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 .”
— Bill Prentice
build upon our platform and serve as a quality resource for the industry .”
Another critical consideration for maintaining quality is conducting risk assessments .
“ An all-hazards approach is a CMS requirement and that includes performing a risk assessment to determine what a facility ’ s infection risks are ,” Link says . “ This includes an all-hazard risk assessment , for example when your facility is at risk for hurricanes — how does that look during a pandemic when a hurricane occurs and evacuation and sheltering take place with isolation precautions .”
Prentice points to the aforementioned studies demonstrating that ASCs can provide safe outpatient surgical care to their patients despite the pandemic . “ These findings are consistent with other reports we have seen ,” he says .” As always , ASCs will continue to adhere to the highest standards of infection prevention and to monitor patient outcomes and internal benchmarks to ensure they can continue to provide the safe , high-quality care that patients expect in the ASC setting .”
Identifying opportunities for improvement remains critical for all healthcare institutions , not just outpatient facilities , but efforts may be even more laser-focused there .
“ ASCs continue to rely heavily on internal and external benchmarking to help them make sure they are delivering the best care possible and to help identify areas for improvement ,” Prentice confirms . “ We have not seen any dramatic shifts in the numbers associated with the quality measures ASCs report , but we have seen some changes in case volume over the last year and a half . We will continue to monitor the reports from ASCA ’ s 2021 Clinical & Operational Benchmarking program to see if these trends continue .”
In that aforementioned October 2020 ASCA podcast , Prentice and guests discussed the wisdom of adding COVID-19-related protocols or measures to ASC benchmarking surveys .
“ I think adding to our benchmarking survey is a great idea ,” Craig said . “ I think it will provide us even more data to show the excellent results and the safe outcomes , even during a pandemic . Also , I feel it is beneficial to have different team members performing random audits , and / or utilizing a checklist would be helpful to promote a safe environment .”
Kinsey agreed , noting , “ I think that adding both the benchmarking and a checklist is helpful , particularly for independent surgery centers that maybe don ’ t have a corporate partner helping to develop those ( assets ) that serve as a reminder . I think it ’ s easy to get in the weeds as we ’ re changing so rapidly the protocols and just trying to keep up . What we are hearing is that as folks are being surveyed , and the last couple of months as surveys have started up again , they are looking for specific information about how we manage COVID .”
Link says that benchmarking in the midst of the pandemic is critical for ASCs , noting , “ We cannot ignore other infection related occurrences such as surgical site infections ( SSIs ),” she says . “ It is important when standards of care have been relaxed due to an emergency that as soon as possible , they return to that standard , such as SSI prevention bundles of care and surveillance to identify an outbreak , whether it is for COVID-19 or multidrug-resistance organisms ( MDROs ).”
The pandemic ’ s overall impact on caseloads could potentially skew ASC benchmarking in the year to come . This spring , the ASCA conducted a short survey of its members and found that 82 percent of respondents reported lower or significantly lower procedure volume in 2020 compared to 2019 , a finding which aligns with other reports coming out of this segment of healthcare delivery , Prentice notes .
This ASCA survey reflects the experiences of 314 respondents in 44 states . As Taira ( 2021 ) reports , “ As expected , ASCs reported severe effects of the COVID-19 pandemic on their operations in 2020 . Stoppages on elective surgeries in spring 2020 , though brief , caused significant declines in procedure volume . Eighty two percent of respondents reported lower or significantly lower procedure volume in 2020 compared to 2019 . This aligns with previous ASCA surveys performed last year and publicly reported numbers such as those from Envision Healthcare in April 2020 that reported a 70 percent reduction in ambulatory surgery services since the onset of the pandemic . The severe reduction in procedure volume had obvious effects on facility finances , with 70 percent of survey respondents reporting lower or significantly lower revenue in 2020 compared to 2019 . This aligns with a previous ASCA survey in which almost 60 percent of facilities reported significantly lower revenue between March 31 and Oct . 31 , 2020 , compared to the same period in 2019 .”
Taira ( 2021 ) adds , “ State-mandated elective surgery stoppages were not the only reason for reduced procedure volume in 2020 . Seventy percent of respondents to the 60-Second Survey reported higher than usual patient cancellations . The uptick in cancellations was due to a myriad of reasons : recent exposure to a COVID-19 positive person , recent travel prior to procedure date and patient discomfort with undergoing medical treatment during the pandemic were all considerations that led to a significant number of patient cancellations in 2020 .”
“ Recent reports from our members , however , suggest that caseloads are rebounding and , in some cases , exceeding previous levels as ASCs work to help address a pent-up demand for care ,” Prentice says .
The COVID-19 Timeline and Clinical Recommendations
AORN ’ s Link confirms that while ambulatory surgery centers faced the same near-total shutdown as hospitals did for a while , however , she emphasizes , “ It became apparent that they were a perfect place to perform urgent procedures where patients do not require an overnight bed .”
Similarly , reopening of ASCs mirrored that of hospitals .
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