As time passed, the practice of using straight-edged razors was aban- doned industry-wide. Performing a study of straight-edged razor use now would be unnecessary as ASCs have been at 100 percent non-razor use for years. If you achieve such a level, you probably do not need to be measuring it anymore. Another way an ASC might strug- gle with QAPI would be by failing to establish an end for a study. Every study should reach a point where it ends, either by achieving the desired goal or determining that the issue that was studied is not actually an issue (more on this shortly). A study should not go on indefinitely. A third way would be misunder- standing what is acceptable to call a study. For example, your front desk receives multiple complaints


patients claiming they are spending an unreasonable amount of time in your waiting room. This is a good topic for a QAPI study, but what if your data shows that no one is typically waiting more than 10 minutes? Your examina- tion has shown that what was believed to be a possible problem is not a prob- lem. ASCs are sometimes hesitant to present this process and conclusion as a study, but it is acceptable as it meets the quality assurance component of QAPI. A final way ASCs can miss the

mark is believing that the topic for a study performed by another ASC is an appropriate topic for themselves. Just because another ASC is experienc- ing an issue worthy of attention—and a study—does not mean your ASC is experiencing the same issue. With that said, there is no harm in starting to track the subject to determine whether you might have a similar problem and, thus, an issue worthy of study.

Leveraging Data Despite vague requirements and sev- eral ways QAPI studies could come up short, QAPI can still be simpler than many people realize.

How do you know what areas to focus on? Try to conduct a vari- ety of studies. One approach to con- sider is concentrating studies in four areas: patient satisfaction, physician satisfaction, financial gain and clini- cal outcome. Rotate through these areas with a mindset that none of your ASC’s departments will escape scru- tiny. This will help ensure you do not focus on just one or two areas and can work to achieve significant improve- ments that will touch all aspects of your operations. Make the identification and analy-

Analyzing data is not just for identifying problems. It also is for determining whether your improvement efforts are accomplishing what was intended.”

— Daren Smith , Surgical Information Systems

What data are you tracking already?

Every ASC should conduct patient sat- isfaction surveys. What are they tell- ing you? What possible problems are patients noting? If you conduct phy- sician satisfaction surveys, what are those telling you? What about staff surveys? What is the information they are showing you?

Then, there is the data collected for routine evaluations of your ASC’s operations where you are gathering clinical, operational and financial val- ues. The purpose of tracking these areas is to identify trends, both good and bad. There also are likely oppor- tunities in the data you document and share for state and federal reporting. Can you use that data to identify pos- sible problem areas?


sis process easier by ensuring data is presented in a format that is simple to read and understand. A graphical for- mat can help you quickly identify pos- sible concerning trends that you can drill down into further to solidify theo- ries about the reason(s) for the trends.

Keep Your Eyes on the Prize As previously stated, analyzing data is not just for identifying problems. It also is for determining whether your improvement efforts are accomplish- ing what was intended. If the data indi- cates they are not, determine whether there are other ways to achieve the desired changes to the data set. Assuming you achieve improve- ments, you need to determine when you will consider the problem solved, which will dictate how long to con- tinue studying the problem.

Recognize that in some instances, changes you try might fail to ever move the needle the way you hoped. It is possible that impacting the data might be out of your control. If you suspect that undertaking additional efforts would

prove just as futile,

examine your data to find a new study topic worthy of attention and one that might be more likely to deliver on the great promise of QAPI.

Daren Smith is the director of ASC solutions for Surgical Information Systems in Alpharetta, Georgia. Write him at

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