FEATURE Use Your Anesthesiologists Outside of the OR


Anesthesia can help ASCs overcome common accreditation pitfalls BY ROBERT KURTZ


A


SCs looking to improve their accreditation survey perfor-


mance would be wise to involve anes- thesia personnel in the preparation efforts, advises Thomas Wherry, MD, cofounder of Total Anesthesia Solu- tions, a provider of anesthesia service solutions in Ellicott City, Maryland, and a former surveyor for the Accred- itation Association for Ambulatory Health Care. Anesthesia professionals are a nat- ural fit for accreditation improvement efforts because they work on the full continuum of patient care, says Marc Koch, MD, chief executive officer and president of Somnia Anesthesia, an anesthesia practice management com- pany based in New Rochelle, New York. “It can be easy to forget that anesthe- sia personnel are members of the medi- cal staff,” Koch says, “and unlike a sur- geon who might be particularly focused on the operating room or a nurse who might work in just one area, anesthesia tends to have broad knowledge.”


Anesthesia personnel really are the perfect people in the perfect place with the perfect time to help lead the accreditation effort.”


— Marc Koch, MD Somnia Anesthesia


Anesthesiologists are often the only


physicians in the ASC for the entire day, says Tom Mitros, MD, an anesthe- siologist at Limerick Surgery Center in Limerick, Pennsylvania. “Surgeons come and go around their procedures and are not typically available to help with operations. A lot of ASCs grow dependent on their anesthesia staff because they are a constant.”


Engaging Anesthesia An effective way to involve anesthesia personnel in accreditation efforts simply to ask, Koch says. “If they


is


are willing to become involved but feel they require education to make a significant contribution, you can send the anesthesia clinician for courses, lectures and problem-based seminars.” Consider naming someone from the anesthesia group to an administrative position, such as medical director or director of quality improvement, Mitros says. “By getting them involved in those kinds of activities, they will naturally become involved in accreditation. It is also worth noting that in many states, the anesthesiologist must stay until the last patient is discharged. When they are waiting for this final patient to leave the ASC, they have time to get involved in accreditation-related projects.” Some ASCs choose to make


involvement in accreditation an expec- tation of the anesthesia group’s con- tract or employment, Wherry says. “I would absolutely make sure you have them participate in all peer review and quality activities, and even employee meetings that deal with accreditation preparation. If necessary, you can con- sider offering incentives to encourage greater involvement, such as provid- ing certain equipment they request or financial incentives.”


Areas for Improvement While anesthesia personnel can likely assist in many efforts related


achieving and maintaining accredita- tion, there are a few areas where they might be best suited to make a signif- icant impact. One such area is infec- tion control, which, Wherry says, has come under increased scrutiny by Medicare and the accrediting bodies in the past few years. “A lot of my colleagues are not


aware of how stringent surveyors are as far as safe injection practices,” he says. “Work with your anesthesia group to conduct random mock sur- veys of your anesthesia providers and consider using ‘ghost observers’ so providers do not know they are being


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