Ambulatory Surgery Centers Seek Relevance While Lagging in Transparency
January 27, 2012 -- Oregon ambulatory surgery centers want to be an integral part of any newly formed Coordinated Care Organization. But some question just how transparent the 86 freestanding outpatient centers in the state are when it comes to reporting quality.
Participation by ASCs in the Oregon Patient Safety Commission has been slow, now with 58 percent of the facilities reporting severe medical errors. By comparison, all of Oregon’s hospitals are currently taking part in the hospital error-reporting program. And more than 75 percent of nursing homes have agreed to participate.
“It’s fair that we’ve had a little bit more of a challenge in reaching those smaller, more rural facilities,” said Bethany Higgins, the commission’s executive director.
But Higgins said the commission is making progress. Oregon ASCs now use a “safe surgical checklist,” pioneered by the commission. They also offer training courses on infection control, which many ASCs have taken part in, Higgins said.
“The training around infection protection seems to have caught a lot of interest,” Higgins said. “I’m really encouraged by that.”
But, when it comes to reporting rates of healthcare acquired infections, ASCs have largely avoided slower to publicly report as hospitals have been doing for the past several years. However, those ASCs that do partipicate have a much higher rate of reporting than, say, nursing homes. Only 8 percent of pariticpating nursing homes reported errors to the commission compared to 61 percent of participating ASCs.
While outpatient surgery centers typically involve elective procedures by relatively healthy patients, significant infections can occur especially with the use of endoscopes for colonoscopies. Based on a survey of ASCs last year, gastrointestinal endoscopy accounted for 25 percent of the procedures done by outpatient centers in Oregon.
Naomi Price, a consumer representative on the Patient Safety Commission, who looks closely at the infection rates, believes the state has been derelict in not requiring ASCs to report that information to the Legislature. The Health Care Acquired Infection Rate Committee has been in existence for the past four years.
“The Legislature, in devising the infection reporting statute, required the ASCs to start reporting the same way as hospitals,” Price said. “However, in rule making the state sidestepped the wishes of the Legislature and has stepped away from that requirement and just made baby steps.”
Oregon ASCs sincerely want to report infections, said Kecia Rardin, president of the Oregon ASC Association. It just needs to be meaningful, she said. For more than a year, committee members have been debating how best to report those rates.