Ambulatory surgery centers (ASC) are generally set up to serve the needs of their patient communities while maximizing revenue for their physician, investor, or hospital owners. Take away those incentives, and it is reasonable for an ASC manager to ask, "What are we doing here?" Yet with falling reimbursement rates…

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A government advisory panel has recommendeda0.6% inflation update for Medicare payments to ambulatory surgery centers for 2011. The recommendation came from the Medicare Payment Advisory Commission (MedPAC). Though MedPAC does not have an official role in setting the inflation update, its recommendations are influential with Congress and the Centers for…

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Pilot survey: ASC infection control lapses Infection control category Facilities with lapses* Examples of lapses Hand hygiene, use of gloves 12/62 (19%) 4 facilities had providers who failed to perform hand hygiene after contact with blood, body fluids, or nonintact skin. Injection and medication safety 19/67 (28%) 18 facilities used…

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Purchasing managers are used to walking a tightrope between tough bargaining with suppliers and respect for the product preferences of physicians. Eventually, purchasing professionals, as well as physicians, realize these goals need not be inconsistent. The best value often is in the best product. At many ambulatory surgery centers (ASC),…

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When surveyors from the Centers for Medicare and Medicaid Services (CMS) arrived at Robinwood Surgery Center in Hagerstown, Maryland, at 2 pm one day last summer, the leaders were ready. "The surveyors were very thorough. You won't pass this if you don't operate as a quality facility and follow all…

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Last in a series on ASC quality improvement. Like surgical facilities throughout the country, Lakeview Surgery Center is striving to make sure patients who have prophylactic antibiotics ordered before surgery receive them on time. Not only is on-time delivery of antibiotics the standard of care, but Lakeview also wanted to…

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Third in a series on ASC quality improvement. As is common practice, patients at Delaware Surgery Center in Dover have always been asked about allergies to penicillin and other substances. But when some started having adverse reactions to the alternatives, the center's staff looked for ways to improve results. They…

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Not long after the March 2008 death of Florida teenager Stephanie Kuleba from malignant hyperthermia (MH), a group of anesthesiologists, emergency physicians, and surgery center officials began talking about how her death could have been prevented. The result of their research and discussions is proposed guidelines on emergency transfer of…

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Routine sterilization of unwrapped or uncontained loads is inappropriate and should be cited as a violation of the government's infection control requirements for ambulatory surgery centers (ASCs). But an ASC that properly uses short sterilization cycles for wrapped/contained loads should not be cited, the Centers for Medicare and Medicaid Services…

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Performing quality improvement (QI) studies is a challenge for many ambulatory surgery centers (ASCs). The requirements are well known but not so easy to execute. QI is a regulatory expectation. But there is an underlying principle—making sure the facility is continually improving in areas that make a difference to quality…

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