Becker's Hospital Review

148 CMO / CARE DELIVERY Kaiser Health News report questions safety of ASCs: 5 things to know By Leo Vartorella A mbulatory surgery centers are often considered low- cost alternatives to expensive in-hospital care, but a March 2 report from Kaiser Health News and USA Today raised questions about the safety of ASCs and the regulations that govern their practices. Here are five things to know. 1. The report claimed the proliferation of increasingly complex surgeries at ASCs shed a light on facilities' poor preparation for emergency scenarios. ASCs are required to have patient transfer agreements to local hospitals in the event of an emergency, complying with state and federal regulations. The report cited examples of patients who were transferred from ASCs in rural areas where hospitals were up to 30 miles away and were unable to access the emergency care needed. 2. ASCs are a surgical site option for elective procedures for patients who are good candidates for the outpatient setting. These patients are otherwise healthy and dont have comorbidities. Not every patient is a good candidate for outpatient surgery; those with pre-existing conditions are better suited for the hospital. Preexisting conditions can complicate even the most routine surgeries, and the report claims over 260 patients have died since 2013 after procedures at ASCs. Though federal regulations require ASCs keep resuscitation equipment on hand in case of emergencies, a number of the patient deaths detailed in the article took place in facilities that skirted these regulations. However, the Ambulatory Surgery Center Association issued a statement March 2 in response to the article, reporting more than 200 million successful procedures have been performed in ASCs across the country over the same five year period. 3. The report cited examples of patients who felt hurried out of ASCs and died on the way home. "The stories these reporters tell are indeed tragic and will no doubt be deeply concerning to readers. Unfortunately, the article fails to provide a comparison to other sites of care and make clear that medical errors occur across all sites of care, including hospitals, and typically at much higher rates than in ASCs," said Rebecca Craig, RN, MBA, the CEO of Fort Collins, Colo.-based Harmony Surgery Center and Peak Surgical Management. 4. In the third quarter of fiscal year 2017, the most recent data available, the rate of emergency department visits within one day of ASC discharge was 0.69 percent, according to statistics from ASC Quality. 5. Physicians are allowed to have ownership in ASCs, collecting a percentage of the facility fee for each case. The article's authors suggested this ownership may influence their decision to direct cases to the center , but the laws governing ASC referrals vary by state, with some states barring surgeon referrals to any ASC where they or a family member maintain a financial interest.n Why more physicians, scientists plan to run for Congress this year By Alyssa Rege C andidates in Pennsylvania, California and Texas are part of a wave of scientific and medically trained individuals running for office at every level of government to advocate for scientific issues, according to e Washington Post. Joseph Kopser, a Democrat running for the U.S. House of Representatives Texas-Dist. 21 seat, told e Washington Post he is running for Congress because he feels the current administration has devalued the importance of various scientific issues, and will most likely continue to do so. "I absolutely feel that science is under attack," Mr. Kopser said. "It's the opposite of when John F. Kennedy said he wanted to get us to the moon in less than 10 years. e way [President Donald] Trump is going, in 10 years, he'll have us back in caves." e majority of scientific and physician candidates running for office were recruited to become involved in government by 314 Action, a political action committee founded in 2016 to support political candidates with scientific or technical backgrounds, according to the report. 314 Action officials told e Washington Post roughly 7,000 people responded to the organization's call to action, and an estimated 400,000 donors have agreed to support candidates backing science- based policies. e organization is working with 30 candidates nationwide, including Hans Keirstead, PhD, a neuroscientist running in California's 48th District, and Mai Khanh Tran, MD, a physician running for the California Dist. 39 seat. Officials said the organization will back 15 of the candidates it is currently working with. If elected, Drs. Keirstead and Tran would join the one current Congress member with a PhD in a physical science, Rep. Bill Foster, D-Ill., a physicist, and 14 other representatives with medical degrees. By comparison, more than 200 representatives identify as lawyers, according to the report. n

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