Adding in-house testing to an ASC's list of services requires the right research, application and integration processes. While there are challenges with implementing new testing protocols, they can lead to substantial benefits for your practice, including improved consultations, better outcomes and greater efficiency.
During a Jan. 25 webinar sponsored by McKesson Medical-Surgical and hosted by Becker's Hospital Review, four industry experts discussed benefits of in-house tests, hurdles associated with outside tests and the importance of documentation for compliance and quality control.
- Suzi Cunningham, administrator at Advanced Ambulatory Surgery Center in Redlands, Calif.
- Martin M. Quigley, MD, MBA, MHA, a site surveyor for the Accreditation Association for Ambulatory Health Care
- Brian Williams, vice president of compliance and regulatory affairs at MedTrainer in Redland, Calif.
- Steve Dunn, senior segment manager of ASC and orthopedics at McKesson
1. Strengthen your center. The COVID-19 pandemic, coupled with accelerating outpatient migration, has put point-of-care testing top of mind for ASCs. "The conversation is more important than ever," according to Mr. Dunn, especially as surgery centers "strive to bundle and manage services across episodes of care, and enhance outcomes and financial results."
2. Less risk, better outcomes. The key question to ask when determining whether you should perform certain tests in house is: Can I dramatically improve the quality of patient care by knowing now instead of later? "If the answer is yes, then we need to determine the scale of testing needed," Mr. Dunn said, discussing the opportunity to reduce surgical site infections caused by MRSA colonization as an example. "While the likelihood of the risk may be relatively small, the magnitude of the risk occurring could be devastating," he said.
3. COVID-19 testing at ASCs. Like many ASCs, Advanced Ambulatory Surgery Center canceled elective surgeries in March and began taking trauma cases from local hospitals, so the hospitals could cater to emergent cases and COVID patients. The ASC outsourced COVID testing to a lab in Texas, but results became delayed by up to seven days as the pandemic surged across the country. "We knew we needed to secure a faster testing mechanism, and it needed to be accurate," Ms. Cunningham said. "In mid-May we got our analyzer and were able to test COVID patients on the date of service. It has been a game changer for us."
4. Challenges with outside lab tests. Many staff feel "overwhelmed, stressed and pressured by the amount of work involved with ordering and tracking of outside lab tests," Mr. Dunn said. The lack of EMR integration creates extra work for employees who may need to look for charts and reconcile lab reports to orders. Centers operating at a hectic pace can lead to staff overlooking labs, forgetting call backs and failing to confirm results.
5. Compliance and quality control. Documentation, testing and quality assurance are paramount for centers adding new tests, according to Mr. Williams. This includes documenting quality control testing, documenting that tests are within range and documenting that reagents are not expired. "If it's not written, it didn't happen," Dr. Quigley said.