Quality data on ambulatory surgery centers and hospital outpatient services available

As my colleague Joyce Frieden reported for MedPage Today on Tuesday, in 2020, reporters will be able to compare the quality of some hospital outpatient departments and some ambulatory surgical centers for the first time, using metrics that are somewhat similar to those used to check up on hospital quality.

After all, some 60% of surgical procedures today are performed in an outpatient setting, so patients have a right to know what policies and procedures the facility uses to safeguard against errors and complications.

The Leapfrog Group, a nonprofit organization that surveys health care organizations for employers who want value for their premium dollars, has launched these voluntary surveys of these two outpatient settings, in which patients generally go home the same day they were admitted for a procedure – for example, cataract removal or colonoscopy.

Some of the questions Leapfrog is asking are critical for patient safety and quality.  For example, it asks whether an ASC’s medical, surgical and clinical staff are properly trained in resuscitation, such as advanced cardiovascular life support (ACLS) or pediatric advanced life support (PALS), in case patients have an allergic reaction to anesthesia or another type of complication.

The survey asks each facility whether it uses a safe surgery checklist; what volume of various types of invasive or surgical procedures are performed there (since higher volume in many cases is an indication of better quality), such as mastectomies or upper GI endoscopies; whether surgeons and anesthesiologists are board certified; and whether the facility has a policy in the case of a serious adverse event that causes harm, such as whether it apologizes to the patient and reports the event to an accreditation organization.

For its first release of its survey results, the Leapfrog Group provided only nationally aggregated data, and only for about 321 ambulatory surgery centers and 1,141 hospital outpatient departments.  That’s less than 6% of ASCs and about half of the hospital outpatient departments in the nation. By next year, Leapfrog expects more outpatient facilities to add their contributions to the self-reported survey.

Please read Frieden’s story to see where the gaps in quality and patient safety were and what was so surprising about this initial review.

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