cost of health care and have a negative impact on the quality of care we pro- vide to our patients. An ASC also can benefit from gathering data by using that information to set strategic goals. Data collection can engage a facility’s leadership and staff in the gathering process. As that happens, the process of collecting data can become a prior- ity for the organization and help ensure accountability, thus encouraging every- one involved to give patient/procedural safety the highest level of attention. Another recommendation for ensur- ing the safe performance of hand and upper extremity surgical procedures within an ASC is to define measures of efficiency for the surgeon and staff contributing to the case and then eval- uate those measures. Efficiency can be defined in terms of productivity and quality. Construct a knowledgeable staff and ensure that your ASC’s employees are accustomed to the surgeons’ rou- tines. Staff should be acquainted with

the specialization of the surgical pro- cedures to make certain that the work processes have a continuous flow. Rec- ognizing the importance of this training can reduce the number of steps needed and the amount of time involved in delivering patient care in both large and small ways. Recruit standardized surgeons who can manage their surgical time effi- ciently and are willing to standardize their equipment and supplies. Surgeons who have the capabilities to do both, will concentrate more intently on the quality of care that is being delivered. Select the patients who will receive

care in your ASC carefully. At the West- ern PA Surgery Center, preoperative clearances are coordinated and man- aged by a dedicated nurse practitioner. Preoperative patient phone calls are uti- lized to double check NPO (nothing by mouth) status, to identify new infections/ lesions on the skin and to determine if the patient has had any recent medical

ASCA’S MEMBER REFERRAL PROGAM Word of mouth is a proven way to refer

membership to your peers. As an active member of ASCA, you know first-hand the value of membership. Help us inform your colleagues of the benefits of ASCA membership.

changes that would prompt reevaluation. Patients with severe lung disease, latex allergies, active infection, quadriplegia and American Society of Anesthesiol- ogy (ASA) 4 status are treated at hospi- tals as opposed to the ASC. Occasionally a surgeon may perform a hand and upper extremity procedure in the ASC on a morbidly obese patient or patients with additional medical issues, however, these cases depend on a case-by-case anesthesiologist’s evaluation. Anesthe- siologists can utilize regional anesthe- sia to decrease the associated anesthesia risks. The regional anesthesia can also result in excellent pain control for the comfortable discharge of the postopera- tive patient from the ASC.

Conclusion Earn a $25 Gift Card

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Hand and upper extremity surgical pro- cedures can be performed safely in an ASC. Data collection, measuring and reporting on the efficiency of the staff and surgeon and adhering to a vigorous patient selection process all can contrib- ute to an ASC’s level of commitment to patient safety and procedural success. As the delivery of surgical care con- tinues to transform, health care provid- ers and organizations must be receptive to the needs of the ever-changing health care community. The recommendations suggested here have ensured that effi- ciency can be maximized and that com- munication with our patients, in regards to their safety, can be maintained. These proposals have contributed to the suc- cess of the Western PA Surgery Center and have ensured that hand and upper extremity surgical procedures can be performed safely at our ASC as we con- tinue to identify both positive and nega- tive attributes that continuously affect the culture of our organization.

Jennifer Peterson is the administrative direc- tor of Western PA Surgery Center in Wexford, Pennsylvania. Write her at jpeterson@wpasc. com. Glenn Buterbaugh, MD, is the medical director of Western PA Surgery Center. Write him at


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