Digital Debut

Digital Debut

Who Can and Cannot Translate in ASCs?

In 2010, the Patient Protection and Affordable Care Act—commonly referred to as the ACA—brought sweeping regulatory changes to the health care industry. Section 1557 of the ACA instituted new nondiscrimination requirements, which prohibits health care providers from discriminating in health care or health coverage based on a variety of traits.


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Improve Your ASC's Safety Culture

In 2014, the Andrews Institute Ambulatory Surgery Center in Gulf Breeze, Florida, conducted its first annual safety culture survey. It asked the employees to rank the ASC's performance in areas including safety priority within the facility, safety as part of the ASC's ongoing agenda, accountability, issues corrected, teamwork and training.


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Provide Health Literacy to Patients

ASC staff typically have limited time to spend with patients. This makes it imperative for staff to take advantage of every moment available to provide critical education to patients, says Missy Soliz, RN, quality and risk manager for Mississippi Valley Surgery Center and Mississippi Valley Endoscopy Center in Davenport, Iowa. "We must also do so without overwhelming them or talking over their heads," she says.


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The Joint Commission Updates Emergency Management Requirements

In response to the Centers for Medicare & Medicaid Services (CMS) emergency preparedness final rule, The Joint Commission is updating its emergency management requirements for ASCs and other types of accredited organizations.


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AJRR Issues 2017 Annual Report

The American Joint Replacement Registry (AJRR) has issued its 2017 Annual Report on hip and knee arthroplasty data. The report analyzes data on 860,080 hip and knee replacement procedures performed by 4,755 surgeons at 654 organizations.


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Options for Post-Acute Services

As more complex procedures continue to move to the outpatient setting, ASCs should actively be looking at where patients can receive the best post-acute recovery care, recommends Rebecca Craig, RN, CASC, ASCA Board president and chief executive officer of Harmony Surgery Center and Peak Surgical Management in Fort Collins, Colorado.


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Lending a Healing Hand

One World Surgery in Chicago, Illinois, a nonprofit, partners with communities, health-care providers and leaders in health care to deliver surgical services globally. ASCA has joined hands with the organization to help fulfill its mission. Below is an excerpt from an interview with Claire Cunningham, executive director of the organization.


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Battling the Hurricane-Driven Drug Shortages

Hurricane Maria devastated Puerto Rico last month and disrupted the production of several drugs and medical supplies, including IV solutions. While the US Food and Drug Administration (FDA) is working with companies, such as Baxter International, to alleviate the shortages, ASCs could take a few steps to manage the shortages effectively.


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ASC Study Finds Colonoscopy Patients Prefer Propofol

Results of a clinical trial conducted at an Ohio ASC show that patients prefer propofol over a combination of fentanyl/midazolam as their anesthetic for outpatient colonoscopies. From a patient and provider perspective, the researchers conclude, propofol appears to be superior to fentanyl/midazolam for outpatient colonoscopy.


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HIPAA Biannual Update

Since our last update in January, health care organizations across the country posted 145 breaches of protected health information (PHI) affecting 500 or more individuals. Most of the breaches (77 percent) were caused by unauthorized access and hacking.

OCR Breach Investigation Causes


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OSHA Updates its Regulations

In 2013, the Occupational Safety and Health Administration (OSHA) issued a proposed rule to improve the tracking of workplace injuries and illnesses through the electronic collection of establishment-specific injury and illness data. After receiving comments on the proposal, OSHA issued the final rule that became effective January 1, 2017 (Occupational Safety and Health Administration 29 CFR Part 1904).


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MACRA Is Here

In last year’s November-December Focus magazine we outlined the Medicare Access and CHIP Reauthorization Act, commonly known as MACRA. This act, passed in 2015, instituted new mechanisms for Medicare physician payment, replacing the old Sustainable Growth Rate (SGR) formula. With the arrival of a new administration, as well as the June release of proposed updates, it seems worthwhile to reiterate MACRA’s overarching structure, highlight some new developments and give an indication of how it might affect clinicians operating in ASCs in the coming years.


