Establishing quality improvement studies for your ASC is essential to meeting accreditation requirements by the Accreditation Association of Ambulatory Health Care, but more importantly, QI studies help ASCs target areas of improvement to improve clinical outcomes or operational efficiency. Steve Smith, director of Surgery Center of Wisconsin Rapids explains how the facility used a QI study to crackdown on infection control and the processes surrounding it.
Q: How did the facility's QI study for infection control start?
Steve Smith: That all started when we started benchmarking infection control. We found that at our surgery center, we had an infection rate of less than 1 percent. We were already doing really well with infection control, so we needed to do a QI study just to verify the process behind that was being executed correctly. So we started with the sterilization process. We did the QI study, implemented some changes and re-tested our infection rates with those changes to make sure those changes were going to work for us.
Q: What changes were made to ensure the process behind sterilization is effective?
SS: We extended our timing out for sterilization. Full sterilization is made up of two parts: sterilizing and then biological testing. Biological testing is done to make sure all the instruments that were previously sterilized have been wiped clean. We found that the sterilizer was running just fine, but we tested our biologicals to see how much time we really needed to ensure better sterilization. So, our staff ran some tests and found that increasing the length of time resulted in better sterilization.
Additionally, we watch where we're scheduling our cases so that we have enough sterilized instruments for other cases. What we do is look at what we scheduled for that day and make sure we have time to sterilize equipment completely between cases. We also have a lot of equipment, so we don't have to double up on anything. The importance of fully sterilizing is that many accrediting bodies frown upon flash sterilizing, which is when a physician needs to sterilize an instrument that, for example, just fell on the floor and they need it right away. The physician will sterilize the instrument but not put it through full sterilization with biological testing. He or she will just drop it in for the convenience of having it right away.
Learn more about Surgery Center of Wisconsin Rapids.
Q: How did the facility's QI study for infection control start?
Steve Smith: That all started when we started benchmarking infection control. We found that at our surgery center, we had an infection rate of less than 1 percent. We were already doing really well with infection control, so we needed to do a QI study just to verify the process behind that was being executed correctly. So we started with the sterilization process. We did the QI study, implemented some changes and re-tested our infection rates with those changes to make sure those changes were going to work for us.
Q: What changes were made to ensure the process behind sterilization is effective?
SS: We extended our timing out for sterilization. Full sterilization is made up of two parts: sterilizing and then biological testing. Biological testing is done to make sure all the instruments that were previously sterilized have been wiped clean. We found that the sterilizer was running just fine, but we tested our biologicals to see how much time we really needed to ensure better sterilization. So, our staff ran some tests and found that increasing the length of time resulted in better sterilization.
Additionally, we watch where we're scheduling our cases so that we have enough sterilized instruments for other cases. What we do is look at what we scheduled for that day and make sure we have time to sterilize equipment completely between cases. We also have a lot of equipment, so we don't have to double up on anything. The importance of fully sterilizing is that many accrediting bodies frown upon flash sterilizing, which is when a physician needs to sterilize an instrument that, for example, just fell on the floor and they need it right away. The physician will sterilize the instrument but not put it through full sterilization with biological testing. He or she will just drop it in for the convenience of having it right away.
Learn more about Surgery Center of Wisconsin Rapids.