ASC Quality Collaboration
Quality Report
1st Quarter 2010
This public report of ambulatory surgical center (ASC) quality data has been made possible through the voluntary efforts of participants in the ASC Quality Collaboration. The following organizations agreed to collect and submit clinical quality data reflecting patient admissions* from January 1, 2010 through March 31, 2010: Ambulatory Surgery Center Association; Ambulatory Surgical Centers of America (ASCOA); AmSurg; Healthcare Facilities Accreditation Program (HFAP); HCA Ambulatory Surgery Division; National Surgical Care (NSC); Nueterra; Surgical Care Affiliates (SCA); Symbion; and United Surgical Partners International (USPI).
This report presents aggregated performance data for six ASC facility-level quality measures developed by the ASC Quality Collaboration and endorsed by the National Quality Forum:
- Patient Fall in the ASC
- Patient Burn
- Hospital Transfer/Admission
- Wrong Site, Side, Patient, Procedure, Implant
- Prophylactic IV Antibiotic Timing
- Appropriate Surgical Site Hair Removal
This data and the accompanying information do not present all there is to know about the quality of ASCs. Patients are encouraged to discuss these quality indicators with their local ASC staff and their physician.
The data presented here has been self-reported by participating organizations and has not been independently validated by the ASC Quality Collaboration.
Questions or comments regarding this report may be directed to Donna Slosburg, Executive Director, ASC Quality Collaboration at donnaslosburg@ascquality.org.
Patient Fall in the ASC
Falls are an important issue for patients having outpatient procedures or surgery because virtually all patients receive sedatives, anesthetics and/or pain medications as a routine part of their care. The use of these medications increases the likelihood of a fall.
The frequency of ASC admissions experiencing a fall while in the confines of participating ASCs is shown below as a rate per 1000 admissions. Lower rates are better.
| Rate of patient falls in the ASC | 0.149 per 1000 admissions |
|---|
Represents the experience of 1,278,879 ASC admissions seen at 1,130 facilities between January 1 and March 31, 2010
The data trends for this measure over the last four quarters are presented below in both tabular and graphical formats.
Data Summary: Patient Fall in the ASC
Reporting Period |
2Q2009 |
3Q2009 |
4Q2009 |
1Q2010 |
Number of Participating ASCs |
1,213 |
1,116 |
1,183 |
1,130 |
Number of ASC Admissions Represented |
1,454,885 |
1,338,301 |
1,397,975 |
1,278,879 |
Patient Fall Rate per 1000 ASC Admissions |
0.183 |
0.157 |
0.179 |
0.149 |
Patient Burn
Burns are an important issue for patients having outpatient procedures or surgery because the equipment and supplies routinely used in providing these types of services can increase the risk that a patient will experience an unintended burn.
The frequency of ASC admissions experiencing a burn, regardless of severity, while in the care of participating ASCs is shown below as a rate per 1000 admissions. Lower rates are better.
| Rate of patient burns | 0.037 per 1000 admissions |
|---|
Represents the experience of 1,275,578, ASC admissions seen at 1,123 facilities between January 1 and March 31, 2010
The data trends for this measure over the last four quarters are presented below in both tabular and graphical formats.
Data Summary: Patient Burn
Reporting Period |
2Q2009 |
3Q2009 |
4Q2009 |
1Q2010 |
Number of Participating ASCs |
1,209 |
1,107 |
1,181 |
1,123 |
Number of ASC Admissions Represented |
1,454,819 |
1,325,395 |
1,388,469 |
1,275,578 |
Patient Burn Rate per 1000 ASC Admissions |
0.042 |
0.044 |
0.045 |
0.037 |
Hospital Transfer/Admission
ASCs provide surgical services to patients not requiring hospitalization. Therefore, ASCs screen patients referred to their facilities to ensure they can be safely cared for as an outpatient.
The frequency of ASC admissions experiencing a transfer or admission to a hospital upon discharge from participating ASCs is shown below as a rate per 1000 admissions. Not all conditions requiring a hospital transfer or admission result from the care the patient received in the ASC, nor can all medical conditions requiring a hospital transfer or admission be anticipated in advance. Therefore, some level of hospital transfer or admission is expected.
| Rate of hospital transfers/admissions | 1.081 per 1000 admissions |
|---|
Represents the experience of 1,334,614 ASC admissions seen at 1,185 facilities between January 1 and March 31, 2010
The data trends for this measure over the last four quarters are presented below in both tabular and graphical formats.
