Complication and infection prevention requires participation and reinforcement from center executives, physicians and patients. In doing so, outpatient surgery centers can “create a culture of sensitivity to avoiding infections that are avoidable,” Donald Fry, MD, executive vice president for clinical outcomes management at Chicago-based analytics firm MPA Healthcare Solutions, said on a panel at the Becker’s ASC 23rd Annual Meeting: The Business and Operations of ASCs.
Here are three questions for ASC administrators to consider about outpatient surgery complication and infection prevention.
1. What are the most common complications in the outpatient surgical center setting? Common complications vary by specialty, Sandra Jones, executive vice president and COO at Dallas-based ASD Management, said. For ophthalmology centers, the most common issue is toxic anterior segment syndrome, an inflammation and corneal edema most prevalent after cataract surgery. As for pain management, Ms. Jones and Scott Glaser, MD, co-founder and president of Pain Specialists of Greater Chicago, agree falls are the most common complication in outpatient surgical centers.
Dr. Fry added the most common complications in outpatient surgical center settings involve issues linked to the patient’s procedure, such as urinary retention, urinary tract infection, pneumonia, constipation or acute pain from the procedure.
“I would make a plea that we need better data across all age groups of what is the actual outcome of the patients,” said Dr. Fry, also an adjunct professor of surgery at Chicago-based Northwestern University Feinberg School of Medicine. “Because if you don’t know the score in the game, you can’t tell whether you’re winning or losing.”
2. What are the best ways to reduce and prevent outpatient complications? Patient and family education is an imperative step in combating outpatient surgery-related complications, all the panelists agreed. Dr. Glaser said making families aware of potential weakness and numbness after surgery bares high importance.
“A lot of falls happen in the parking lot or at home, so it’s making the family aware that [the patient] looks good in here but there is still going to be some weakness,” following discharge, Dr. Glaser said.
Dr. Fry said early rescue through better communication can also keep patients from readmitting. He added if possible, an in-home caregiver can limit complications.
3. Who should oversee complications and infection control prevention in an outpatient surgery center? Dr. Fry said whoever is chosen to lead infection control needs to be a champion within the ASC and take responsibility to ensure that there’s compliance with practice.
“Everybody’s got to be involved in it,” Ms. Jones added. “But with Medicare you have to appoint someone in charge of infection prevention and someone that is licensed … and it might be an administrator who puts on that 18th hat that they have to wear.”
However, Ms. Jones said the ability for one person to lead surgery-related complication and infection control only works if all staff members are educated to the same caliber.
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