Healthcare continues to move to the outpatient setting, and surgery centers wishing to thrive in this space will need to produce superior patient outcomes. Donald Fry, MD, executive vice president for clinic outcomes management for MPA Healthcare Solutions and an adjunct surgery professor at Chicago-based Northwestern University Feinberg School of Medicine, argues the industry needs to have systems in place to measure quality outcomes.
"There is not a great deal of objective evidence circulating about infections in this space because metrics for measuring these infections and outcomes in an ASC are not firmly established," he says. "It is extraordinarily difficult to track emergency department visits and admission events that result from a prior operation at surgery centers or physician offices. The bottom line is many clinicians in ASCs may not really know what their results [for infection and complication rates] are."
Dr. Fry and his colleagues at MPA Healthcare Solutions are publishing data that found between 40 percent and 50 percent of emergency department visits after elective major operations occur in facilities other than where patients received their initial procedure. This figure is higher than published literature which puts this figure between 20 percent and 40 percent, Dr. Fry says.
Surgery centers may often not be aware their patient was admitted to a hospital following a procedure because there is no mandate requiring hospitals to inform such facilities.
"ASCs and other facilities often take an arms-length position after their patients leave their facilities," Dr. Fry says. "I am not being critical of ASCs or HOPDs as much as I am critical of our general lack of databases allowing us to track what has happened to patients receiving outpatient surgical care."
Tracking hospital admissions and emergency department visits may be a vital way for surgery centers to assess their infection and complication rates, and make the necessary changes to minimize that figure. Therefore, Dr. Fry argues a central repository featuring meaningful data should drive change, rather than the government continually attempting to change infection control processes. Without the systems in place to limit complications, surgery centers may have high rates of infections and complications, especially if hospital and other facilities do not report the reason for admissions.
"The government often uses process measures rather than outcomes measures. They ask you a series of questions such as, 'Did you shave the hair at surgical site correctly?'" Dr. Fry says. "This has to change or there will be no value-based care. Measuring outcomes need to precede efforts to transform processes."
To see Dr. Donald Fry and 120+ other speakers discussing the biggest trends and topics in ASCs and healthcare today at the Becker's ASC 23rd Annual Meeting - The Business & Operations of ASCs on Oct. 27-29, 2016. Click here to learn more and register!
