Member Focus Archives

Member Focus Archives

Member Focus

Member Focus Archives

Member Focus invites ASCA members to express their views on key ASC issues. Share your perspective with your colleagues and get to know your peers in the ASC community.

Want to be the next featured member? Answer to participate.

Questions? Please email Member Relations Manager LaToya Millet.

 


 

Sharon Petruzzi

 Sharon Petruzzi

Title: Nurse Manager
Name of ASC: Susquehanna Surgery Center
City: Bloomsburg
State: Pennsylvania
How long has your facility been an ASCA member? 5 or more years

 

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How do you handle postop instructions with your patients?Do you do it pre-operatively/with a family member/send home written discharge instructions?

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Postop instructions begin at our facility with the preop phone call. During that call, we review with the patient specific needs that they would have after getting home from surgery, e.g., ice, dressings, pain medications and nutrition. On the day of surgery, the preop nurse reviews the discharge instructions with the patient and their significant other, if the patient so desires. We have the patient sign the discharge instructions in the preop area prior to any sedation. Prior to discharge, the postop nurse again reviews the discharge instructions with the patient and their significant other, and they are sent home with the written instructions.

We have found that this three-fold approach works well. The more knowledge the patient has about his/her after care, the better their surgical experience.

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What hiring methods do you use to fill open positions at your ASC?

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Newspaper advertisements and word-of-mouth through our nursing communities.

 


 

Julie Baker

 Julie Baker

Title: Director
Name of ASC: Prairie Star Surgery Center
City: Lenexa
State: Kansas
How long has your facility been an ASCA member? 5 or more years

 

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How do you handle postop instructions with your patients?Do you do it pre-operatively/with a family member/send home written discharge instructions?

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Postop instructions are most effectively communicated using a variety of methods. We start discussing postop instructions with both the patient and family members from the moment they arrive at the surgery center. The instructions are reinforced throughout their stay in the facility and family members are handed a folder with complete, highlighted instructions as they leave the facility.

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What hiring methods do you use to fill open positions at your ASC?

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We utilize both a skill survey and behavioral assessment tool prior to scheduling an interview. Interviews are conducted with the director, charge nurse and education specialist. Often, applicants are brought back for a second, more focused peer interview.

 


 

Deb Yoder

 Deb Yoder

Title: Director of Clinical Operations
Name of ASC: Surgical Management Professionals
City: Kalona
State: Iowa
How long has your facility been an ASCA member? 5 or more years

 

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How do you handle postop instructions with your patients?Do you do it pre-operatively/with a family member/send home written discharge instructions?

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At our facilities, we utilize a multifocal approach. Each age learns and interprets differently, and data shows that we need to hear things many ways to process, learn and retain the information. Teaching both the patient and family member in preop, prior to sedation and administration of any medication(s), and having the patient sign an understanding of the preop instructions is the most efficient method and meets appropriate medication administration standards. During the postop phase, after the patient is settled, has pain controlled and is in a position to review and hear the information again, the postop nurse reviews the instructions one more time.

It is very important that with two nurses providing instructions they stick to the script and what the doctor wants, not interjecting personal stories or opinions of how care should be handled. If a patient hears the instructions 1) in the office during the initial discussion of the procedure, 2) in preop, 3) in postop, and then again, a day later during the postop phone call, there is greater chance that they hear and learn. Written documentation of postop instructions are necessary for accreditation and learning opportunities. Another opportunity to educate patients in by posting links on the ASCs website to the most common procedures with instructions on both preop and postop needs. This allows the patient yet another opportunity to get the information needed to be both prepared for the procedure and care after the procedure.

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What hiring methods do you use to fill open positions at your ASC?

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Prior to filling positions, one needs to determine the true needs of the facility. Is this position pertinent to the ongoing operations? Can it be combined with another position? Do the current and projected volumes require this position be filled?

Looking at different organizational structures and getting creative can sometimes allow a facility to realign job roles and utilize current staff. Best use of staff is to look at the current mix and the given skill sets. If it is a management position, is there staff in-house that could grow and utilize new skills to move into the roll? This helps promote positive culture and encourages the staff members to grow their skill sets and extend current comfort levels.

