At this point in the COVID-19 pandemic, testing, staffing and burnout are top of mind for ASC leaders.
Five insights on how ASCs are adapting to these and other challenges:
1. Testing. As of July, Lubbock, Texas-based Covenant High Plains Surgery Center was testing all patients for COVID-19, sending them to the hospital to be swabbed. However, it was exploring bringing swabbing into its own facility. Becker's ASC Review spoke to the ASC's administrator for more details.
As the founder of Austin, Texas-based Water Leaf Surgery Center and Genotox Laboratories, Matt McCarty, MD, believes testing patients and employees for COVID-19 is "central" to maintaining safety and business viability.
"Screening has taken a back seat to diagnostic testing" as COVID-19 testing surges, Dr. McCarty said. As a result, Texas ASCs are struggling with insufficient "supply of high-quality 95 percent sensitivity/95 percent specificity [testing]."
2. Staffing. At The Surgicenter of Kansas City (Mo.), physicians are logging long hours as they work through higher-than-normal case volumes, but with nonclinical employees taking vacation time as normal, the facility has shared staff with its seven sister ASCs.
After bringing back pro re nata staff in mid-June, St. Joseph (Mo.) Center for Outpatient Surgery has worked to foster a sense of safety by testing all patients for COVID-19 at its partner hospital and installing glass barriers in the reception area.
Kelsey-Seybold Clinic (Houston) avoided furloughs during standstills in March and April by reassigning staff to other areas within the organization where they could assist with clinical or administrative duties. Once Texas' lockdown ended, the ASC gradually increased volumes. It is now maintaining 90 percent of normal volumes to prepare for the possibility that someone calls off; this would leave the center short-staffed if it were operating at full capacity. In the past two months, the ASC has hired five nurses from local hospitals and made five administrative positions remote.
3. Screening. Austin, Texas-based Personique Surgery Center installed a contactless kiosk to mitigate the spread of COVID-19, as well as other transmittable viruses and diseases. Visitors must complete a questionnaire through the Sentry Health Kiosk to get access to the building housing Personique Surgery Center and Austin Clinic for Men. If a visitor does not follow the prompts or provides information indicating high risk, the kiosk will notify Personique staff to determine next steps.
4. Personal protective equipment. A silver lining of the pandemic is that infection control has improved, according to the Texas Ambulatory Surgery Center Society. There is extra effort in screening, sanitizing and adherence to guidelines, as well as a better understanding of appropriate donning and doffing of PPE.
ASCs may be able to conserve PPE by testing all pediatric patients for COVID-19 before they undergo procedures requiring anesthesia, according to research presented at the American Society of Anesthesiologists' 2020 annual meeting.
5. Accreditation. To avoid waiting until the end of the summer for accreditation via traditional survey, Portland-based Bridge City Surgery Center underwent a virtual start-up survey by the Accreditation Association of Ambulatory Surgery Facilities June 12. Oregon is the only state allowing AAAASF to conduct start-up surveys virtually during the COVID-19 public health crisis.