While rapidly rising in popularity, surgery centers provide patients with specialized care. Without being attached to a large healthcare conglomerate, surgery centers can typically schedule procedures faster, while sending patients home from procedures earlier.
However, without being backed by a large hospital, surgeons follow less strict processes and procedures. While that helps with less red tape and more efficiencies, there are certain risks that ASCs need to be ready to address with patients. The lack of resources in an independent center can result in catastrophic outcomes.
What are the top risks for ASCs?
Risk management in surgery centers typically lies in day-to-day operations. The biggest upside to utilizing an ASC is a shortened hospital stay. This helps cut down on costs for the actual surgery center, allowing for more space to be used for caseload as opposed to recovery. However, this means that surgery centers run a higher risk for patient readmission which is a costly snafu.
Data management and setting up processes and procedures seems to be another challenge that many surgery centers face. Without oversight from a massive organization, staff can be spread thin and implementing new can be extremely overwhelming.
From decreasing patient risk to data management- here are the top 4 risks that surgery centers face during day-to-day operations.
1. Patient readmission.
Sending a patient home too soon after surgery proves to be a dilemma many surgeons face while working in a surgery center. Majority of surgery centers keep regular business hours unlike hospitals that remain open. Surgery Centers move patients out quickly knowing other patients are coming in for procedures, or to discharge everyone before the center closes.
According to an investigative report from Kaiser Health News, more than 260 patients died due to complications from procedures performed at independent surgery centers between 2013-2019. While the number doesn’t seem high over a span of five years, these deaths were following routine procedures. This statistic doesn’t count for readmission rates.
The cost of hospital readmission rates is enormous and estimated to be $26 billion annually. Surgery centers are continuously challenged to keep costs down while increasing productivity. This means that readmissions are something that needs to be avoided at all cost. However, because procedures at ASCs are out-patient, the risk for readmission rises.
2. Patient immobilization leading to DVT.
One of the largest risks for patients following a surgery is immobilization. When patients are recovering, blood will coagulate in veins, causing blood clots. Often in a surgery center setting, deep vein thrombosis is treated with pharmaceuticals. This can cause other complications for patients such as excess bleeding which can lead to increase in swelling.
For most total joint surgeries, there are three stages of immobilization. Before surgery, patients reduce movement in order to avoid pain. During surgery, patients are unable to move, then post-surgery patients are imobile during recovery. After some healing but during the recovery process, patients can still struggle with movement due to pain, swelling from DVT preventing pharmaceuticals.
In order to decrease risk of patient death or readmission, patients can be sent home with DVT prevention devices that simulate mobilization. These cold compression devices not only help reduce the risk of deep vein thrombosis, but can decrease pain and swelling, helping stimulate recovery for patients. Reducing swelling means blood is not pooling in a joint which will lead to readmission and risk for blood transfusion. P
Portable DVT kits are created to allow patients to leave a surgery center and still prevent deep vein thrombosis at home without taking extra narcotics.
3. Risk of blood transfusion in a hospital setting following surgery performed at ASC.
No matter where a surgery is performed, complications are always a risk. Surgeons understand that each patient that goes into surgery will have a certain amount of blood loss. The risk for surgery centers is they cannot perform a blood transfusion if necessary, a patient would have to be transported to a traditional hospital setting.
When recovering, prescribing pharmaceutical medical to assist with DVT prevention causes excess bleeding that isn’t associated directly with the surgery. When there is blood loss, it’s not always known where the blood will end up. If it’s pooling into a joint, it will cause pain and swelling, decreasing mobilization, and increasing risk of DVT.
Another way to ensure patient safety is to administer patient surveys often. While this is an extra added task for surgery centers, there are software options to help automate post-operative surveys and help gather patient data quickly. This practice can alert surgeons if a patient is in distress or needs an additional evaluation. Surgery centers that use PRO-MAPP for post-surgical surveys have seen up to 90% survey completion rate from patients.
4. Risk of late payments and excess back office work.
Large hospital groups are well accustomed to a gap between surgery and payment. However, to survive surgery centers need to tighten the gap between surgeries and payment. Utilizing software such as PRO-MAPP allows post-operative notes to be completed in less than 10 minutes after surgery.
This means that instead of waiting for a month to receive dictation back from a surgeon, post-operative notes are being done automatically. This function can help surgery centers save up to $3,000 in monthly dictation costs while reducing time from serving to billing by 80%.
Efficiency and cost savings will be key for surgery centers, especially in the future. Orthopedic surgeons are continuing to implement enabling technologies into their practice. Robotics are still in their infancy and are a major investment for smaller surgery centers. However, surgical robots do decrease patient risk and help surgeries to be performed faster.
It becomes easier to justify the investment when surgery centers are paid faster, and can decrease office expenses. This is only going to become more valuable to stay relevant in the age of enabling technologies.