BACKPAGE


Use Benchmarking to Drive QAPI ASCs nationwide are using ASCA Benchmarking to improve their performance BY ROBERT KURTZ


T


he clinical staff at Lakeview Sur- gery Center in West Des Moines,


Iowa, believed their patients always received their prophylactic intravenous (IV) antibiotics “on time,” recalls Kate Foreman, the ASC’s quality coordinator. “On time,” according to the defi- nition used in Medicare’s ASC Qual- ity Reporting (ASCQR) Program’s ASC-5: Prophylactic Intravenous (IV) Antibiotic Timing measure meant these antibiotics were initiated within one hour prior to the time of the ini- tial surgical inci sion or the beginning of the procedure, or two hours prior if Vancomycin or fluoroqui nolones were administered. “We thought that since we were in


an ASC and all of our patients came in an hour before surgery, we would be at 100 percent,” Foreman says. When Lakeview measured its per- formance in this area using ASCA Benchmarking, the numbers told a dif- ferent tale. The ASC fell short of its expectations, Foreman says. To address this concern, Lakeview conducted a quality assessment and performance improvement (QAPI) project. “We discovered that we had physi- cians who came in late and rooms that would run behind schedule,” Foreman recalls. “This would sometimes cause us to miss the administration of on- time antibiotics. Through our QAPI project, we implemented changes and are now close to 100 percent with on- time antibiotics on a consistent basis.” Changes included adding the antibi- otic administration time to the handoff communication sheet and waiting until a surgeon is in the building to adminis- ter doses for first cases. “ASCA Benchmarking reports help us identify potential negative trends,” she continues. “They provide guidance


Benchmark and Improve


Learn more about ASCA Benchmark- ing at www.ascassociation.org/ ascabenchmarking.


You can think you are providing the best care possible to your patients, but it is only through comparing your performance to others that you will truly know whether that is the case.”


— Patricia Darimont, RN Castle Surgicenter


on where we should be focusing our improvement efforts.” Lakeview is one of a growing num-


ber of ASCs nationwide using data from ASCA’s online clinical and oper- ational benchmarking survey to drive positive change inside its facility. Areas they are addressing include out- comes, billing and staffing. Like Lakeview,


the Castle Sur-


gicenter in Aurora, Illinois, uses its ASCA Benchmarking reports to help identify worthwhile QAPI projects. Castle, says Patricia Darimont, RN, the ASC’s clinical manager, has used


34 ASC FOCUS OCTOBER 2017 |www.ascfocus.org


ASCA Benchmarking data for that purpose on multiple occasions. Like Lakeview, one QAPI project centered around on-time antibiotics. Another concerned the ASC’s normothermia outcome reports. “You want your patient’s tempera- ture to be above 96.8 Fahrenheit when they enter the post-anesthesia care unit (PACU),” Darimont says. “What we learned through ASCA Benchmarking was that we were performing below other ASCs in this area.” For its QAPI project, the ASC


tracked information that included the types of procedures, lengths of pro- cedures, the temperature of patients when they reached PACU and whether patients had a warming blanket. “We were only putting the warming


blanket on our shoulder arthroscopy cases, which we considered our ‘long’ cases,” Darimont says. “Our shoul- der patients were not coming back to the PACU cold. It was other patients whose cases lasted for more than an hour and who did not receive a warm- ing blanket who were cold.” Castle has rolled out several changes to improve performance with normothermia outcome, includ- ing placing blankets on all patients whose cases are expected to take more than an hour and storing blan- kets in the operating room rather than PACU to remind the surgical team to use them.


Darimont credits ASCA Bench- marking for shedding light on sev- eral areas that could be improved in her ASC’s clinical practices. “You can think you are providing the best care possible to your patients, but it is only through comparing your performance to others that you will truly know whether that is the case.”


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40