TK Miller, MD, and Chuck Peck, MD, discussed the urgent need to create and implement a standardized infection prevention program in ASCs. Though setting up a standardized program is not obstacle free, Dr. Peck explains that it "could result in less waste, more importantly fewer errors and better quality outcomes for patients, the net result being increased cost effectiveness." Here are four challenges faced by ASCs when trying to put into practice a standardized program. 1. Many different surgeons. ASCs are used by many different surgeons. Some may have an interest in the center and some may simply use the center to perform procedures, and all will have a busy schedule. Familiarizing the surgeons, not to mention the regular staff of the ASC, with a new infection prevention program can be potentially time consuming. Every new physician and staff member should have infection control included within the orientation program at the center. They should also meet with the director of the infection control program.
2. Many different subspecialties. Many ASCs are multispecialty facilities and each subspecialty is accompanied by specific habits and methods. The variance in surgeon and staff behavior can be difficult to streamline when working toward the execution of a standardized program. If a best practice IC system is in place, the risk of infectious complications is greatly reduced and less susceptible to individual variation among subspecialties. Focus on the system, not the individuals.
3. High turnover rate. Outpatient procedures require a high patient turn over rate. A single ASC can treat thousands of patients during the course of year. Documenting and tracking each patient and everything associated with each procedure as required for an effective infection control program takes organization and commitment. Build fail-safe mechanisms into the system. Make IC part of the culture and not just a one-time project4. Consequent infections may involve different healthcare settings. ASCs are required to collect patient complications and hospital admissions related to surgery for their infection control program. However, patients that do acquire an infection at your ASC may not necessarily return for treatment, instead turning to a hospital or different healthcare setting. This can make it difficult to track what infections originated at your ASC and how. The advent of electronic medical records and Regional Health Information Organizations should help alleviate this concern.
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