Biggest hazards facing ASCs: 3 leaders share opinions

Whether your surgery center is a joint venture, has been recently acquired, or is independently operated, one thing all ASCs have in common is hazard control and prevention protocol.

Anything from devices, un-sanitized surfaces, IV bags or unwashed hands can pose an infection and safety hazard for staff, physicians and patients.

Most ASCs pay close attention to cleaning endoscopes and preventing MRSA infections, but they unfortunately also have their own host of other infection hazards. Various surgery center leaders across the country actively work to mitigate infection and educate their staff about proper quality control.

Seemingly the most obvious and easiest way to mitigate infection in a surgery center is handwashing, but leaders still echo the sentiment that hand hygiene is an issue receiving much attention and allocation of resources.

United Surgical Partners even has "secret shoppers" to monitor and collect data on who in the center is washing their hands appropriately and how often. The data is then entered into an electronic quality system to benchmark performance and compliance across centers as well as to analyze trends and habits.

"Hand hygiene is an issue everywhere in healthcare. We're in a very fast-paced environment so ensuring appropriate hand hygiene is crucial," says Ann Shimek, RN, MSN, CASC, SVP of Clinical Operation and CCO of United Surgical Partners.

Debbie Comerford, RN, BSN, CNOR, CASC, LHRM VP of operations at ASCOA, echoes the sentiments about hand washing, and ASCOA takes similar proactive measures to monitor and enforce proper hand hygiene measures.

"It is surprising how many people do not [follow hand hygiene protocol]. We have an extensive hand hygiene policy, based on CDC guidelines. It is expected that you cleanse your hands before and after putting gloves on. When I observe and go into centers I know what I am looking for. I want to see that when the staff cleans the operating room after a case, they are cleaning their hands after they take out the trash and before they start opening the next case," says Ms. Comerford.

Another huge factor effecting hazards and infection control in ASCs is safe injection practices, according to Ms. Comerford. In past years physicians and staff would split IV doses amongst different patients to be cost-effective, but this poses huge infection hazards and is against Medicare regulations.

"Propofol comes in a 20mL bottle and you only need 10 ccs so you think its okay, but its not. We've put a lot of effort on this topic. It is a difficult culture to pierce, to get people to stop splitting doses," says Ms. Comerford.

Surgical Care Affiliates implements a lot of the same quality precautions and measures as USPI and ASCOA, including webinars, inspections and data collected to analyze trends.

"SCA has clinical experts who stay current with industry best practices, federal regulations and accreditation standards and work with facilities in providing resources, guidance and support in keeping facilities well-informed of what they need to know, not only to be in compliance with standards, but to ensure a continuity in the provision of safe patient care," says Jan Allison, RN, CHSP, director of accreditation and survey readiness with SCA.

ASC leaders and administration staff all over the country are not only being reminded constantly of hazards such as hand washing, disinfection and safe injection but they are also being monitored closely as well as being given the resources and education they need to understand how to effectively combat hazards to ensure that all healthcare professionals and patients are receiving top quality care.

More articles on quality issues:
35 new cases of Ebola, says WHO: 5 things to know on latest outbreaks
Higher risks at smaller hospitals, says report: 5 things to know
IOM: 15 core areas physicians can focus on to provide true quality

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