Anesthesia services in dental facilities

The dental facility is not required to close for the review.

However, the anesthesiologist or FPA may require assistance from dental facility managers or delegated staff to complete the practice environment assessment.

Sometimes, an onsite assessment is required. The peer assessor may request to conduct the assessment in person or virtually.

There is no cost for dental facility or owner when an anesthesiologist or FPA undergoes a PEP assessment.

Costs for couriering medical records to CPSBC for review or other assessment information is the responsibility of the anesthesiologist or FPA participating in the assessment.

PEP endeavours to limit the disruption to the dental facility’s routine activities.

CPSBC may require dental facility staff to support some of the assessment process components such as the ones listed below.

Emergency cart review

The assessment includes the review of the emergency cart serving as a backup for patients undergoing procedural sedation. This will require the anesthesiologist or FPA to provide sample pictures and documentation of the equipment and supplies. If there are deficiencies in this area, a video conference review of the emergency cart may be required to confirm the presence of all required components. The anesthesiologist or FPA may ask dental facility staff to assist with completing this component.

Dental chart review

During the peer assessment, the anesthesiologist or FPA is asked to submit photocopies of selected dental charts to CPSBC. The anesthesiologist or FPA may ask dental facility staff for help with the anesthesia chart entries.

Compensation of dental facility staff time towards the facilitation of the assessment is up to the dental facility owners' discretion. CPSBC does not provide information or recommendations for compensation. Assessments are not conducted after normal business hours.

The review of the dental care is out-of-scope for this assessment.

The goal of PEP is to provide anesthesiologists and FPAs with information on their practice, provide guidance, and support them in making necessary changes to ensure patients receive safe care. For example, absence or flaws in critical emergency cart items could result in the temporary disruption of procedures that require sedation in order to avoid patient risk.

CPSBC encourages anesthesiologists and FPAs to work with the dental facility owner to identify any gaps before the practice environment assessment and review all of the following:

NHMSFAP accreditation standards

• Anesthesia
• Class 1 General Anesthesia Facility Emergency Cart
• Class 2 IV Sedation/Analgesia Facility Emergency Cart
• IV Procedural Sedation and Analgesia for Adults
• Malignant Hyperthermia
• Pediatric Emergency Cart
• Post-anesthesia Care

Guide document

• Accreditation Standards for Anesthesia Services in Dental Facilities

Areas for improvement identified by the anesthesiology peer assessor are provided to the anesthesiologist or FPA for their review. In some cases, the information may be reviewed with the Practice Enhancement Program Committee.

At the end of the assessment, the anesthesiologist or FPA receives a report outlining the opportunities for improvement and additional support. They are expected to correct all deficiencies. Failure to do so may limit or prevent the anesthesiologist or FPA's ability to continue practicing in that facility.

The assessment process is confidential and educational. Only the anesthesiologist or FPA has access to the final assessment.

Dental anesthesia assessment information is not reported to the provincial health officer or medical health officer unless there is a risk of significant harm to public health and safety, as per the Health Professions and Occupations Act.