Going into 2011, ASCs should be cognizant of the impact of the economy, healthcare reform and other legislation on patient safety issues. Harlan Pollock, MD, president of American Association for Accreditation of Ambulatory Surgery Facilities, which has published over 1 million cases demonstrating safety in AAAASF-accredited facilities, shares six thoughts on patient safety in 2011 and beyond.
1. Infection control standards will continue to be a challenge. The Centers for Medicare & Medicaid Services made a significant revision to its interpretive guidelines for infection control in 2009, which has become a cause for concern for the healthcare industry as a whole. Dr. Pollock says since then, ASCs have come a long way in understanding and effecting the proper programs, processes and procedures to meet the interpretive guidelines. However, the regulations are somewhat confusing and clarification is necessary for ASCs to achieve compliance with infection control standards. AAAASF is working with CMS to address these concerns. Of course, part of the inspectors' concern is the extra paperwork required, which hopefully can be reduced in the future, Dr. Pollock says.
2. Healthcare reform may increase pressures on patient safety. Although the healthcare industry is cautiously awaiting the results of healthcare reform implementation, most healthcare leaders agree the healthcare overhaul will significantly impact patient access to care. With an estimated 33 million individuals becoming insured by 2015, Dr. Pollock says there will be a critical shortage of physicians to meet patient needs and causing additional pressure on healthcare facilities.
"Our concern is really the access for patients to affordable care," he says. "Many office-based surgical facilities, which offer a safe, inexpensive alternative, are excluded from reimbursement by third party payors.
"Additionally, the reduction in surgeons and facility reimbursements is also discouraging. These problems can be detrimental to patient safety and will limit access to affordable care."
AAAASF believes that the statistics for patient safety in its accredited facilities demonstrate the quality of care available at properly equipped and staffed ambulatory facilities. This quality and safety information speaks for itself and demonstrates the vital role that such providers will have to play when faced with an influx of newly covered patients. The challenge is getting the message of safety to reformers and payors," Dr. Pollock explains.
3. Impact of electronic medical records on patient safety is still unclear. While there is some literature suggesting EMRs doesn't necessarily improve the quality of patient care, government leaders and healthcare providers generally agree EMRs help to deliver efficient and high-quality care in a cost-effective way. The goal of meaningful use of health IT, however, was only introduced in 2009 and is still very much a young concept. Dr. Pollock says it will be some time until the healthcare industry truly knows what kind of an impact EMRs will have on patient safety.
4. Education is the key to safety. AAAASF provides current and innovative educational programs for inspectors, facility directors and staff.
"[AAAASF] is very reactive to changes, such as the new interpretive guidelines for infection control by CMS. We make sure to implement the appropriate changes to our standards and provide the necessary education on those new and complicated topics," Dr. Pollock says.
Other organizations, such as Association of periOperative Registered Nurses, Association for Professionals in Infection Control and Epidemiology, state ASC associations and the national ASC association, are also helpful in guiding ASCs reach patient safety excellence.
5. Patient safety is an umbrella term. Patient safety is a conglomeration of many different things, and ASCs must plan to find solutions for all patient safety issues that affect their respective facilities in 2011. Patient safety, for example, does not stop at hand hygiene, proper environmental cleaning or needlestick safety.
"Patient safety means so many different things and may even take on different meanings with different specialties, such as GI and reprocessing of endoscopic equipment," he says. "[AAAASF], for example, has a set of standards for procedural facilities only. In an effort to simplify the accreditation process, AAAASF utilizes a designated set of standards for surgical facilities that are both Medicare and non-Medicare as well as procedural and oral surgical facilities.
6. Propofol is still a hot-button issue. The use of propofol as an anesthetic agent in outpatient surgery centers is still an area of debate and a cause for concern among accrediting agencies. The main concern is the narrow margin of safety of this drug, which can provide sedation or can rapidly become a general anesthetic. Without proper anesthetic management and monitoring, the results can be disastrous.
