Ambulatory Surgery
Careful screening and scrutiny needed to select ambulatory surgery patients
The patient, an elderly woman, arrived at Red Rocks Surgery Center in Golden, Colorado, for an ophthalmology procedure. A paraplegic, she was using a scooter chair. Administrator Jane Klinglesmith, BS, RN, CNOR, watched her checking in at the admissions desk and noticed she was on dialysis. As she approached, Klinglesmith…
Follow protocols when using medications from compounding pharmacies
Compounding pharmacies have long been valued for their ability to tailor prescription drugs for specific patients. More recently, they have helped conserve scarce drugs by redistributing them from larger to smaller single-use vials. For an ambulatory surgery center (ASC) that is not associated with a hospital and therefore has no…
ASC executives to meet with lawmakers
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…
New CMS guidelines suggest changes in advance directive policies
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…
ASCs must prepare to meet latest CMS infection control expectations
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…
Risk assessment helps prevent falls in ACS patients
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…
Minnesota's adverse event reporting system has led to patient safety improvements
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…
Escorts essential for ensuring postop patient safety
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,”…
CMS proposes modifying ASC rule requiring staff radiology services
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…
Faster procedures benefit patients and bottom line
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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