Actual hiring needs to include a current and applicable job description, clear outline of real duties and expectations related to the person filling the role and a time frame needed to fill the role. It is never good or best for the facility to just fill the position with a body. Utilizing a team approach to interviewing allows staff and managers to be a part of the decision and ownership process. If the employee turns out to be not as successful as hoped or has trouble with orientation/culture, the team takes the responsibility of the decision, not just the hiring manager. The team approach also allows the culture of the facility to come through. The new employee gets a feel for the ASC and the type of environment he/she will be working in. All positions can be filled with the team interview approach. A director or administrator could then approve the staff’s decision before the governing board’s final decision.

Utilizing all search engines for posting the position and, if needed, a consultant also is beneficial depending on the region and position needed. Posting and sharing on Facebook or LinkedIn often allows a facility to get the word out related to needs and is cost effective. Encouraging staff to spread the word about the opening to their network and utilizing a referral bonus for staff members who refer an individual that is hired is a good way to attract new employees.

 


 

Sue Valind

 Sue Valind

Title: GI manager
Name of ASC: Menomonee Falls Ambulatory Surgery Center
City: Menomonee Falls
State: WI
How long has your facility been an ASCA member? 5 or more years

 

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How do you handle postop instructions with your patients?Do you do it pre-operatively/with a family member/send home written discharge instructions?

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Preop: We do postop instructions in the preop area with both patient and driver. We inform them that the findings and associated instructions will be filled in after the procedure is completed.

Postop: We walk into the postop room and document all information the MD shares with patient/driver. We document these on the discharge instructions and review all information with the family/driver. A carbon-copy is sent home with the patient.

Follow up call at 24 hours postop: We follow up with the patient if they have any questions.

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What hiring methods do you use to fill open positions at your ASC?

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Right now, we:

  1. Question current staff if they have any referrals
  2. Put ad in the local online jobs listing
  3. Review applicants
  4. Narrow candidates to four or five
  5. Conduct phone interviews, narrow candidates to approximately three
  6. Perform face-to-face interviews
  7. Ask top two candidates to come in for a half day to shadow and see what we are all about and observe them
  8. Based on staff feedback and my assessment, I do a job offer.

 


 

Sandra Oglesby, RN, CASC

 Sandra Oglesby

Title: Director of Nursing
Name of ASC: Laser Spine Institute
City: Tampa
State: FL
How long has your facility been an ASCA member? 5 or more years

 

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How do you handle postop instructions with your patients?Do you do it pre-operatively/with a family member/send home written discharge instructions?

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General postop instructions are introduced and reviewed with patient and care partner in the preoperative area. The postop instructions are reviewed again with patient-specific instructions and medication reconciliation in Phase II just prior to discharge. Printed copies are provided to patient at discharge.

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What hiring methods do you use to fill open positions at your ASC?

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I like to have candidates interview with the leadership team first, followed--on the same day, when possible--by a peer interview. For each position, a peer interview team is selected from the entire ASC team by the entire ASC team. This peer team will interview all candidates for a specific open position. With leadership guidance, the peer team chooses specific interview questions that will be asked to each candidate. A rating system is attached to each question for the peer team to rate the candidates’ response to each question. Peer interviewers are asked to determine if this candidate should be recommended for hire, keeping notes on why or why not. Completed forms are held by the director of nursing until all candidates have been interviewed. After all candidates have been interviewed, the peer team compiles its results and presents its recommendations to the leadership team. After considering the voice of the ASC through the peer interview team, a decision is made by the leadership team and an offer is made. I have used this hiring process for more than 10 years and it has proven to be a win-win for my teams. When the team is active in choosing new hires, they take ownership to onboard the new employee as one of the team from the beginning. Complimenting the current team with new hires is success.

 


 

Terri Cochran, RN, CASC

 Terri Cochran

Title: Center Director
Name of ASC: Orthopaedic Surgery Center
City: Gainesville
State: FL
How long has your facility been an ASCA member? 5 or more years

 

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How do you handle postop instructions with your patients?

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During our on-site pre-operative patient visit, patients receive specific instructions regarding post-operative pain, post-operative nausea and vomiting, bleeding and infection, both verbally and in writing. In addition to this, they also receive sample discharge instructions from both the surgeon and the anesthesiologist with the explanation that a personalized set of instructions will be provided to them at the time of their discharge. All discharge instructions are reviewed with both the responsible adult and the patient on the day of surgery, with written copies to go home with. All discharge instructions include a contact phone number, in case there are any questions. Any patient discharged with a pain pump or following any total joint replacement also has direct contact information for the anesthesia provider.

