Safety and Quality Ratings for ASCs
Ambulatory surgery centers (ASCs), modern healthcare facilities focused on providing same-day surgical care (including preventive and diagnostic procedures), have emerged as key players in ensuring safe, high quality, and cost-effective health care delivery 1. Indeed, with a strong record of positive patient outcomes, they have reshaped the outpatient experience for millions of American patients by providing them with a convenient alternative to hospital-based procedures 2. However, their safety and quality is important to monitor in order to ensure that patient outcomes are not negatively impacted. Several organizations, both public and private, provide safety and quality ratings for ASCs to this end.
Capitalizing on recent advances in surgical and pain management techniques, ASCs today regularly and safely perform most outpatient surgery procedures. In addition, since ASCs often specialize in certain specialties and/or procedures, they are able to place additional focus on patient experience and safety. In so doing, similar to hospital operating rooms, surgeons, nurses and medical professionals in ASCs adhere to a strict set of protocols 3.
The safety and quality of ASCs is ensured by close monitoring. Like hospitals, ASCs must abide by a number of laws and regulations. Most ASCs, for example, are Medicare-certified, and a large number are accredited by independent agencies that provide safety and quality ratings after a thorough screening and inspection process.
In order to maintain a safe and sanitary environment, every ASC needs to establish and maintain procedures for preventing infections. The Centers for Disease Control (CDC) recommend contracting teams specializing in infection prevention 4 which can manage an ASC’s infection prevention program in a facility-tailored way. Meanwhile, individual ASCs may also utilize standardized surveys established to rate their own safety and implement changes accordingly 5. The national Agency for Healthcare Research and Quality (AHRQ), to this end, created the Ambulatory Surgery Center Survey on Patient Safety Culture. The survey is specifically designed for ASC staff, focusing on their own assessments of patient safety in their facility.
Similarly, ASCs must conduct regular, comprehensive ratings of the safety and quality of care they provide to their patients. Today, both Medicare’s Ambulatory Surgical Center Quality Reporting (ASCQR) program and a program coordinated by the ASC Quality Collaboration (ASC QC) serve as robust, open-access ASC quality reporting programs 6.
The ASC QC was created in 2006 as a cooperative effort between a number of different organizations in order to begin to develop standardized ASC quality measures 8, concentrating on both outcome and process measures. To date, nearly 2,000 ASCs have voluntarily participated in the reporting of its 11 distinct ASC performance measures.
Administered by the Centers for Medicare and Medicaid Services (CMS), the ASCQR, in contrast, has been gathering data since 2012, focusing on 9 different performance areas 7. To date, nearly 97% of ASCs in the U.S., or over 5,000, collect and report performance measures to this program
Both of these reporting programs continue to evolve, meanwhile, as a result of the ongoing cooperation and collaboration of ASC staff, government regulators, and independent rating agencies.
Overall, ASCs offer safe and high-quality health care. However, as an increasing number of procedures shift from the hospital to the ASC, in-depth quality and safety assessments will be critical to maintaining such high standards into the future and across clinical contexts 9.
References
1. Grisel, J. & Arjmand, E. Comparing quality at an ambulatory surgery center and a hospital-based facility: Preliminary findings. Otolaryngol. – Head Neck Surg. (2009). doi:10.1016/j.otohns.2009.09.002
2. What Is an ASC? – Advancing Surgical Care. Available at: https://www.advancingsurgicalcare.com/advancingsurgicalcare/asc/whatisanasc.
3. Quality of Care in ASCs – Advancing Surgical Care. Available at: https://www.advancingsurgicalcare.com/safetyquality/qualityofcareinascs.
4. for Disease Control, C. Guide to Infection Prevention For Outpatient Settings: Minimum Expectations for Safe Care.
5. Ambulatory Surgery Center Survey on Patient Safety Culture | Agency for Healthcare Research and Quality. Available at: https://www.ahrq.gov/sops/surveys/asc/index.html.
6. ASC Quality Reporting – Advancing Surgical Care. Available at: https://www.advancingsurgicalcare.com/safetyquality/ascqualityreporting.
7. ASC Quality Reporting | CMS. Available at: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ASC-Quality-Reporting.
8. Welcome – ASC Quality Collaboration. Available at: https://www.ascquality.org/home.
9. Witiw, C. D., Wilson, J. R., Fehlings, M. G. & Traynelis, V. C. Ambulatory Surgical Centers: Improving Quality of Operative Spine Care? Glob. Spine J. (2020). doi:10.1177/2192568219849391