In 2000, the Institute for Quality Improvement launched its performance measurement and benchmarking initiative to help centers achieve accreditation as well as gain a better understanding of what made certain centers successful.
Here are four things to know about the Accreditation Association of Ambulatory Health Care Institute's performance measures and benchmarks:
1. The organization has shifted its focus. When the AAAHC Institute initially started its studies, it focused on comparing prices, anesthesiology issues and various procedures' indications.
"It was harder and harder to compare apples to apples for prices because of market variations," says Naomi Kuznets, PhD, senior director and vice president of the AAAHC Institute. "As we progressed, we shifted gears and started focusing on a number of safety issues."
The AAAHC Institute is focusing on analyzing benchmarks for various safety issues, such as compliance with national guidelines for colonoscope reprocessing, as well as procedure times and scheduling. Through the colonoscopy and other ambulatory procedure studies that the AAAHC Institute offers, Dr. Kuznets explains that the Institute has uncovered major variations in pre-procedure time as well as discharge time.
2. Surgery centers can learn from other practices. After analyzing the information provided by participating organizations, the AAAHC Institute requests information from top performers about how they achieved these results.
"This is not just listing the best performers," Dr. Kuznets says. "It is about other organizations in the study or centers purchasing the report looking at their practices and seeing if it would make sense for them to adopt these best practices."
Top performers can relay information about how many staff members were involved in a procedure as well as which medications they used before, during and after the procedure. Therefore, organizations that have slower discharge times could consider using other medication aside from opioids, because top performers may use a medication that allows patients to leave faster without sacrificing optimal patient outcomes.
The AAAHC Institute also compares organizations performance if they participate in one study period to the next to assess improved practices. Dr. Kuznets explains that for the recent colonoscopy study, one center decreased its average time patients spent in the facility by 15 minutes, a significant reduction, by switching to Propofol, which has a very short half-life compared to opiate based anesthesia.
3. Benchmarks can identify inefficiencies. Through its recent benchmarking study, the AAAHC Institute uncovered that many endoscopy centers had opportunities to improve their efficiency. Endoscopy centers can use data from procedures and surgeon's past procedure length to give patient a more accurate timeframe of when they should arrive at the center, which may lead to a decreased wait time and in turn, may improve patient satisfaction scores.
"If you have one physician who tends to run long or has patients who have more complex cases, then you need to schedule appropriately so a patient isn't waiting longer than necessary," Dr. Kuznets says.
Patients who come too early can congest the waiting area. If this has been a problem, suggest that patients should not come earlier than suggested due to limited seating. Patients with extended wait times (such as an hour) may not think of their entire experience as favorably as they could without the wait. Preparation work is also key, so patients do not spend time doing paperwork that a staff member could have completed before she/he came into the center.
4. The AAAHC Institute seeks input from patients. Healthcare is transitioning to value-based care where the patient experience is exceedingly important. To obtain high reimbursement, endoscopy centers should allocate resources toward improving processes that patients deem a priority. The AAAHC Institute asked patients who had treatment at the ASCs participating in the study about what mattered to them. Interestingly, the survey revealed many patients did not care how quickly they were put on a schedule.
"Endoscopy centers may try to fit patients in as quickly as possible," Dr. Kuznets says. "But is this what is important to patients?"
Not only does the time the patient is in the facility have a cost to the center but smooth movement of patients from the time the patient steps into the center until they leave can influence patient satisfaction. The AAAHC Institute has found that when staff members work as a team and are cross-trained may be particularly beneficial to the smooth and timely movement of patients through the center.
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