Becker's ASC Review

57 Quality & Accreditation 5 Key Changes in CMS Guidance for ASC Surveyors By Laura Dyrda T he Centers for Medicare and Medicaid Services have revised their State Operations Manual guidance for surveyors of ambulatory sur- gery centers, clarifying the physician discharge order requirements for ASCs, according to an Ambulatory Surgery Center Association report. The update was released in a surveyor memo to the "State Operations Manual, Appendix L: Guidance for Surveyors — Ambulatory Surgical Centers." Here are five things to know about the updates: 1. New guidelines state, "It is permissible for the operating physician to write a discharge order indicating 'the patient may be discharged when stable,'" a move ASCA has long advocated for. 2. Previously, patients were expected to leave the ASC within 15 minutes to 30 minutes of the time physicians signed a discharge order. Now, the patients can remain until they are stable, even if it's past that 15 to 30 minute window. 3. Another rule change was solidified in the memo regarding staff radiol- ogists. The guideline now says, "Make explicit that radiological services may only be provided in an ASC when integral to surgical procedures offered by the ASC." 4. The ASC's governing body is required to appoint an individual to over- see radiology services. 5. The individual who is in charge of the radiological services can already be working at the ASC, but needs qualifications in accordance with state law and federal regulations. n IMPORTANT PRODUCT INFORMATION FOR CENTURION® VISION SYSTEM CAUTION: Federal (USA) law restricts this device to sale by, or on the order of, a physician. As part of a properly maintained surgical environment, it is recommended that a backup IOL Injector be made available in the event the AutoSert® IOL Injector Handpiece does not perform as expected. INDICATION: The CENTURION® Vision System is indicated for emulsification, separation, irrigation, and aspiration of cataracts, residual cortical material and lens epithelial cells, vitreous aspiration and cutting associated with anterior vitrectomy, bipolar coagulation, and intraocular lens injection. The AutoSert® IOL Injector Handpiece is intended to deliver qualified AcrySof® intraocular lenses into the eye following cataract removal. The AutoSert® IOL Injector Handpiece achieves the functionality of injection of intraocular lenses. The AutoSert® IOL Injector Handpiece is indicated for use with the AcrySof® lenses SN6OWF, SN6AD1, SN6AT3 through SN6AT9, as well as approved AcrySof® lenses that are specifically indicated for use with this inserter, as indicated in the approved labeling of those lenses. WARNINGS: Appropriate use of CENTURION® Vision System parameters and accessories is important for successful procedures. Use of low vacuum limits, low flow rates, low bottle heights, high power settings, extended power usage, power usage during occlusion conditions (beeping tones), failure to sufficiently aspirate viscoelastic prior to using power, excessively tight incisions, and combinations of the above actions may result in significant temperature increases at incision site and inside the eye, and lead to severe thermal eye tissue damage. Good clinical practice dictates the testing for adequate irrigation and aspiration flow prior to entering the eye. Ensure that tubings are not occluded or pinched during any phase of operation. The consumables used in conjunction with ALCON® instrument products constitute a complete surgical system. Use of consumables and handpieces other than those manufactured by Alcon may affect system performance and create potential hazards. AEs/COMPLICATIONS: Inadvertent actuation of Prime or Tune while a handpiece is in the eye can create a hazardous condition that may result in patient injury. During any ultrasonic procedure, metal particles may result from inadvertent touching of the ultrasonic tip with a second instrument. Another potential source of metal particles resulting from any ultrasonic handpiece may be the result of ultrasonic energy causing micro abrasion of the ultrasonic tip. ATTENTION: Refer to the Directions for Use and Operator's Manual for a complete listing of indications, warnings, cautions and notes. © 2015 Novartis 1/15 CNT15005JAD 88672 CNT15005JAD PI BASCR.indd 1 1/19/15 12:46 PM M edical errors rank third among the leading causes of death in the United States, according to studies cited in a recent Vox article. They are ahead of car crashes, new disease out- breaks, breast cancer, AIDS, plane crashes and drug over doses. Here are five things to know from the article: 1. Around 2 percent to 3 percent of the people who go into hospitals receive severe harm as a result. 2. Errors can be caused by simple things such as messy handwriting or getting the drug dos- age wrong in addition to wrong site surgery and infections. 3. Estimates run from 44,000 to 98,000 Amer- icans die each year as a result of medical er- rors, but when asked to estimate the number of medical error deaths, both physicians and the general public said around 5,000. 4. Errors with medical prescriptions were linked to 7,000 deaths annually. 5. Many medical errors go unreported, in part because physicians are embarrassed and afraid of lawsuits. n Medical Errors Still a Leading Cause of Death in America — 5 Things to Know By Laura Dyrda 13th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine June 11-13, 2015 • Westin Michigan Avenue Hotel • Chicago, IL 90+ Surgeons Speaking & 108 Sessions • Key Note Speakers: Deion Sanders, Billy Beane and Bill Walton For more information, visit www.beckersspine.com or call (800) 417-2035.

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