1. Trying to move too quickly. In order to combat lower reimbursements, many ASCs are trying to increase efficiency and eliminate wasted time. But when it comes to risk management, faster might not be better. “Surgery centers need to follow protocols, follow policies and not take shortcuts,” Ms. Jones says. When staff members ignore policies in favor of doing a procedure quickly, they are likely to ignore instructions that ensure patient safety.
Ms. Jones offers the example of a day when a center is scheduled to perform seven cataract surgeries. In preparation for the surgery, the staff sets out seven lenses. When the third patient’s surgery is canceled because of high blood pressure, but the lens isn’t removed because the staff is in a rush, the new third patient receives the wrong lens.
“Sometimes the process can get too much like an assembly line,” Ms. Jones says. “You have to step back and verify and make sure you have everything in place.”
2. Skipping steps because of a physician practice affiliation. When an ASC is closely affiliated with a physician practice, sometimes checks and balances are dropped because the communication between the two groups is so streamlined. Ms. Jones says if a physician owns a surgery center and the ASC has the ability to go into the practice software to pull out the H&P and plan of care, they may pull the wrong plan and therefore perform the wrong surgery.
“If the practice had not been so closely affiliated with the surgery center, there would have been extra steps in place,” she says. “They would not have been able to simply pull out the H&P. They would have received it, checked it against planned procedure and done other things that help prevent mistakes.”
This doesn’t mean that physician practices and ASCs have to sever ties, she says, but closely affiliated groups should make sure their staff members and physicians are following a strict checklist of steps.
3. Failing to consider the patient’s perspective. In any medical facility, it is hard to know if your staff is communicating effectively with each patient. Staff members and physicians who have gone through years of medical training may inadvertently use medical lingo that patients don’t understand. Ms. Jones recommends reviewing your patient instructions with a non-medical staff member to ensure that all medical terms are clearly defined and the instructions are easy to understand. “Take a fresh look at how these sentences could be interpreted by someone without a medical background,” she says.
She also recommends looking at your pre- and post-operative processes to ensure that patients have absorbed the right information about their surgery and post-operative care. She cites an experience she had receiving LASIK surgery, when, after the procedure, the staff gave her a list of post-operative care instructions to read and sign. Of course, having just undergone eye surgery, she couldn’t see well enough to read the form. Try to look at the experience from your patient’s perspective through each step of the surgical process, and solicit feedback from patients on the clarity of your instructions, she says.
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