On June 15, The Oregonian reported that only half of Oregon surgery centers participate in the state's voluntary reporting system, established by the Oregon Patient Safety Commission in 2007. The report stated that of the 43 surgery centers that have joined the effort, less than two-thirds reported the details of adverse events in 2010. Kecia Rardin, president of the Oregon Ambulatory Surgery Association, discusses the data presented in the article and why quality reporting is becoming essential for surgery centers.
1. Surgery center reporting data may not tell the whole story. When stacked up against the participation rates for hospitals and nursing homes, surgery centers did not come off well in the Oregonian report. However, Ms. Rardin believes the fragmented nature of the ASC industry may skew the data somewhat. "We're such a diverse organization, and surgery centers go everywhere from small, single-specialty, one-OR surgery centers that are more an extension of a practice to large, multi-specialty centers that are open five or even six days a week," she says.
The differences between these kinds of surgery centers could make it difficult to compare quality reporting rates, she says. Small ASCs may lack the resources or time to report quality, whereas even smaller hospitals will generally have the funds and available staff to report adverse outcomes. Plastic surgery centers that do not accept Medicare patients and limit themselves to a small number of highly specialized and perfected procedures may not see the importance of reporting data to the state. She says while she encourages all surgery centers to report data on outcomes, a simple percentage of reporting participation may not tell the whole story.
She added that the reporting numbers for hospitals and nursing homes may not be as strong as they appear in the report — while 56 of Oregon's 58 hospitals and three-quarters of the state's nursing homes "participate" in the voluntary program, only 67 percent of hospitals and 8 percent of nursing homes submitted a report last year. "The bigger picture would have been why all medical facilities in general are hesitant to submit a report on patient safety," she says.
2. Reporting is important even for surgery centers with few adverse outcomes. Ms. Rardin says many surgery centers fail to report adverse outcomes because they have so few. A surgery center that sees one infection every year may feel that their data is useless. However, Ms. Rardin says reporting data on low adverse event rates can improve the reputation of surgery centers and create a more accurate picture of industry-wide outcomes.
"Every single surgery center affects our reputation, so our only choice is to reach out to all of them and encourage them that transparency of quality data is important and they should be proud of it," she says. "Even if they're saying, 'I don't have anything to report,' they should report that they have nothing."
3. Reporting will give ASCs a place in accountable care organizations. While the future of accountable care organizations is still uncertain, data reporting could improve the position of surgery centers if ACOs come to fruition, Ms. Rardin says. "ASCs have already proven that we have a place in the ACO model because of our financial efficiency," she says. "We've proven that, but we have to prove that we're there on quality as well." She says ASCs should not be afraid to release data on infection rates, especially if that data demonstrates that surgery centers have strong quality outcomes. She says surgery center leaders should pay attention to standards developed by the National Quality Forum and report any data they have.
4. Financial burdens may not be as significant as expected. Smaller surgery centers may balk at the idea of reporting quality outcome data because of the added stress on ASC staffing and finances. But Ms. Rardin says the financial burden associated with quality reporting may not be that significant — especially in Oregon, where surgery centers are mandated to pay a fee regardless of whether they report data or not. "It will take more RN or staff time to go through the reporting and gathering of data and root cause analysis, but the Patient Safety commission has created a great online site where you can submit the data and go through a really great root cause analysis," she says.
5. Reporting improves benchmarking for all surgery centers. Surgery centers might assume that quality reporting benefits the industry but has little effect on their operations, but Ms. Rardin says that quality reporting benefits all surgery centers by highlighting industry-wide problems that may apply to individual ASCs. Surgery centers can also refer to the collection of data to determine whether their outcomes are better or worse than their peers, giving them a benchmark to work from when conducting quality improvement studies.
"There's room for improvement in every facility in the United States, and when the Patient Safety Commission can compare this information to other confidential information, they can identify trends and share the lessons learned and help everyone improve patient care," Ms. Rardin says. She says surgery centers may also realize the significance of an incident they previously overlooked when they see data from other centers.
Learn more about the Oregon Ambulatory Surgery Center Association.
