While rapidly rising in popularity, surgery centers provide patients with specialized care. Surgery centers can often schedule surgeries with ease and send patients home faster than a large healthcare conglomerate.
Facing less red tape and less strict processes, is an asset that sets ambulatory surgery centers apart. However, by performing outpatient surgeries, there are certain risks that ASCs need to be ready to address with patients.
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. Outpatient procedures helps cut costs and allows for more resources allocated to surgeries. 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.
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 so the surgery center can close in the evening. And knowing that other patients are coming in for procedures the next morning.
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.
One way to decrease readmission rates is by implementing a patient engagement program. A patient engagement program is one way to digitally engage the patient and track surgery outcomes. This starts with data management, integrates patient education, and then helps send and measure patient surveys.
Implementing a patient engagement program is simple with the help of software such as PRO-MAPP. This software allows for doctors to improve patient communication workflows through digital forms. It also helps surgery center administrators build out well-designed emails for post-surgery surveys.
By tracking outcomes through a patient engagement program, surgery centers can reduce readmission rates.
2. Patient immobilization leading to DVT.
Orthopedic surgeries are happening more frequently. It’s predicted that there are one million annual total joint arthroplasty surgeries performed in the US this year.
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 immobile during recovery.
In order to decrease risk of patient death or readmission, surgeons can prescribe DVT prevention devices that simulate mobilization and standard blood flow.
Sequential compression devices, or SCDs, not only help reduce the risk of deep vein thrombosis, but can reduce swelling and aid in overall recovery. Reducing swelling means blood is not pooling in a joint which will lead to readmission and risk for blood transfusion.
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.
Post-operative complications are always a surgery 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. If a patient needed a blood transfusion, they would be transported to a hospital.
Surgeons can prescribe anticoagulant medications to help prevent blood clots during recovery. But, a side effect of these medications is 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.