Infection control practices at ambulatory surgery centers are coming under renewed scrutiny this week with the publication of a government study showing lapses at more than two-thirds of a small sample of ASCs surveyed.
The findings, based on a 2008 pilot round of government infection control inspections at 68 ASCs, were first released last year and were presented at a conference back in March. But they've garnered fresh attention this week after being published in the Journal of the American Medical Association. Alarming headlines like, "Poor Hygiene a Danger at Outpatient Surgery Centers" and "How Sanitary Are Outpatient Surgical Centers? The Answer May Surprise You," have dominated media coverage of the study.
The ASC industry asserted "its strong commitment to patient safety" in a statement responding to the study yesterday. The statement notes that the findings were based on inspections conducted before CMS enacted new infection control conditions for coverage last year, and that the industry has since "engaged in a proactive educational effort with ASCs across the country to promote adherence to the new standards."
"The industry takes this report seriously, and since the release of the findings from the pilot study in 2009, we have worked with CMS, accrediting bodies, state ASC associations, medical and nursing professional organizations, and leaders in quality measurement to address concerns quickly and effectively," says Andrew Hayek, chair of the Ambulatory Surgery Center Advocacy Committee and president and CEO of Surgical Care Affiliates.
Industry leaders also note that the study authors did not provide comparative data on infection control practices and lapses at other types of healthcare settings, such as hospitals and long-term care facilities. "Data show that we have low rates of complications and infections related to procedures performed in our thousands of facilities across the country," says David Shapiro, MD, chair of the Ambulatory Surgery Center Association, "and ASC quality and safety are regulated by several rigorous, independent processes — including Medicare certification, state licensure and voluntary accreditation."
Beginning this year, ASCs will also come under the umbrella of the HHS Action Plan to Prevent Healthcare-Associated Infection, said Health and Human Services Secretary Kathleen Sebelius in response to the JAMA study.
"Just because procedures are being performed outside the hospital doesn't mean patient safety standards and attention to infection control do not need to be met," says Ms. Sebelius. "All healthcare providers and suppliers should take this as an opportunity to evaluate their current infection control policies, and more importantly, make sure their staff understand and follow them."
Irene Tsikitas
