Issue link: https://beckershealthcare.uberflip.com/i/1134178
28 Thought Leadership 3 ASC quality insights from Northwestern Medicine nursing manager Lynn Nolan By Rachel Popa L ynn M. Nolan, MSN, RN, Manager of the Universal Care Center and post anesthesia care unit at North- western Medicine Lake Forest (Ill.) Hospital, shared her tips and insight on how to improve quality and infection control at ASCs. Note: Responses have been lightly edited for style and clar- ity. Question: For ASCs looking to improve quality, where would you recommend they start? Lynn Nolan: When looking to improve quality in ambula- tory surgery, it is essential to be familiar and understand the current American Society of PeriAnesthesia Nurses standards and the evidence-based practices directed at improving quality and patient outcomes. ASPAN standards outline the minimum requirements and recommenda- tions in assessment and documentation and acuity-based staffing in all phases of care. In these standards there are also specific practice recommendations supported by peer reviewed journals to help guide practice. After ensuring the basics are in place by following the standards, it is impor- tant to identify appropriate staffing ratios based on ASPANs acuity and the patient flow. ASCs are a rapidly changing environment, and effective throughput is one of the most important factors in ensuring efficient, high quality and cost-effective care. Analytic data is necessary and something often thought of after implement- ing process improvement. I would recommend identifying your specific metrics and then having analytic data in place to evaluate the effectiveness of process change. Q: What would you say are the quality measures (hand washing, medications, etc.) that get overlooked the most, and how can ASCs improve? LN: On-time starts is an interdisciplinary team approach. Key stakeholders must be able to identify the barriers and then track the data very closely. It requires continuous fol- low up and the ability to address the reasons immediately to effect change. Surgical site infections are also a big issue. There are multiple strategies to reduce SSIs —- not all of these are implemented in ASCs. To decrease the number of surgical site infections, ASCs can implement SSI prevention bundles, track the data and drill down if an SSI occurs to determine gaps and make changes and lastly, improve hand washing. Q: What are some ways staff can improve hand wash- ing? LN: I have seen a handwashing tutorial where they used something called Glow Germ. This was one of the most powerful lessons I saw because it focused on how effective/ ineffective handwashing was based on how much "glow" showed on the hands after washing. n Dr. John Prunskis: Key trends to watch in the ASC industry By Laura Dyrda J ohn V. Prunskis, MD, CEO and medical director of the Illinois Pain Institute and e Regenerative Stem Cell Institute in Barrington, Ill., discussed the best opportunities for ASCs in the next five years. Note: Responses were edited for style and clarity. Question: What healthcare trends are game-changers for ASCs today? Dr. John Prunskis: e recognition that hospitals receive substan- tially greater payments than ASCs and physician offices for identical procedures is gaining greater traction. ose hospital payment rates are coming down. EHRs continue to be a negative influence for physicians, patients and overall healthcare in most scenarios. e continued interest and acquisitions of ASCs is exerting its input on the market. Q: Where do you see the biggest opportunity for ASCs to thrive in the next five years? JP: Delivering excellent care at payment rates lower than hospitals. Q: How can ASC owners ensure the viability of their busi- ness in a competitive market? JP: Having top physicians who regularly use the ASC and provide qual- ity service. Q: What payer trends should ASC owners and operators pay attention to today? JP: Out-of-network has dwindled. Favorable in-network rates are important. Q: What are ASCs doing today that won't lead to success in the future? JP: ey need to make sure that they are staffing correctly. n