In a webinar hosted by Becker's ASC Review on May 5, Laurie Deihs, RN, MPH, assistant director of education at the Accreditation Association for Ambulatory Health Care (AAAHC); and Kris Kilgore, RN, administrative director at Surgical Care Center of Michigan in Grand Rapids and an AAAHC surveyor discussed the importance of emergency preparedness as well as how to ensure that your ambulatory surgery center is always prepared for any crisis or disaster.
There are a number of emergencies an ASC could face, and in the world of elective, outpatient surgery, rapid response teams are virtually nonexistent, according to Ms. Deihs.
"ASCs typically have lean staffing and staff members often wear multiple hats," she said. "Team effort is the key."
Here are five key elements of emergency preparedness at ASCs:
1. Creating an internal emergency plan. According to Ms. Kilgore, every ASC needs an internal plan to deal with emergencies. Write down the plan and use it to train new staff members as well. To help create the plan, conduct a risk assessment of the center.
An emergency preparedness risk assessment includes examining a number of different factors — from patient demographics to weather conditions in your area. "Do you have a lot of elderly patients coming to your ASC? What are your patients' comorbidities? Also, consider facility issues such as flooding," said Ms. Kilgore. "Another issue, that we are now seeing more and more in the news, is dangerous intruders or people carrying firearms entering the facility. Create a plan for dealing with those situations as well."
If you have an existing emergency plan, compare it with the risk assessment. You may find that the plan does not fit the risk assessment and then have to make changes, said Ms. Deihs.
Additionally, it is helpful if the internal plan includes the different roles staff members will play in case of an emergency, the chain of command during a crisis and an evacuation guide.
2. Completing staff and physician education and training. Training and education is not the same thing as simulation-based drills, noted Ms. Deihs. However, to successfully complete drills, educating staff beforehand is helpful.
"Use webinars, videos and other tools to make it fun for staff members," said Ms. Kilgore. "Check state requirements to complete appropriate staff training."
3. Assessing emergency medication and equipment. The risk assessment will help ascertain what kinds of medication and equipment are required in the facility. The 'crash cart' needs to reflect certain factors, such as patient demographics and the levels of anesthesia used. Keeping these carts up-to-date and organized is important, notes Ms. Kilgore.
4. Conducting simulation-based drills. These drills not only help teach staff members skills to mitigate an emergency, but also help ingrain those behaviors, says Ms. Deihs. Base the drills on real-world scenarios. Each staff member is assigned a particular role, such as facilitator or documenter. Typically the administrator or a physician leader takes on the role of facilitator and leads the team through the drill.
"But I've seen centers conduct drills where each staff member gets an index card with the role they will be playing," said Ms. Kilgore. "There are lots of ways to make the drills fun. But it is important that all members of the ASC team, clinical and administrative, take part."
Create an annual calendar of emergency drills, suggests Ms. Deihs. Whether these are surprise drills or known to staff, remember to change the location of the drill and track participants. Include ancillary staff as well. "When it comes to emergency preparedness, it is all hands on deck," she said.
Also, don't forget to have a debriefing with staff after the drill is completed. Staff members may have suggestions for improvements. Compliment the staff and incorporate suggestions in the action plan.
5. Evaluating and developing a corrective action plan. After debriefing with staff and looking at the documentation from the drill, identify corrective steps to improve staff response. "Also, have a timeline in place for rolling out the corrective action plan," said Ms. Deihs. "And communicate this to the staff as well as any potential changes in processes or practices."
Download the webinar presentation slides here.
View the webinar by clicking here.
We suggest you download the video to your computer before viewing to ensure better quality. If you have problems viewing the video, which is in Windows Media Video format, you can use a program like VLC media player, free for download here.
Note: View archived webinars by clicking here.