Jani SR, Liu X, Dutton RP, Urman RD. Initial results from the National Anesthesia Clinical Outcomes Registry and overview of office-based anesthesia. Anesthesiol Clin. 2014 Jun;32(2):431-44. doi: 10.1016/j.anclin.2014.02.018. PMID: 24882129.
  20. Berglas NF, Battistelli MF, Nicholson WK, Sobota M, Urman RD, Roberts SCM. 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. 2018 Jan 5;13(1):e0190975. Doi: 10.1371/journal.pone.0190975. PMID: 29304180; PMCID: PMC5755935.
  21. Robert MC, Choi CJ, Shapiro FE, Urman RD, Melki S. Avoidance of serious medical errors in refractive surgery using a custom preoperative checklist. J Cataract Refract Surg. 2015 Oct;41(10):2171-8. doi: 10.1016/j.jcrs.2015.10.060. PMID: 26703293.
  22. Young S, Osman BM, Urman RD, Shapiro FE. Patients, procedures, and PPE: Safe office-based anesthesia recommendations in the COVID-19 era. Best Pract Res Clin Anaesthesiol. 2021 Oct;35(3):415-424. doi: 10.1016/j.bpa.2020.11.006. Epub 2020 Nov 20. PMID: 34511229; PMCID: PMC7678419.
  23. OBA Manual (Office-Based
  24. SAMBA OBA Curriculum
  25. APSF NEWSLETTER June 2020 PAGE 53 Educating the Next Generation: A Curriculum for Providing Safe Anesthesia in Office-Based Surgery
  26. MMS OBS Guidelines 2011, pending update 2022 (Mass Medical Society)
  27. Shapiro FE, Punwani N, Rosenberg NM, Valedon A, Twersky R, & Urman, RD. (2014). Office-based anesthesia: Safety and outcomes. Anesthesia and Analgesia. https://doi.org/10.1213/ANE.0000000000000313
  28. Macias A, Shapiro FE.  A 20/20 view of ophthalmic anesthesia: a reflective lends aimed to envision the future.  Anesthesia Patient Safety Foundation Newsletter. 2021;36(3);101-04.
  29. Young S, Pollard RJ, Shapiro FE.  Pushing the envelope: new patients, procedures, and personal protective equipment in the ambulatory surgical center for the COVID-19 era. Adv Anesth.  2021;39:97-112.
  30. Urman RD, Southerland W, Shapiro FE, Joshi, G. Concepts for the Development of Anesthesia-Related Patient Decision Aids, Anesth Analg. 2019 May;128(5):1030-1035. PMID: 30320645
  31. Osman B, Shapiro FE. Office-Based Anesthesia: A Comprehensive Review and 2019 Update, Anesthesiol Clin. 2019 Jun;37(2):317-331. PMID: 31047132
  32. Shapiro FE, Foreword, Emerging Concepts in Patient Safety, Int Anesthesiol Clinics. Summer 2019: 57(3) p1
  33. Osman, BM Shapiro FE. Office-based anesthesia. In: UptoDate, Lagasse RA, Ed., Nussmeier NA Deputy Ed., UpToDate, Waltham, MA. Feb 2020.
  34. Pollard RJ, Shapiro FE. Does choice of anesthesia affect surgery? Evidence-based Practice of Anesthesiology. In Fleisher Evidence-Based Anesthesia 4th edition. Philadelphia, Saunders, 2022.  (In press.)  
  35. Southerland W, Tollinche LE, Shapiro FE, Decision Aids: The role of the Patient in Perioperative Safety, Int Anesthesiol Clinics. Summer 2019: 57(3) p4-11.
  36. DeLima A, Osman B, Shapiro FE. Safety in Office-Based Anesthesia: An Updated Review of the Literature From 2016 to 2019, Curr Opin Anaesthesiol.Epub Ahead of Print]. doi: 10.1097/ACO.0000000000000794. PMID  31503034
  37. Southerland W, Beight L, Shapiro FE, Urman RD. Anesthesia Decision aids: Do they work? Curr Opin Anaesthesiol. 2020 Apr;33(2):185-191. DOI: 10.1097/ACO.0000000000000832. PMID 31913145