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Got OAS CAHPS Questions?

While most in the ASC community are now aware that the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) Survey will be mandated by the Centers for Medicare & Medicaid Services (CMS), a lot of questions remain.


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Know Your State’s Nursing Scope of Practice Definitions

The term “scope of practice” has different definitions in policy and professional documents, which is why it is critical to know how your state’s regulations define the term, says Debra Stinchcomb, RN, CASC, consultant with Progressive Surgical Solutions in Fayetteville, Arkansas.


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ASCA 2017 Convenes in Washington, DC, this Month

At a time when Washington, DC, is under the world’s microscope, it seems fitting that ASCA is bringing the ASC community into the heart of the action at ASCA 2017, May 3–6, at the Gaylord National Resort & Convention Center in National Harbor, Maryland.


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Attend the Federal Policy Sessions at ASCA 2017

ASCA’s annual meeting this year, ASCA 2017, will take place May 3–6 at the Gaylord National Resort & Convention Center in Washington, DC. There is no better time or place to learn more about the ways that the decisions the federal government is making will impact your ASC.


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21st Century Cures Act Becomes Law

Late last year, Congress passed the 21st Century Cures Act, which includes a version of the Electronic Health Fairness Act of 2015. The bipartisan Cures Act, introduced by US Representatives Fred Upton (R-MI) and Dianne DeGette (D-CO) and signed into law by President Barack Obama on December 13, 2016, is a large, nearly 1,000-page legislative package that provides funding for the National Institutes of Health, the Food and Drug Administration, combating opioid abuse and more.


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HIPAA Biannual Update

Since our last update in April 2016, health care organizations across the country posted 257 breaches of protected health information (PHI) affecting 500 or more individuals. The majority of the breaches included unauthorized access and hacking.


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Introducing the New ASCA Affiliate Program

New this year, the Ambulatory Surgery Center Association (ASCA) has introduced an Affiliate Program that replaces the ASCA Vendor Membership category. The new five-tiered recognition program was developed to recognize and further support the ASC industry’s suppliers and business partners dedicated to helping you run your centers more effectively and efficiently. Members of the Affiliate Program can be identified by the ‘Affiliate’ button within their advertisements throughout ASCA and industry publications and web sites, as well as onsite at conferences and seminars.


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Achieving and Sustaining a Culture of Patient-Centric Care

The culture that an ASC is aiming for doesn’t just develop naturally, says Jo Ellen Braden, RN, CASC, quality assurance performance improvement (QAPI) coordinator at Taylor Station Surgical Center in Columbus, Ohio. It requires hard work and commitment.


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Outcomes of Spine Surgery in an ASC

The number of anterior cervical discectomy and fusion (ACDF) surgeries, one of the most common spine procedures performed in the US today, continues to rise as a result of the growing elderly population in the country, says Anthony L. Asher, MD, ASCA Board member, director of the Neuroscience Institute at Carolinas HealthCare System and a senior partner at Carolina Neurosurgery & Spine Associates in Charlotte, North Carolina.


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Bundle Up

The federal government has initiated broad adoption of bundled payment methodologies in inpatient settings including the Bundled Payment for Care Improvement (BPCI) initiative and more recently, the Comprehensive Care for Joint Replacement (CJR) regulations. According to the Centers for Medicare & Medicaid Services (CMS) more than 500 hospitals now participate in these programs.


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Top 2015 CMS Citations

The Centers for Medicare & Medicaid Services (CMS) ran a FY 2015 citation frequency report for ASCA for both health surveys and Life Safety Code surveys. Unfortunately, we do not have more specific information as to what areas within each tag might be commonly cited, but this should at least give facilities an idea of where CMS is focusing its attention.

Infection control issues were once again at the top of the “Most Cited” listed. We expect this to continue to be a hot survey topic, since CMS updated the Infection Control Surveyor Worksheet last summer.