 


 

Crystal Barrett

Crystal Barrett

Title: Administrative Coordinator
Name of ASC: Surgical Center of Greater Annapolis
City: Arnold
State: MD
How long has your facility been an ASCA member? 1 year

 

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What emergency preparedness protocols does your ASC have in place?

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Our center updates and trains our staff on several emergency preparedness protocols, including those for medical emergencies, fire, bomb threats, severe weather, active shooter/hostage situations, autoclave failure, electrical failure and medical vacuum failure. Our full emergency operations plan was developed by myself, our nurse manager and members of our nursing staff. We often have live drills to ensure that our staff knows what to do in any of these situations.

 


 

Danielle Mullen

Danielle Mullen

Title: Medical Biller
Name of ASC: Copper Ridge Surgery Center
City: Traverse City
State: MI
How long has your facility been an ASCA member? 5 or more years

 

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How do you make sure that insurance reimburses you on time?

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You need to stay on top of them. After I bill a claim, I wait 1-2 weeks, then I call to make sure that they received the claim. If I have not received any denial or payment by 30 days after I sent the claim, I call again to check its status. If you stay on top of it, they will process it rather quickly.

 


 

Christy Bingham

Christy Bingham

Title: Intra-procedural Director
Name of ASC: Copper Ridge Surgery Center
City: Traverse City
State: MI
How long has your facility been an ASCA member? 5 or more years

 

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What are the top three things you do to maintain patient safety in your ASC?

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  1. Utilize the patient identifiers in preop area before walking back to the operating room. Patient verification in preop requires a minimum of two patient identifiers to confirm identity and for patient safety. The OR circulator will ask for the patient’s name, DOB, physician, and what procedure they are having done.
  2. Perform a surgical time-out before and after surgery/procedure to assure patient safety and better patient outcomes. This guarantees all members of the surgical team are aware of the potential risks, and share any thoughts to the group. This develops a patient-centered environment and safety culture.
  3. Maintain on a regular basis operating room staff competencies. Copper Ridge Surgery Center maintains staff competencies by performing scenario-based fire and other safety related drills on a quarterly basis; providing annual in-service training on specialized equipment; and utilizing professional organizations to enhance and maintain competency through continued education or networking. It is important to stay up-to-date and current on industry standards.

 


 

LoAnn Vande Leest

LoAnn Vande Leest

Title: Chief Executive Officer
Name of ASC: Northwest Michigan Surgery Center LLC, dba, Copper Ridge Surgery Center
City: Traverse City
State: MI
How long has your facility been an ASCA member? 5 or more years

 

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What is the best part about attending an ASCA annual meeting?

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The ASCA annual meeting is my go-to meeting for high-level insights to our industry. It all starts with Bill Prentice and his slate of speakers, including some of the board members, who talk about what the government is doing, how it is affecting our industry, and what we should do in response.

Other speakers, many of whom are professionals from our field, speak on a wide variety of timely topics. These topics include issues that are in the forefront and ones that everybody needs to be learning about. I frequently have a hard time deciding which sessions I need to go to because they are all so informative and useful.

On the exhibit floor, the vendors always have the newest and the best products and show us where the trends in the industry are going. I can see what's new and smart technology-wise. The interaction with colleagues from across the US is priceless. Learning from others how their centers address issues is a result of networking at its finest. This is great value for the money! Copper Ridge Surgery Center sends three to four of our leaders every year, and we always come back with pertinent information to share and new ideas to research for their applicability to our center.

 


 

Jean Day

Jean Day

Title: Director of Education
Name of ASC: Pinnacle III
City: Crestone
State: CO
How long has your facility been an ASCA member? 5 or more years

 

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What key advocacy issue is your ASC most concerned about?

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  • External benchmarking key performance measures across our managed ASCs;
  • Consistent performance of peer review process across our managed ASCs; and
  • Adoption of SaaS (software as a solution) selected by corporate across our managed ASCs. ASCs are sadly out of step in this regard and are underutilizing what’s available in the market place to streamline, and enhance business operations. Pinnacle has been progressive and using many software applications, which has created greater standardizations across our organization. We have all our policies contained within a software application. We also use a software solution for administering our quality management program, which includes risk management, KPIs and performance improvement studies, and patient response in terms of their consumer experience. We use another software for patient progression, similar to airlines flight boards. This allows guests waiting and inter-departments to know just where a patient is and when they will be transferred to the next area, like PACU. So now, instead of picking up the phone and notifying the nurses, it’s all automated. This same application also allows for requested physician-preferred items to be synchronized in communication between the surgeon, OR nurse and the health care rep, eliminating multiple phone calls to coordinate delivery. We also manage safety data sheets and core competency for staff education, such as OSHA, HAZMAT. These have improved our rate of compliance by using software applications.

