The following article appeared in the July 2010 issue of Connection, the bi-monthly e-newsletter from the AAAHC.
Q: As a Medicare-certified ASC, can the recovery room be used simultaneously for pre-operative functions?
Denise Ricketts-Goombs, RN, MPH, MBA, AAAHC Surveyor: The Centers for Medicare and Medicaid Services' (CMS) Interpretive Guideline at 416.44(a)(2) allows for dual uses (pre-op/post-op), but it also says "consistent with accepted standards of practice." I think the "accepted standards" is the key phrase. This question must be asked in each separate practice environment. For example, take a one physician/one OR ophthalmology ASC. Such a type of service may have a very low infection rate and limited opportunity for cross contamination. Therefore; assuming other infection control practices are adhered to (e.g. appropriate hand hygiene, safe use of eye drops and injectables, environmental cleaning processes etc.), it would be acceptable to use the post-op area for pre-op care in this practice setting.
At the other end of the spectrum, however, a one physician/one room ASC that provides wound care may not be a candidate for dual use of its post-op area, since the potential for cross-contamination would be much higher.
Protection of patients' right to privacy and confidentiality of their clinical information are other important factors to consider, if the decision is made to use the post op area for dual purposes. The use of cubicle curtains at all times, nurses and physicians speaking in a low voice, cohorting of the pre-op and post-op patients and restricting the presence of family members in the area, may all help in maintaining the necessary privacy and confidentiality
Another area for consideration is the sensitivity of having pre-op patients observing post-op patients and the anxiety it could cause for patients waiting for their impending procedures. Maintaining privacy and confidentiality would help situations like these.
Learn more about AAAHC.
Read more accreditation and ASC safety tips:
- Guidance for Preventing Patient Falls
- Guidance for Proper Peer Review
- 3 Quick Tips to Better Meet Accreditation Standards
Q: As a Medicare-certified ASC, can the recovery room be used simultaneously for pre-operative functions?
Denise Ricketts-Goombs, RN, MPH, MBA, AAAHC Surveyor: The Centers for Medicare and Medicaid Services' (CMS) Interpretive Guideline at 416.44(a)(2) allows for dual uses (pre-op/post-op), but it also says "consistent with accepted standards of practice." I think the "accepted standards" is the key phrase. This question must be asked in each separate practice environment. For example, take a one physician/one OR ophthalmology ASC. Such a type of service may have a very low infection rate and limited opportunity for cross contamination. Therefore; assuming other infection control practices are adhered to (e.g. appropriate hand hygiene, safe use of eye drops and injectables, environmental cleaning processes etc.), it would be acceptable to use the post-op area for pre-op care in this practice setting.
At the other end of the spectrum, however, a one physician/one room ASC that provides wound care may not be a candidate for dual use of its post-op area, since the potential for cross-contamination would be much higher.
Protection of patients' right to privacy and confidentiality of their clinical information are other important factors to consider, if the decision is made to use the post op area for dual purposes. The use of cubicle curtains at all times, nurses and physicians speaking in a low voice, cohorting of the pre-op and post-op patients and restricting the presence of family members in the area, may all help in maintaining the necessary privacy and confidentiality
Another area for consideration is the sensitivity of having pre-op patients observing post-op patients and the anxiety it could cause for patients waiting for their impending procedures. Maintaining privacy and confidentiality would help situations like these.
Learn more about AAAHC.
Read more accreditation and ASC safety tips:
- Guidance for Preventing Patient Falls
- Guidance for Proper Peer Review
- 3 Quick Tips to Better Meet Accreditation Standards