Accreditation surveyors for ambulatory surgery centers are now paying more attention to benchmarking and quality improvement projects. They want to see projects tackling vital issues for the center that can lead to growth opportunities. "Every surveyor's first question is becoming about the QA/QI program at surgery centers," says Marcy Sasso, Founder of Sasso Consulting. "They want to see centers identifying a process that doesn't work effectively and put together a project for improvement. It's a requirement for most ASC accreditations. Choose something that is meaningful for your center and document how you're making it better."
Here are eight steps to benchmarking, quality improvement and cost savings.
1. Internal benchmarking. A great place to start with benchmarking studies is within your own center. Gather data from your physicians about procedure times, turnover times and costs. Any time there is a considerable variation, there's an opportunity for improvement.
"When you do internal benchmarking, you can take into account why one physician is choosing more expensive materials or opening more materials than others," says Ms. Sasso. Then it's time to take action with your data.
2. Develop a plan to improve. Benchmarking won't help unless the ASC makes an effort to improve. Begin the conversation at a board meeting to demonstrate how data is distinctive and discuss opportunities for standardization.
"Go after dollars to make the board/physicians take note," says Ms. Sasso. "If many are using very expensive materials and they aren't owners they may not care. You need to track the data and have a conversation with the board about whether accommodating these physicians makes sense. Review the data and note when someone is $20 or $30 in the wrong direction."
3. External benchmarking. The next level of benchmarking includes measuring the center's data against local and/or national benchmarks to compare best practices. Choose a sister center or engage with a benchmarking company to access additional ASC data.
"You want to benchmark against others because otherwise you don't know how you compare," says Ms. Sasso. "You might be at 80 percent of medical record audits, but if everyone else is at 99 percent you may not be doing best practices the way you should."
4. Choose projects with room to grow. Surgery centers seeking accreditation must undergo quality improvement projects two per year and surveyors want to see projects where centers actually improve. Benchmarking in all areas should be significant for real time knowledge and for quality improvement initiatives.
"If a surveyor walks in, they want to see projects where you aren't 100 percent already," says Ms. Sasso. "For example, you have to be 100 percent with pre-op antibiotics, so unless you're having real trouble with that, it's not a helpful project to pick and benchmark. Pick something that is consequential for your center."
5. Develop an action plan. After deciding on an area to improve, develop an action plan, begin data collection and log your progress. Changes in the action plan can occur later on, but starting with that roadmap is a great way to prepare for success.
"If another center is turning over rooms more quickly, examine what your issue is," says Ms. Sasso. "Maybe you don't have enough staff, one room is not properly equipped or you've got a deficient process. These are factors you can turn into dollars and cents if you do it right. But you have to make changes for the right reasons and then you'll save money."
6. Investigate your process. Interview nurses and physicians about the inefficient processes and ask them why it is being done that way. Many centers require things to be performed in triplicate or in a certain order; oftentimes, they continue these processes because it's always been done that way, not because they are correct or efficient.
"When there is open communication and you can really observe what's going on, there will be an opportunity for change," says Ms. Sasso. "Physicians and staff will be thrilled because you are either saving them time and/or money."
7. Collect data. A software program or an electronic medical record can collect data necessary for operational or financial benchmarks. Track patient wait times, costs or other benchmarks from the computer and see how they improve as the action plan is implemented.
"You are collecting data, so you want to make it beneficial for you," says Ms. Sasso. "Make sure everyone knows why you are focusing on a specific dataset and what you plan to do with the information."
8. Start the improvement process. Once you identify an issue, start the process for improvement. "This way you can tell a surveyor you know your procedure/process doesn't work and you are trying to fix it," says Ms. Sasso. "If a center just leaves the issue and asks people to do better, that's not improving the process."
For more information about Sasso Consulting “Benchmarking for Compliance" Program, you can reach Marcy via email at marcy@sassoASC.com
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