says. Each accreditation organiza- tion has its own specific require- ments. Meanwhile, CMS does not use the term “benchmarking” in the Medicare ASC Conditions for Cover- age. “CMS requires a process reflect- ing benchmarking as it describes quality assessment and performance improvement (QAPI) requirements,” she says. “Quality ‘indicators’ or 'measures' are discussed in the Medi- care interpretative guidelines, which are key to benchmarking.” To help ensure your ASC is per- forming compliant benchmarking activities, review Medicare’s inter- pretive guidelines, your applicable state licensure rules and regulations, and your accreditation organization’s standards, Kizirian says. Accredited ASCs are required to participate in “external bench- marking”—the practice of compar- ing their processes and performance metrics to other like organizations, DiMarino says. Her ASC’s accredita- tion organization does not define the metrics to measure nor the frequency of benchmarking activities. "Survey- ors expect to review documentation that we have benchmarked ourselves externally,” she says. To meet its accreditation orga- nization's benchmarking require- ments, Clifton says, her ASC relies on a few resources. “We do ASCA's Salary & Benefits Survey to make sure we are in line and competitive with our salaries. We also do annual benchmarking with the Outpatient Ophthalmic Surgery Society. As a single-specialty ophthalmology cen- ter, we like to compare ourselves with similar organizations so we have a clear understanding of how we are performing and can pinpoint areas of improvement.” DiMarino recommends ASCs par- ticipate in ASCA’s benchmarking survey. “They measure you against all of the other ASCs participating in the program. ASCA has a nice way of

Lead with a positive narrative and behaviors to create a commitment and belief in the benchmarking process.”

—Susan Kizirian, Ambulatory Surgical Centers of America

displaying your performance, look- ing at patient care processes as well as the clinical and financial aspects. You will receive those metrics on a quarterly basis, which not only helps you satisfy the requirement for ongo- ing data collections, but also gives you the information you need to set new goals for improvement.” As a bonus, ASCs that partici-

pate in ASCA’s Clinical & Opera- tional Benchmarking Survey now receive a complimentary resource: “Benchmarking Basics for ASCs: A How-to Guide for Improving Your ASC.” DiMarino participated in the guide's development. “It has great information ASC administra- tors can use to help them get started with benchmarking.” For ASCs that do not want to participate in benchmarking sur- veys, there are other ways to meet requirements, such as partnering

with other ASCs and sharing met- rics or benchmarking against data in peer-reviewed publications. “When selecting external benchmarks, it is vital that an ASC assess the similar- ities and differences between it and the ASCs participating in the exter- nal benchmarking data collection process,” Kizirian says. "ASCs need to set up data collection processes internally to assure that the data cap- tured is accurate and consistent.” ASCs also must remember to document their work, Clifton says. “I always note where the data we benchmark ourselves against is derived from so that I can submit the exact data source with every bench- mark when we are surveyed.”

Turning Data Into Action The value of benchmarking is not just in comparing how your ASC is performing against other ASCs. “One of the best applications for benchmarking is to use the infor- mation you gathered as a resource to develop and conduct quality improvement studies,” Kizirian says. “The scope of benchmarks can help address clinical, administrative and cost-of-care issues.” In the new ASCA benchmarking guide, readers learn how to bench- mark using the “plan-do-study-act (PDSA)” method. “This is a straight- forward process ASCs can follow to improve themselves," DiMarino says. As an example, DiMarino points

to slower operating room turnover time as a common issue ASCs work to improve. Following the PDSA process, an ASC would first deter- mine its performance goal for the turnover time metric and how data will be gathered. Next, the ASC would identify possible actions to improve performance. “For turnover time, you might

want to look at your staff through- put process,” DiMarino says. “Are there steps taking extra time to com-


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