The Ambulatory Surgery Center Association (ASCA) annually asks members to participate in a “fly-in” to meet with members of Congress to raise awareness about the implications of health care policies. As ASCA vice president of government relations Steve Miller notes, there is nothing like hearing directly from a constituent to…

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Ambulatory surgery patients who become incapacitated should have their wishes for care honored, the Centers for Medicare and Medicaid Services (CMS) stresses in its new guidelines. Previously, the guidelines permitted an ambulatory surgery center (ASC), for reasons of conscience or policy, to refuse to honor advance directives calling for cessation…

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A perennial concern associated with surgery is avoidance of infection. As science reveals new risks and remedies, protocols change and so do regulations. To monitor infection control at ambulatory surgery centers (ASCs), surveyors use a 15-page worksheet from the Centers for Medicare and Medicaid Services (CMS). The ASC Infection Control…

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Anyone undergoing surgery is at heightened risk of falling, especially during recovery from sedation, and for the most vulnerable patients, a fall can be disabling or even deadly. Falls are among the adverse events monitored by the Centers for Medicare and Medicaid Services and state surveyors. The science of assessing…

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The number of patient falls, wrong-site procedures, and suicides increased slightly in Minnesota during 2012, but pressure ulcers, medication errors, and objects left in patients decreased, according to a recent study of the state’s hospitals and surgery centers. The “Adverse Health Events in Minnesota 2012 Public Report,” released in January…

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Before any elective surgery, patients are expected to arrange for an escort who will take responsibility for them at discharge—someone who will drive them home and possibly care for them as they recover from the effects of anesthesia. Despite a strict policy that patients must have a “responsible adult escort,”…

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Many ambulatory surgery centers (ASCs) have little need for a staff radiologist because only a few procedures require on-site imaging. Yet, ASCs are subject to a rule similar to those that require hospitals to keep radiologists on staff. That will no longer be true if a proposed change takes effect…

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Shortening the time it takes for an outpatient procedure may increase volume, OR utilization, and hence revenue—but that is not the point, say the nation’s top performers in a recent survey of procedure times. Rather, the purpose is to enhance patient safety and satisfaction. For example, less time in the…

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Since the early days of aviation, pilots have used checklists before, during, and after each flight. Cooks follow recipes. Builders don’t build without team meetings and signoffs at every step. Health care professionals, however, only recently began to adopt checklists. Often, the excuse has been that medicine is an art,…

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Surgical infection rates are dropping to zero, mammography results now arrive in minutes rather than weeks, and patient satisfaction surveys actually reflect patients’ interpretations of their experiences. This new world has arrived in some innovative locations, and it is poised to spread. The Accreditation Association for Ambulatory Health Care (AAAHC)…

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