Facilities have learned what their vulnerabilities are , whether it is supply management , PPE , and their role in elective and urgent surgery when inpatient
ORs are on hold .”
— Terri Link , MPH , BSN , CNOR , CIC , CAIP , FAPIC
determine whether the patient came into contact with the virus in the ASC or somewhere else , the overall number of cases is so small that the safety of the ASC setting is assured .” Prentice adds , “ The pandemic has just been another reminder of how important it is for all healthcare providers to adhere to the infection prevention policies they have in place and to make sure they are tracking patient outcomes and fully addressing any concerns that arise .”
As was seen in acute-care facilities , transmission-based precautions evolved in ASCs in response to the pandemic .
“ After the pandemic was declared , ASCs adopted several new policies and procedures to ensure the safety of their patients , visitors , physicians and staff ,” Prentice says . “ Some we see most commonly include requiring face coverings for patients and staff in all areas of the ASC , social distancing , screening questionnaires , additional cleaning and air circulation procedures and requiring the friends and family members who accompany patients to the ASC to wait outside the facility instead of in the waiting room . Whether all of some of these precautions remain in place once the pandemic comes to an end remains to be seen .”
Regarding infection control practices that will continue , Wilson notes , “ Many centers report enhanced hand hygiene monitoring and reporting , additional cleaning of common areas , a continued focus on masking , additional training in airborne diseases and respiratory protection , and enhanced respiratory protection programs for employees . Screening of patients and obtaining pre-operative histories have been a longstanding practice in ASCs . Screening of patients , staff and visitors is still in place , depending upon the specific community and regulatory guidance . As we all know , this is not entirely behind us , and ASCs will continue to place patient safety as a top priority . In addition , we are anticipating that CMS will include COVID-19 vaccination of healthcare workers in their upcoming Proposed Rule for ASC Quality Reporting .”
Wilson continues , “ As more of the population is vaccinated and restrictions ease , ASCs are continuing their vigilance while easing back on some practices such as having no visitors allowed in the facility with patients . From what has been reported to me through the ASC Quality Collaboration , there are practices such as patient screening that will certainly stay in place for quite some time .”
In an October 2020 ASCA podcast , Prentice had noted that , “ What I think is often overlooked when we talk about these new protocols is that all of the rigorous infection prevention procedures that were already in place that I think really helped with the pandemic . And I would surmise that those have done most of the work in keeping patients safe .”
Podcast guest Rebecca Craig , CEO of Harmony Surgery Center and Peak Surgical Management in Fort Collins , CO , concurred , noting , “ Absolutely . I appreciate you bringing up the stringent infection prevention processes and procedures that we have in place , even before COVID-19 , which is why the ASC industry historically has had such low infection rates . It really did not take our industry much of a leap with the new protocols . And I would add that restricting family members or visitors is one of the new protocols that has been very beneficial . Any time that you can decrease traffic , it reduces the potential for spreading bugs to our patients .”
Keeping staff motivated to adhere to COVID-19 precautions comes down to them being a condition of employment , noted ASCA podcast guest Janie Kinsey , RN , administrator of the Surgicenter of Kansas City as well as a member of ASCA ’ s board of directors and current vice president . “ With the staff , we continue to provide the why and the data about the pandemic and our local infection rates and hospitalization rates , and the bottom line is it ’ s part of their job and a requirement for being employed . So , that ’ s fairly simple to control that within the ASC environment just by mandating it . At this point we have a few months behind us with the new protocols and with our patients that are a little bit cynical about not being able to have their family with them or why they have to wear a mask while they ’ re in our facility , we just remind them that with that history , we ’ ve been very fortunate not to have patients or staff members getting sick or infected with the virus , and really many of the other viruses that are common during particularly this time of the year when we ’ re entering into fall in the beginning of flu season . Communicating is the bottom line .”
Although staff compliance with the cornerstones of transmission prevention are key , a driving force behind ASCs ’ low infection rates could be QAPI programs , which are the coordinated application of two mutually-reinforcing aspects of a quality management system : Quality Assurance ( QA ) and Performance Improvement ( PI ). As Prentice explains , “ QAPI programs , by design , allow all ASCs to examine all the operational areas in their facilities and decide , based on data obtained by the ASC , where meaningful improvement is possible . In the last year , many ASCs did add items related to COVID-19 to their QAPI meeting agendas , and we expect that to continue until , ultimately , those items will be rolled into a broader category dealing with infectious diseases that many ASCs already include in their QAPI programs .”
Compliance with quality measures is also a key way that outpatient surgery centers are maintaining a tight focus on quality and safety . “ The ASC Quality Collaboration developed the first standardized quality measures appropriate to ASCs and continue to pursue measures that are important to patients , providers , and payors ,” Wilson emphasizes . “ Our focus for the last year has been on the development of a new reporting platform that will enable much more detailed analysis and expansion of reporting capabilities . We are eager to expand our service to ASCs and their patients . In addition , our relationships with regulatory agencies and accreditation organizations will continue as we