 


 

Julie Hamberis

Julie Hamberis

Title: Associate vice president of surgery/ambulatory services
Name of ASC: McLeod Regional Medical Center of the Pee Dee Surgery Center
City: Florence
State: SC
How long has your facility been an ASCA member? 1 year

 

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What steps does your ASC take to ensure patient satisfaction?

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Service excellence and patient satisfaction are measured at our center three ways. We participate in the OAS CAHPS survey, perform director- and AVP-level patient and family rounding prior to discharge to ask how their visit was, and we hand out comment cards to every patient for every visit to get input on how we can improve their experience. This information is shared quarterly to our quality oversight committee, which consists of the medical director, AVP and VP.

 


 

Tracy Hoeft-Hoffman

Tracy Hoeft-Hoffman

Title: Administrator
Name of ASC: Kearney Ambulatory Surgical Center, dba Heartland Surgery Center
City: Kearney
State: NE
How long has your facility been an ASCA member? 5 or more years

 

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What steps does your ASC take to ensure patient satisfaction?

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Patient satisfaction starts with hiring the right team! Hire winners, not whiners. Next, you have to take care of the team because they are the first people your patients encounter. This starts with the first phone encounter the patient has with us and ends with the postop phone call. Satisfaction scores don't tell the whole story, so we look at each patient comment to see what we can do to improve. Happy employees and surgeons leads to high patient satisfaction.

 


 

Lee Anne Blackwell

Lee Anne Blackwell

Title: Vice President of Clinical Services
Name of ASC: Practice Partners in Healthcare, Inc.
City: Birmingham
State: AL
How long has your facility been an ASCA member? 5 or more years

 

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What is the single most important step to maintain quality in your ASC?

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The entire team must be focused on driving best practices for achieving safe patient and optimum organizational outcomes. This team is represented by dedicated interdisciplinary stakeholders from operational and clinical leadership, physician and allied health providers of key specialties, perioperative and perinanesthesia nurses and technical staff members, and other identified service suppliers.

Effective strategies to support timely communication and ongoing best practice education throughout the team is paramount in achieving goals and objectives and implementing meaningful actions for success. This is the foundation of a well-engineered quality improvement and patient safety program with goals, objectives and strategies focused on continuous improvement.

 


 

Lisa York

Lisa York

Title: Executive Director
Name of ASC: Hunterdon Center for Surgery
City: Flemington
State: NJ
How long has your facility been an ASCA member? 5 or more years

 

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What is the single most important step to maintain quality in your ASC?

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I believe that as a director, whether a nursing director or an executive director, staying in touch with staff, doing daily rounds and offering high-quality patient care are crucial steps. Empower and trust your team to do the best possible for the patients and let them know that they have a voice. Keeping your eyes on the facility and feet on the ground will allow for problems and opportunities to be visualized and acted upon.

 


 

James McClung

James McClung

Title: Nurse Administrator
Name of ASC: Center for Specialty Surgery of Austin
City: Austin
State: TX
How long has your facility been an ASCA member? 2 years

 

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What is the single most important step to maintain quality in your ASC?

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At CSSA, we believe in a shared governance management style. CSSA, being a small center (2 OR/2 proc. room), we do not make numerous decisions without first consulting our “leader” of the area being affected. Through this transparent style of management, we hope to promote an “ownership type mentality” in our employees. For instance, we are using several different clinical metrics to set and obtain our annual goals. By involving our employees in metrics and goal setting, a feeling of “ownership” or getting what they want out of their environment is created. Secondly, by using this process, you can use their goals and metrics with a performance-based type evaluation and bonus system. The ultimate goal is to eventually release the employee into creating effective surveys, performance indicators and goals for their individual areas. Once accomplished, the success of your employees and their created positive trends will pass down to an increase in excellent service for your patients.

 


 

Kris Sabo

Kris Sabo

Title: Executive Director
Name of ASC: Pend Oreille Surgery Center
City: Ponderay
State: ID
How long has your facility been an ASCA member? 5 or more years

 

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What is the single most important step to maintain quality in your ASC?