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Grow Your ASC

It is no secret that growing an ASC can be a challenge. Every ASC administrator is faced with the same goals: optimizing capacity and continuously growing the center’s volume. The multispecialty center—four operating rooms and two procedure rooms—that I manage was no exception. In 2010, the center was barely performing 100 cases each month, and we were competing in a very tight market. Within a five-mile radius of our center, there were no fewer than 17 single-specialty surgery centers.


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Phase Two of HIPAA Audit Program Underway; Are you Ready?

As a part of its continued efforts to assess compliance with the HIPAA Privacy, Security and Breach Notification Rules, the US Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has begun its next phase of audits of covered entities and their business associates. OCR will review the policies and procedures adopted and employed by covered entities and their business associates. These audits will primarily be desk audits, although some on-site audits will be conducted.


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Banner Health, Phoenix VA Partner to Deliver Care to Veterans

Banner Health of Phoenix, Arizona, will join hands with Phoenix VA Health Care System on a public-private partnership that will help expedite outpatient surgical care to thousands of veterans in the Phoenix area, according to a May 12, 2016, release.

Officials at the partnering organizations expect Phoenix VA physicians to provide approximately 2,500 surgeries per year at Banner Health’s SurgiCenter in Phoenix, Arizona, over the span of the five-year agreement.


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CMS Approves New ASC Accrediting Agency

The Centers for Medicare & Medicaid Services (CMS) approved the Institute for Medical Quality (IMQ) of San Francisco, California, as a national accrediting organization for ASCs that participate in the Medicare or Medicaid programs (also known as Medicare deemed status). The approval came on April 29, 2016, following a CMS review conducted to ensure that IMQ’s standards of accreditation meet or exceed Medicare’s Conditions for Coverage requirements.


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ASCA 2016 Convenes in Dallas in May

Plan now to make the most of the opportunities there

In a year filled with change and uncertainty in health care, ASCA is offering ASC professionals a one-stop shop where they can get everything they need to manage their facility more effectively and make critical decisions that will ensure their ASC’s future success. ASCA 2016, May 19–22 at the Gaylord Texan Resort & Convention Center in Dallas, Texas, is that destination.


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HIPAA Quarterly Update

First quarter 2016: January 1–March 31

The Secretary of the US Department of Health and Human Services (HHS) requires health care organizations to publicly post breaches of health information protected by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) that affect 500 or more individuals. During the first quarter of 2016, health care organizations across the country posted 54 breaches of protected health information (PHI) affecting 500 or more individuals. When compared to the first quarter of 2015, the number and types of breaches are similar and do not indicate significant changes or trends. Unauthorized uses/disclosures of a patient’s PHI was the most frequent type of breach during the first quarter, and historically is the most frequent type of breach.


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Manage Your Drug Supply

Effective ways to keep on top of shortages and costs

Managing her ASC's medication inventory is not just an occasional part of the job for Cheryl Ezerskis, CASC, executive director at West Parkway Ambulatory Surgery Center in Pompton Plains, New Jersey. "I spend more time managing our inventory than I care to admit," she says. "I have to monitor medications every day. Getting the medications we need to do our procedures is a never-ending game I have to play."


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Accreditation Agency Opens Advanced Certification Program

The first of its kind for ASCs

The Joint Commission launched its Total Hip and Knee Replacement Advanced Certification Program and began to accept applications from interested facilities on December 17, 2015. On-site reviews will start on March 14, says Wendi Roberts, executive director of certification at The Joint Commission. “We are getting applications every day and currently have approximately 15 applications [as of Feb. 3, 2016],” she says.


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New and Improved

More spine and gynecologic procedures move to the outpatient setting

Substantial developments in outpatient spine surgery in recent years make many spine procedures a much better match to the outpatient setting than before, and this trend is likely to continue, says Fred Naraghi, MD, an orthopedic surgeon and neurosurgeon who practices out of the Comprehensive Spine Center and performs cases at San Francisco Surgery Center, both located in San Francisco, California.


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