When something goes wrong at an ASC, the instinct is to look at what happened in the moment, but a growing number of ASC leaders say the more important question is what was already broken before the incident occurred.
The answer, more often than not, runs through staffing.
“One thing I wish more outpatient organizations built earlier is operational infrastructure before rapid growth,” Jess Doto, MSN, APRN, medical director of Elysara Ithaca and Elysara Medical & Wellness in New York, told Becker’s. “Many safety issues stem from scaling services faster than systems, policies, training, and oversight structures can support them.”
It’s a pattern familiar to leaders across the ASC space. Centers grow, add cases, bring on new staff while the operational backbone doesn’t keep pace. The result is often a slow accumulation of small gaps that don’t surface until something goes wrong.
Liz Hunt, CEO of Green Mountain Surgery Center in Colchester, Vt., told Becker’s her center’s safety work shifted meaningfully when leadership started paying attention to what she calls “weak signals,” which includes trends in staffing patterns, recovery variances and near-miss reports before they escalated into patient safety events.
“Some of the most valuable safety insights come from events that almost happened,” she said. “Creating psychological safety around reporting and ensuring staff consistently see action taken afterward has been critical in strengthening trust and engagement in the process.”
That psychological safety piece is harder to build than it sounds. Megan Friedman, DO, chair and medical director at Pacific Coast Anesthesia Consultants in Los Angeles, told Becker’s providers are less likely to surface problems when they fear the aftermath.
“Providers are less likely to report events when they feel they will simply be nitpicked apart afterward,” Dr. Friedman said.
Allison Thomas, RN, director of clinical services and quality at Gastrointestinal Associates in New York City, said recurring staff education has been one of the most effective tools for keeping safety awareness from fading between incidents. Her center’s quarterly safety in-services, including targeted training on fall prevention, keep standards visible across both tenured staff and new hires.
“These recurring reviews keep safety initiatives fresh in everyone’s minds and contribute to stronger patient outcomes,” Ms. Thomas said.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.