Rafael Lugo, MD, is a board-certified general surgeon and CEO at Lugo Surgical Group in Shenandoah, Texas. In a recent interview with Becker's ASC Review, Dr. Lugo spoke about the role of patient education in preventing surgical site infections.
Question: What is the most important aspect of surgical site infection prevention in ASCs?
Dr. Rafael Lugo: No surgery center wants to have infections, but everyone uses different prep techniques. ASCs actually have one of the lowest infection rates, because most of the cases are performed with healthier patients than those at hospitals.
With surgical site infections, the issue is not necessarily the prep. It's usually due to a lack of education on the patient's part and the personal hygiene a patient maintains at home. Since everything in the surgical center is standardized, educating patients on how take care of the wound is crucial in preventing surgical site infections.
Q: How do you educate patients about preventing surgical site infections?
RL: We're living in the era of information, but the internet is full of inaccuracies. Everyone has opinions, but there are best practices to guide us.
I have a lot of direct communication with patients, and I use email, texting and videos to explain best practices. People don't like papers. Email open rates are low — they used to be high, but people tend to look more at texts now that practically everyone has a phone.
Surgicenters all have their own EHRs and EMR. I have a video series that is personalized to conditions based on ICD-10 codes, so for instance gallbladder patients get a video about what they need to do after gallbladder surgery. Time is of the essence for doctors nowadays. Technology can be your friend and automate this in a very specific and personal way.
The company that can do this for you and I is www.geniusvideo.com. It can be used as a standalone platform or integrated to any EHR/EMR.
Q: What are best practices in patient education?
RL: It's important to make sure that everyone on the surgical team is on the same page and is presenting a unified front. You have to educate nursing staff and then the patients.
It's also important to educate the patient's family, because often times people go home, and their families take care of them after surgery. So to make sure patients listen to the surgeon, you have to educate people who are not directly involved with the procedure as well. I've found that texting stays with them.
With surgical site infections, surgeons have to look at the causes of it and sometimes there has to be more than education involved, but educating will be the best first step.
Stick with proven methods of wound care, and spend time with the patient, because the time you spend with them now pays dividends later. With pay-for-performance, value-based payment, you don't want infection readmissions because you can be penalized later, besides the fact that is good practice.
If nothing else — other than the fact that it is good medicine — five minutes now saves a lot of headaches down the road.
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