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Maintaining employee engagement! We have three different age groups in our work force now, Gen X, Gen Y and the Millennials, collectively referred to as the Connected Generations. We have to take into consideration each of those generation’s needs to keep them engaged. If we don’t keep them engaged, they will move on to places where their goals are being met. If you have constant turnover in staff, your quality of patient care will suffer. To make sure Pend Oreille Surgery Center is taking care of our employees’ needs, we’re totally revamping the way we approach human resources. We’re meeting with our employees one-on-one to ask questions and make sure that their work-life balance is maintained. We’re changing our evaluation system and making them shorter and less time-consuming. We’re trying to stay on top of how work is being done so we can keep our employees engaged.

 


 

Darlene Hinkle

Darlene Hinkle

Title: Director, Perioperative Services
Name of ASC: Fairgrounds Surgical Center/ Children's Surgery Center/ Lehigh Valley Hospital
City: Allentown
State: PA
How long has your facility been an ASCA member? 5 or more years

 

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What new payment method is your ASC currently using or looking to implement in the near future?

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We are constantly looking at our billing practices to make sure that we capture all items that are billable. Using EPIC and OMNICELL, we are assuring better capture of items where applicable.

 


 

Pamela Wrobleski

Pamela Wrobleski

Title: Administrator
Name of ASC: Southwestern Ambulatory Surgery Center; Gamma Surgery Center
City: Pittsburgh
State: PA
How long has your facility been an ASCA member? 5 or more years

 

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What new payment method is your ASC currently using or looking to implement in the near future?

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Our business office constantly works with our surgeons' offices to find ways to improve upfront collections for out-of-pocket expenses, using Care Credit, MedDraft and other options to help patients with high deductibles and coinsurances. We have also implemented various self-pay options for those without coverage with discounts when appropriate or allowed in accordance with our various insurance contracts. There are no ACOs currently in our market, although we have utilized bundled payments through some insurers in the past. All have stopped that practice now.

 


 

Joleen Harrison

Joleen Harrison

Title: Administrative Director
Name of ASC: Mankato Surgery Center
City: Mankato
State: MN
How long has your facility been an ASCA member? 5 or more years

 

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What new payment method or process is your ASC currently using or looking to implement in the near future?

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Mankato Surgery Center has implemented estimate courtesy calls to all commercial payer patients. This helps our patients become aware of their health care coverage and creates transparency on our end on the cost of their procedures. Since the ASC surgical procedures are generally elective, we feel involving our patients with their health-care expenses ahead of time has been successful. It allows the patients to understand what they will owe the ASC. The patient feedback has been positive from those choosing to call their carrier for insurance coverage for their upcoming surgical procedures.

 


 

Tina DiMarino

Tina DiMarino

Title: Administrator
Name of ASC: Mid-Atlantic Surgery Pavilion
City: Aberdeen
State: MD
How long has your facility been an ASCA member? 1 year

 

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What new payment method is your ASC currently using or looking to implement in the near future?

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We utilize CareCredit. Patients who need to have procedures done and cannot afford to pay out of pocket or have high deductibles may use this service to have their procedure performed immediately. Often times, this service may be interest free.

 


 

Dianne Appleby, RN

Dianne Appleby

Title: Executive Director
Name of ASC: Menomonee Falls Ambulatory Surgery Center
City: Menomonee Falls
State: WI
How long have your been an ASCA member? 5 or more years

 

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Share a best practice your ASC uses to ensure compliance with the changing regulatory guidelines.

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We rely heavily on the resources ASCA and our state association provide to keep us informed on changes in the regulatory guidelines. In the 23 years we have been open, we have always sent staff and managers to the ASCA conferences and, more recently, the ASCA webinars have proven invaluable in helping us keep on top of things. Our staff attend webinars, seminars and conferences focused on new/modified regulations and how to meet them. They participate in listservs at the national and state level to share information and learn how others implement and meet guidelines in their centers. They also review and provide input on new or revised policies and procedures directly related to what they do daily. I think our staff's active participation is key to compliance.

We also follow ASC-specific newsletters/publications put out by the accrediting bodies and other ASC-focused organizations. We belong to ASCA, Association of periOperative Registered Nurses (AORN), Society of Gastroenterology Nurses and Associates (SGNA), Association for Professionals in Infection Control and Epidemiology (APIC) and our state ASC association. We receive information from these organizations regularly on how to apply the regulations and the standards of the Centers for Medicare & Medicaid Services (CMS).