Related Articles on Surgery Center Quality:
Study: Warmed Head Drapes Could Increase Risk of OR Fire
DOH Report Shows Lehigh Valley Patient Died From Medication Error
Half of Oregon Surgery Centers Participate in Quality Reporting
1. Surgery center reporting data may not tell the whole story. When stacked up against the participation rates for hospitals and nursing homes, surgery centers did not come off well in the Oregonian report. However, Ms. Rardin believes the fragmented nature of the ASC industry may skew the data somewhat. "We're such a diverse organization, and surgery centers go everywhere from small, single-specialty, one-OR surgery centers that are more an extension of a practice to large, multi-specialty centers that are open five or even six days a week," she says.
The differences between these kinds of surgery centers could make it difficult to compare quality reporting rates, she says. Small ASCs may lack the resources or time to report quality, whereas even smaller hospitals will generally have the funds and available staff to report adverse outcomes. Plastic surgery centers that do not accept Medicare patients and limit themselves to a small number of highly specialized and perfected procedures may not see the importance of reporting data to the state. She says while she encourages all surgery centers to report data on outcomes, a simple percentage of reporting participation may not tell the whole story.
She added that the reporting numbers for hospitals and nursing homes may not be as strong as they appear in the report — while 56 of Oregon's 58 hospitals and three-quarters of the state's nursing homes "participate" in the voluntary program, only 67 percent of hospitals and 8 percent of nursing homes submitted a report last year. "The bigger picture would have been why all medical facilities in general are hesitant to submit a report on patient safety," she says.
2. Reporting is important even for surgery centers with few adverse outcomes. Ms. Rardin says many surgery centers fail to report adverse outcomes because they have so few. A surgery center that sees one infection every year may feel that their data is useless. However, Ms. Rardin says reporting data on low adverse event rates can improve the reputation of surgery centers and create a more accurate picture of industry-wide outcomes.
"Every single surgery center affects our reputation, so our only choice is to reach out to all of them and encourage them that transparency of quality data is important and they should be proud of it," she says. "Even if they're saying, 'I don't have anything to report,' they should report that they have nothing."
3. Reporting will give ASCs a place in accountable care organizations. While the future of accountable care organizations is still uncertain, data reporting could improve the position of surgery centers if ACOs come to fruition, Ms. Rardin says. "ASCs have already proven that we have a place in the ACO model because of our financial efficiency," she says. "We've proven that, but we have to prove that we're there on quality as well." She says ASCs should not be afraid to release data on infection rates, especially if that data demonstrates that surgery centers have strong quality outcomes. She says surgery center leaders should pay attention to standards developed by the National Quality Forum and report any data they have.
4. Financial burdens may not be as significant as expected. Smaller surgery centers may balk at the idea of reporting quality outcome data because of the added stress on ASC staffing and finances. But Ms. Rardin says the financial burden associated with quality reporting may not be that significant — especially in Oregon, where surgery centers are mandated to pay a fee regardless of whether they report data or not. "It will take more RN or staff time to go through the reporting and gathering of data and root cause analysis, but the Patient Safety commission has created a great online site where you can submit the data and go through a really great root cause analysis," she says.
5. Reporting improves benchmarking for all surgery centers. Surgery centers might assume that quality reporting benefits the industry but has little effect on their operations, but Ms. Rardin says that quality reporting benefits all surgery centers by highlighting industry-wide problems that may apply to individual ASCs. Surgery centers can also refer to the collection of data to determine whether their outcomes are better or worse than their peers, giving them a benchmark to work from when conducting quality improvement studies.
"There's room for improvement in every facility in the United States, and when the Patient Safety Commission can compare this information to other confidential information, they can identify trends and share the lessons learned and help everyone improve patient care," Ms. Rardin says. She says surgery centers may also realize the significance of an incident they previously overlooked when they see data from other centers.
Learn more about the Oregon Ambulatory Surgery Center Association.
Related Articles on Surgery Center Quality:
Study: Warmed Head Drapes Could Increase Risk of OR Fire
DOH Report Shows Lehigh Valley Patient Died From Medication Error
Half of Oregon Surgery Centers Participate in Quality Reporting
