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Study: Outpatient Centers Lack Quality Infection Control

Posted Oct 11 2010 12:00am

A recent study by researchers at the U.S. Centers for Disease Control revealed that outpatient surgical centers may not keep patients as safe from infections as they should. The report, published in JAMA, said that researchers found at least one lapse at 68 percent of the 68 centers tested and saw lapses in at least three areas at 18 percent of the facilities. With outpatient operations on the rise, these lapses may affect a growing number of patients. Officials in the outpatient industry have said the data in the study has already been addressed.   Read Article:

Most medical practitioners know about the Semmelweise Study conducted by Ignaz Semmelweise in Vienna in the 1800’s.  Semmelweise was convinced that many infections were actually caused by physicians and hospital staff not using proper hand hygiene. He for his beliefs.  He conducted tests at the Lying In Women’s Hospital in Vienna in 1847 to prove that poor hygiene was responsible for hospital based infections, by using a “business as usual” control set of patients, to compare to patients whose providers washed their hands. Not surprisingly to us today, he was able to clearly prove the relationship between hand hygiene and lowered incidence of infection.

Nonetheless, it was years before hand hygiene was incorporated into hospital procedures.  I bring this up because hand hygiene should be a complete no brainer, since it has been well known to help  control infection for over 160 years.  The article doesn’t specify hand hygiene in particular, but noted that there were violations in 5 areas, with hand hygiene on that list.

More seriously still, in 28% of these centers, there were violations involving multiple uses of single vial medications.

Of note is that outpatient surgery centers are supposed to be inspected every three years and the one in question in the article had gone seven years without an inspection.

When you look at the rate these facilities are mushrooming:  “…the number of Medicare-certified ASCs increased from 2786 in 1999 to 4506 in 2005, an average annual growth rate of 8.3%.2 In 2008, ASCs numbered 5174,” according to the Joint Commission Center for Transforming Health Care, I would recommend doing the research on any center you are where you are scheduled to have an outpatient procedure to make sure they have been inspected–recently.

Here are a couple of websites you can search for information before you visit an outpatient surgery center:

Accredited Ambulatory Health Care and Surgery Centers (AAAHC) – The nonprofit AAAHC currently accredits over 4,000 organizations in a wide variety of ambulatory health care settings, including ambulatory and office based outpatient surgery centers, IVF clinics and specialty clinics www.aaahc.org/eweb/dynamicpage.aspx?webcode=home

Accredited Healthcare Facilities – Joint Commission Accreditation (all states) – Provides a quality check report for hospitals, assisted living facilities, surgery centers, laboratories, etc.  You should be able to view the 2008-2009 quality report scores of various facilities online. http://www.jointcommission.org/GeneralPublic/Choices/hc_amb.htm

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