Infection Control Practices in Ambulatory Surgical Centers

Barie, Philip S.

doi:10.1001/jama.2010.760

Cited by 19 publications

(6 citation statements)

References 11 publications

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“…1–2 In parallel with ambulatory surgery center expansion, there has been a growing focus on ensuring patients receive high-quality care in this setting. 3–4 To this end, the Center for Medicare and Medicaid Services (CMS) has adopted five measures of quality which ambulatory surgery centers were required to begin reporting to CMS as of October 2012 and on which reimbursement will be based beginning in 2014. These measures include patient burns, patient falls, prophylactic antibiotic timing, wrong site surgery, and hospital transfer at the time of discharge.…”

Section: Introductionmentioning

confidence: 99%

Hospital-based, acute care after ambulatory surgery center discharge

Fox¹,

Vashi²,

Ross³

et al. 2014

Surgery

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Background As a measure of quality, ambulatory surgery centers have begun reporting rates of hospital transfer at discharge. However, this may underestimate patient’s acute care needs after care. We conducted this study to determine rates and evaluate variation in hospital transfer and hospital-based, acute care within 7 days among patients discharged from ambulatory surgery centers. Methods Using data from the Healthcare Cost and Utilization Project, we identified adult patients who underwent a medical or surgical procedure between July 2008 and September 2009 at ambulatory surgery centers in California, Florida, and Nebraska. The primary outcomes were hospital transfer at the time of discharge and hospital-based, acute care (emergency department visits or hospital admissions) within 7-days expressed as the rate per 1,000 discharges. At the ambulatory surgery center level, rates were adjusted for age, sex, and procedure-mix. Results We studied 3,821,670 patients treated at 1,295 ambulatory surgery centers. At discharge, the hospital transfer rate was 1.1/1,000 discharges (95% CI, 1.1–1.1). Among patients discharged home, the hospital-based, acute care rate was 31.8/1,000 discharges (95% CI, 31.6–32.0). Across ambulatory surgery centers, there was little variation in adjusted hospital transfer rates (median=1.0/1,000 discharges [25th–75th percentile=1.0–2.0]), while substantial variation existed in adjusted hospital-based, acute care rates (28.0/1,000 [21.0–39.0]). Conclusions Among adult patients undergoing ambulatory surgery center care, hospital transfer at discharge is a rare event. In contrast, the hospital-based, acute care rate is nearly 30-fold higher, varies across centers, and may be a more meaningful measure for discriminating quality.

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Section: Introductionmentioning

confidence: 99%

Hospital-based, acute care after ambulatory surgery center discharge

Fox¹,

Vashi²,

Ross³

et al. 2014

Surgery

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“…In 2010, there were 28.6 million ambulatory surgery visits to hospital and ambulatory surgical centers (ASCs). 3,11 Despite this increasingly large number of surgical procedures at risk for an adverse event, 3 compliance with current infection prevention standards in outpatient settings has been documented to be as low as 33%. 4 The Centers for Medicare and Medicaid Services currently has a voluntary pay-for-reporting program for ASCs to report specific adverse events and has begun to track all postoperative emergency department visits and admissions following surgery in an ASC.…”

Section: Discussionmentioning

confidence: 99%

Surgical site infections in outpatient surgeries: Less invasive procedures contribute substantially to the overall burden

Linsenmeyer

Branch‐Elliman

Kalver

et al. 2019

Infect. Control Hosp. Epidemiol.

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More than 50% of outpatient surgeries predicted to have an increased likelihood of an adverse event were excluded from surgical site infection (SSI) surveillance based on Veterans Affairs Surgical Quality Improvement Program (VASQIP) eligibility criteria, defined by clinician determination of invasiveness. Burden of SSI for eligible versus ineligible surgeries was similar; thus, surveillance activities in the outpatient setting need to be re-evaluated.

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Section: Surgical Volume In Outpatient Settingsmentioning

confidence: 99%

“…According to Barie, 4 nearly three‐fourths of all surgical procedures are now performed in outpatient settings (ie, outside of a traditional hospital setting). In addition, patients with significant comorbidities routinely use outpatient services, 4 and these patients are at high risk for contracting an HAI during the duration of their care and must be managed accordingly both during the perioperative and postoperative processes to mitigate risk. Because of the short length of a patient's stay in ambulatory settings, it is important for perioperative nurses to engage the patient and the patient's family in understanding preventative measures associated with minimizing the risk for surgical site infection (SSI) postoperatively.…”

Section: Surgical Volume In Outpatient Settingsmentioning

confidence: 99%

A Review of the CDC Recommendations for Prevention of HAIs in Outpatient Settings

Garrett¹

2015

AORN Journal

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According to the Centers for Disease Control and Prevention (CDC), most health care-associated infections (HAIs) are caused by contamination from the hands of health care providers or patients, contamination from the environment, and contamination from the patient's own skin. To mitigate common sources of infection transmission, frontline health care providers must be compliant with basic infection-prevention interventions, including hand hygiene, environmental cleaning and disinfection, safe injection practices, and designation of a trained health care professional to be responsible for the infection prevention and control program. Integration of CDC recommendations should incorporate a bundled approach to these interventions and should be part of a comprehensive approach to infection prevention and control. Effective infection-prevention practices in outpatient settings are critical for reducing the risk of infection transmission, improving patient safety and patient outcomes, and reducing costs associated with health care delivery.

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Infection Control Practices in Ambulatory Surgical Centers

Cited by 19 publications

References 11 publications

Hospital-based, acute care after ambulatory surgery center discharge

Hospital-based, acute care after ambulatory surgery center discharge

Surgical site infections in outpatient surgeries: Less invasive procedures contribute substantially to the overall burden

A Review of the CDC Recommendations for Prevention of HAIs in Outpatient Settings

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