"In response to this danger, we have changed our standards and now require an anesthesia provider to administer propofol," Dr. Pollock says. "We also changed our facility classification and require any facility that uses propofol to be staffed and equipped to handle general anesthesia."
Learn more about AAAASF.
1. Infection control standards will continue to be a challenge. The Centers for Medicare & Medicaid Services made a significant revision to its interpretive guidelines for infection control in 2009, which has become a cause for concern for the healthcare industry as a whole. Dr. Pollock says since then, ASCs have come a long way in understanding and effecting the proper programs, processes and procedures to meet the interpretive guidelines. However, the regulations are somewhat confusing and clarification is necessary for ASCs to achieve compliance with infection control standards. AAAASF is working with CMS to address these concerns. Of course, part of the inspectors' concern is the extra paperwork required, which hopefully can be reduced in the future, Dr. Pollock says.
2. Healthcare reform may increase pressures on patient safety. Although the healthcare industry is cautiously awaiting the results of healthcare reform implementation, most healthcare leaders agree the healthcare overhaul will significantly impact patient access to care. With an estimated 33 million individuals becoming insured by 2015, Dr. Pollock says there will be a critical shortage of physicians to meet patient needs and causing additional pressure on healthcare facilities.
"Our concern is really the access for patients to affordable care," he says. "Many office-based surgical facilities, which offer a safe, inexpensive alternative, are excluded from reimbursement by third party payors.
"Additionally, the reduction in surgeons and facility reimbursements is also discouraging. These problems can be detrimental to patient safety and will limit access to affordable care."
AAAASF believes that the statistics for patient safety in its accredited facilities demonstrate the quality of care available at properly equipped and staffed ambulatory facilities. This quality and safety information speaks for itself and demonstrates the vital role that such providers will have to play when faced with an influx of newly covered patients. The challenge is getting the message of safety to reformers and payors," Dr. Pollock explains.
3. Impact of electronic medical records on patient safety is still unclear. While there is some literature suggesting EMRs doesn't necessarily improve the quality of patient care, government leaders and healthcare providers generally agree EMRs help to deliver efficient and high-quality care in a cost-effective way. The goal of meaningful use of health IT, however, was only introduced in 2009 and is still very much a young concept. Dr. Pollock says it will be some time until the healthcare industry truly knows what kind of an impact EMRs will have on patient safety.
4. Education is the key to safety. AAAASF provides current and innovative educational programs for inspectors, facility directors and staff.
"[AAAASF] is very reactive to changes, such as the new interpretive guidelines for infection control by CMS. We make sure to implement the appropriate changes to our standards and provide the necessary education on those new and complicated topics," Dr. Pollock says.
Other organizations, such as Association of periOperative Registered Nurses, Association for Professionals in Infection Control and Epidemiology, state ASC associations and the national ASC association, are also helpful in guiding ASCs reach patient safety excellence.
5. Patient safety is an umbrella term. Patient safety is a conglomeration of many different things, and ASCs must plan to find solutions for all patient safety issues that affect their respective facilities in 2011. Patient safety, for example, does not stop at hand hygiene, proper environmental cleaning or needlestick safety.
"Patient safety means so many different things and may even take on different meanings with different specialties, such as GI and reprocessing of endoscopic equipment," he says. "[AAAASF], for example, has a set of standards for procedural facilities only. In an effort to simplify the accreditation process, AAAASF utilizes a designated set of standards for surgical facilities that are both Medicare and non-Medicare as well as procedural and oral surgical facilities.
6. Propofol is still a hot-button issue. The use of propofol as an anesthetic agent in outpatient surgery centers is still an area of debate and a cause for concern among accrediting agencies. The main concern is the narrow margin of safety of this drug, which can provide sedation or can rapidly become a general anesthetic. Without proper anesthetic management and monitoring, the results can be disastrous.
"In response to this danger, we have changed our standards and now require an anesthesia provider to administer propofol," Dr. Pollock says. "We also changed our facility classification and require any facility that uses propofol to be staffed and equipped to handle general anesthesia."
Learn more about AAAASF.