Data Summary: Hospital Transfer/Admission
Reporting Period |
2Q2009 |
3Q2009 |
4Q2009 |
1Q2010 |
Number of Participating ASCs |
1,294 |
1,177 |
1,266 |
1,185 |
Number of ASC Admissions Represented |
1,528,402 |
1,396,179 |
1,490,427 |
1,334,614 |
Hospital Transfer/Admission Rate per 1000 ASC Admissions |
0.997 |
1.027 |
1.010 |
1.081 |
Wrong Site, Side, Patient, Procedure, Implant
Wrong site, wrong side, wrong patient, wrong procedure and wrong implant events are a concern for patients having outpatient procedures or surgery. There are steps that can be taken to help prevent errors such as surgery performed on the wrong part of the body or the wrong side of the body.
The frequency of ASC admissions experiencing a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event while in the care of participating ASCs is shown below as a rate per 1000 admissions. Lower rates are better.
| Rate of wrong site, side, patient, procedure, implant events | 0.034 per 1000 admissions |
|---|
Represents the experience of 1,308,530 ASC admissions seen at 1,169 facilities between January 1 and March 31, 2010
Reporting Period |
2Q2009 |
3Q2009 |
4Q2009 |
1Q2010 |
Number of Participating ASCs |
1,289 |
1,158 |
1,240 |
1,169 |
Number of ASC Admissions Represented |
1,515,620 |
1,371,209 |
1,447,897 |
1,308,530 |
Rate of Wrong Site, Side, Patient, Procedure, Implant per 1000 ASC Admissions |
0.032 |
0.033 |
0.034 |
0.034 |
Prophylactic IV Antibiotic Timing
Prevention of surgical wound infections is an important issue for patients having outpatient procedures or surgery. In cases where the physician has determined that an antibiotic should be given to help prevent a surgical wound infection, giving the antibiotic at the right time is important. Research indicates that antibiotics given too early, or after the surgery begins, are not as effective.
The percentage of ASC admissions having an order for an antibiotic to help prevent surgical wound infection that received the antibiotic in the appropriate timeframe is displayed below. Higher percentages are better.
| Percentage of ASC admissions with antibiotics ordered who received antibiotics on time | 95% |
|---|
Represents the experience of 779,079 ASC admissions with antibiotics ordered seen at 743 facilities between January 1 and March 31, 2010
The data trends for this measure over the last four quarters are presented below in both tabular and graphical formats.
Data Summary: Prophylactic IV Antibiotic Timing
Reporting Period |
2Q2009 |
3Q2009 |
4Q2009 |
1Q2010 |
Number of Participating ASCs |
666 |
649 |
710 |
743 |
Number of ASC Admissions Represented |
773,772 |
718,644 |
771,422 |
779,079 |
Percentage of ASC Admissions with |
96% |
96% |
96% |
95% |
Appropriate Surgical Site Hair Removal
Prevention of surgical wound infections is an important issue for patients having outpatient procedures or surgery. In certain cases, properly preparing the patient for surgery requires the removal of body hair in the area where the surgery will be done. Removing body hair with electric clippers or hair removal cream reduces the likelihood of a surgical wound infection. Removing body hair by shaving with a razor may increase the likelihood of a surgical wound infection.
The percentage of ASC admissions that had body hair removed with electric clippers or hair removal cream is displayed below. Higher percentages are better.
| Percentage of ASC admissions with appropriate surgical site hair removal | 98% |
|---|
Represents the experience of 692,129 ASC admissions with surgical site hair removal seen at 674 facilities between January 1 and March 31, 2010
The data trends for this measure over the last four quarters are presented below in both tabular and graphical formats.
Data Summary: Appropriate Surgical Site Hair Removal
Reporting Period |
2Q2009 |
3Q2009 |
4Q2009 |
1Q2010 |
Number of Participating ASCs |
423 |
598 |
619 |
674 |
Number of ASC Admissions Represented |
432,936 |
608,622 |
652,325 |
692,129 |
Percentage of ASC Admissions with |
98% |
99% |
93% |
98% |
For more detailed information on these measures, please review the implementation guide found on the home page of the ASC Quality Collaboration website at www.ascquality.org.
* For purposes of this quality report, "admission" is defined as completion of registration upon entry into the ASC. This term is used in order to be consistent with the measure specifications.
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