Ambulatory Surgery Centers Remain Under Close Scrutiny for Infection Prevention and Control Practices

By on 5:31 AM

For the past several years, ambulatory surgery centers (ASCs) have been under close scrutiny at the federal and state level for infection prevention and control practices as the acquisition of healthcare associated infections (HAIs) is not only confined to the inpatient population. In response to a massive exposure of thousands of patients to bloodborne pathogens at the Endoscopy Center of Southern Nevada, the government, through the Centers for Medicare & Medicaid Services (CMS) stepped up survey efforts of ASCs to prevent these occurrences from happening in the future. An ASC infection control surveyor worksheet (pdf) was developed in 2009 and revised in 2013.

ASCs accredited by organizations such as AAAHC and The Joint Commission (TJC) may apply for "deemed status." Surveyors for those organizations are trained by CMS to conduct surveys on behalf of the federal government, specifically relating to the Medicare Conditions for Coverage [http://www.cms.gov/Regulations-and-Guidance/Legislation/CFCsAndCoPs/ASC.html].

Since 2009, Phenelle Segal, RN CIC, President of Infection Control Consulting Services, LLC has been hired as an infection control consultant by numerous ASCs nationwide. Her services include providing "pre-survey" visits to observe best practices, reviewing policies and procedures as well as developing CMS-mandated, written infection control programs for facilities that are deficient.

In addition, Phenelle assists facilities who have been through a survey and acquired CMS-related deficiencies in infection control for ambulatory surgery to develop an infection control correction plan of action (COP). She also assists those deficient facilities to develop or enhance their programs and improve their practices for the purpose of patient safety and better outcomes for follow-up CMS surveys.

Despite the increased focus on infection prevention and control practices in ASCs, Phenelle continues to see deficiencies in a number of areas including hand hygiene, safe injection practices and disinfection/sterilization.

While facilities often believe they are engaging in the correct practices, small and large steps that should be undertaken are omitted. Most times, it takes an external or extra "set of eyes" to identify these missing steps that could be crucial to the status of a CMS/deemed status survey.

If you are concerned about whether your ASC is engaging in proper infection prevention and control practices, or if you feel that your ASC is out of compliance with federal and state regulations, Contact Phenelle for an initial no-charge telephone consultation to discuss your concerns and needs.

Phenelle Segal, RN, CIC, FAPIC

Phenelle Segal, RN, CIC, FAPIC, is the founder and president of Infection Control Consulting Services LLC (ICCS). Phenelle has more than 30 years' experience providing customized comprehensive infection control and prevention services to healthcare facilities nationwide. Her services focus on assisting hospitals, ambulatory surgery centers, dental office and oral surgery practices, doctor's offices, nursing homes and other organizations with implementing and maintaining an infection control program that: complies with The Joint Commission, AAAHC, Centers for Medicaid and Medicare Services (CMS) and other regulatory agencies; respond to situations of noncompliance; and improve the processes for reducing risk.