Healthcare is a variable environment. Patients' needs change and how care is delivered changes, but the need to strive for the highest level of quality and patient safety remains constant. Ambulatory surgery centers have demonstrated excellence in these areas, but the work is never done. Here are three issues ASC leaders can hone in on to consistently improve on overall quality and patient safety.
1. The preoperative process. Naturally, much of the patient safey and quality discussion begins from the time a patient walks through the front door. But, expanding this conversation beyond an ASC's four walls can result in significant improvements. "The majoriy of safety problems and quality of care issues can be picked up on and discussed prior to admission," says Karen Reiter, COO of DISC Sports & Spine Center in Marina Del Rey and Newport Beach, Calif.
Contact with a patient beings with preoperative intake, whether this is done electronically or via telephone. "We use a multi-modal approach to preoperative intake," says Ms. Reiter. Effective communication with the patient and physician's office prior to the date of surgery can identify any potential safety issues and allow adequate time to prepare. Whether a single nurse or multiple staff members are assigned preoperative intake calls, ensure a stringent set of policies are in place.
The preoperative process can not only improve patient safety, but can also play a significant role in how a patient views a center's overall quality. "Satisfaction starts before admission," she says. "We live in a more transparent world and customer care is demanded." All staff members who interact with patients before they even step through the door should be trained in customer service.
2. Patient safety audits. All ASCs have processes in place to prevent safety issues such as patient falls or staff injuries, but too often these processes go without regular review. Consistent and comprehensive patient safety audits guarantee no issues can slip through the cracks. "You should have a designated safety officer, approved by the board," says Ann Geier, MS, RN, CNOR, CASC, chief nursing officer at SourceMedical. "Have a walking tool. You don't need to reinvent the wheel; ask your peers." These audits can be done once a month or as often as needed.
3. Quality studies. Quality studies, though required once a year for accreditation purposes, can be an immense help to a center if done correctly. "As a surveyor, you can always tell when an ASC is doing a study because their survey is coming up," says Ms. Geier. Rather than going through the motions, select an area your center struggles with and design a meaningful study.
QI studies ultimately drive ASC leaders to find areas that could be bettered and take the necessary actions. "I see a QI study in everything," says Ms. Geier. "If anything is trending in the wrong direction, do a study."
For example, patient wait time is often an issue prior to surgery. Find a concrete starting point, set a goal and measure your progress throughout the course of the study. If wait time is two hours at the onset of the study, determine what needs to be done to reach a specific benchmark and determine if those actions are actually working. While QI studies may seem burdensome to many, treating these exercises as nothing more than a chore will have little positive impact. "People have to buy into the fact that quality and safety are integral to the center," she says. "If you do that, you will be successful."
