The clinical staff at Lakeview Surgery Center in West Des Moines, Iowa, believed their patients always received their prophylactic intravenous (IV) antibiotics “on time,” recalls Kate Foreman, the ASC’s quality coordinator.

“On time,” according to the definition used in Medicare’s ASC Quality Reporting (ASCQR) Program’s ASC-5: Prophylactic Intravenous (IV) Antibiotic Timing measure meant these antibiotics were initiated within one hour prior to the time of the initial surgical incision or the beginning of the procedure, or two hours prior if Vancomycin or fluoroquinolones were administered.