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| Infection Control Concerns in ASCs Prompt National Study |
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Are ambulatory surgical centers breeding grounds for infections? The federal government is about to find out.
The highly publicized hepatitis C outbreak that emerged from a Las Vegas endoscopy center earlier this year has spurred the Government Accountability Office to sponsor a national study aimed at measuring the link between outpatient facility care and healthcare-acquired infections.
Laura Kopelson, a GAO spokeswoman, says ASCs often have limited infection control resources in comparison to hospitals. She notes that the Centers for Disease Control and Prevention have reported an increase in the number of viral and bacterial infections in outpatient settings due to unsafe medical practices, and that recent high-profile infections have occurred in ASCs. Still, she notes, the industry lacks data on the frequency and characteristics of healthcare-acquired infections occurring in surgery centers.
The GAO study will involve interviews with infection control and ASC experts, including CDC officials, representatives of professional organizations, academic researchers and clinicians, to measure the potential for government oversight of healthcare-acquired infections in ASCs. The study's findings will be reported to the House Committee on Government Reform at the end of February.
Last March, authorities shut down the Endoscopy Center of Southern Nevada while investigating six hepatitis C cases allegedly contracted at the center. The investigators discovered that the center had reused syringes, single-use vials of anesthesia and scope-cleaning solution, according to the Las Vegas Review Journal. In May, the Southern Nevada Health District linked seven cases of acute hepatitis C to the facility and identified 77 other possible infections associated with the center.
Daniel Cook |
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| Joint Commission: Be Prudent with Technology |
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Just because health information technology is new doesn't mean that it's automatically better or safer than the methods it replaces, according to a Joint Commission Sentinel Event Alert published last week.
Adopting any new technology requires that healthcare facilities take the time to ensure that the choice is appropriate, that end users are properly trained to use the equipment and that the technology has been properly integrated into the workflow in the facility. "If not carefully planned and integrated into the workflow processes, new technology systems can create new work, complicate workflow or slow the speed at which clinicians carry out clinical documentation," says the alert.
To help improve efficiency and prevent patient harm, The Joint Commission recommends that you:
examine workflow issues for risks and inefficiencies;
involve end users in the planning, selection and quality assurance of new technologies;
monitor for problems when new technologies are introduced and work quickly to resolve problems as they arise;
establish training programs and refresher courses; and
monitor and reassess safety and error detection issues related to the technology.
Because there is little published data on adverse events caused by information technology, The Joint Commission is also urging facilities to report errors and near-misses caused by it.
Kent Steinriede |
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| Few Hospitals Share Error Reports |
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While the vast majority of U.S. hospitals collect data about the medical errors that occur within their walls, a new survey of more than 1,600 hospitals indicates that many fail to share that information or to use it to improve the quality of care.
More than 94 percent of hospitals that responded voluntarily to the survey said they have central systems for reporting and collecting data on adverse events. But only about one in five take the time to distribute and review adverse event reports, according to the survey, which was funded by the federal Agency for Healthcare Research and Quality and published in the December issue of the journal Quality and Safety in Health Care.
"The good news is that over 90 percent of hospitals have a formal reporting system, but the challenge is whether that information is being used to maximize learning. We still have a ways to go," says AHRQ researcher and study co-author James Battles, PhD.
Researchers from AHRQ, the RAND Corporation and The Joint Commission identified four features of successful error reporting systems:
protections for staff who report adverse events;
involvement from a broad range of personnel;
timely distribution and review of summary reports to senior staff; and
use of those reports to find ways of preventing future errors.
The survey shows only about a third of hospitals allow anonymous reporting and just 13 percent said they have wide staff involvement, with 96 percent of adverse events being submitted by hospital nursing staffs. Doctors appear to be particularly averse to reporting errors, according to the survey.
Irene Tsikitas |
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| Instapoll: Is Your Facility Accredited? |
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Yes, said 83 percent of the 43 respondents to last week's Instapoll: We're accredited and we're glad that we are. Another 9 percent will soon by surveyed. Only 5 percent questioned the benefits of accreditation and 2 percent have no plans to undergo accreditation.
This week's poll question wants to know if you pre-treat every patient with an anti-emetic prophylaxis. Go to our front page to participate in the poll and view real-time results.
Dan O'Connor |
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| News & Notes |
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Tip of the Week How does your facility celebrate the holiday season? Would scheduling time for giving and receiving boost spirits? In our December 2006 issue, Jay Sveen, CRNA, BS, of Lincoln, Neb., described how the Lincoln Surgical Hospital and Surgery Center holds an unannounced staff meeting for all employees, during which they're issued gift cards and sent to the mall for an hour or two to buy gifts for themselves as well as for local charities. "It's a staff meeting that everyone actually wants to sit in on," writes Mr. Sveen.
Illinois ASC and hospital battle A U.S. District Court judge has thrown out a lawsuit filed by OSF St. Francis Medical Center of Peoria, Ill., against Peoria Day Surgery Center which alleges the surgery center submitted inflated bills to work around the hospital being the preferred healthcare provider of Caterpillar Inc., according to a published report. The lawsuit is the most recent exchange in a heated battle between the two facilities. In 2006, the surgery center filed a still-pending lawsuit to stop St. Francis from entering into agreements with Blue Cross Blue Shield of Illinois and United Health Care to become Peoria's exclusive provider of ambulatory services, notes the report.
3-D assists spine screws In the largest study yet conducted, researchers at the Mayo Clinic in Jacksonville, Fla., found that fewer than 1 percent of 1,084 pedicle screws implanted with three-dimensional guidance systems were significantly misplaced. In comparison, misplacement ranged from 8 percent to 55 percent when fluoroscopy or freehand techniques were used. Mayo researchers published their findings in the January issue of the Journal of Neurosurgery: Spine. Based on the positive results, they say, 3-D guidance is now used in all spinal screw procedures at the at the clinic's Florida campus.
Joint Commission Status Renewed CMS has again granted The Joint Commission deeming authority for ambulatory surgical centers for its maximum six-year period. The CMS designation means that ASCs accredited by The Joint Commission will be "deemed" as meeting Medicare certification requirements. "The Joint Commission is pleased to once again receive this recognition of its accreditation of ambulatory surgical centers," says Michael Kulczycki, executive director of The Joint Commission's Ambulatory Care Accreditation Program. "This public-private collaboration between CMS and The Joint Commission provides quality oversight for ambulatory surgical centers, which are increasingly important as patients undergo surgical procedures in freestanding clinics outside of the traditional hospital setting. It is also significant that this is the third time CMS has granted The Joint Commission's ASC program deeming authority for the maximum six-year term, sending a strong signal about their confidence in our accreditation process."
Correction A feature in last week's E-Weekly misstated the prices for access to electronic versions of The Joint Commission's ASC accreditation manuals. A single-user license costs $297 and a multi-user license costs $1,485, while a hard copy of the manual costs $110. |
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