Making Ambulatory Surgery Safer | Joint Commission
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Making Ambulatory Surgery Safer

Aug 09, 2017 | 2694 Views

Castro_PhotoBy Gerard M. Castro, PhD, MPH
Project Director, Patient Safety Initiatives
The Joint Commission 


17.AHC_Melissa_MillerMelissa Miller, MD, MS
Medical Officer, Division of Healthcare-Associated Infections, Center for Quality Improvement and Patient Safety
Agency for Healthcare Research and Quality

More than 23 million surgeries are performed annually in U.S. ambulatory surgery centers (ASCs). It is likely that this number will continue to increase as more and more procedures are being performed in ASCs rather than hospital settings. 

While the overwhelming majority of ASC procedures are done safely and without incident—as with surgeries in any health care setting—complications can result. These include healthcare-associated infections (HAIs), such as surgical site infections (SSIs) and other safety problems.

The Joint Commission and the Agency for Healthcare Research and Quality (AHRQ), the nation’s patient safety agency, have long been committed to keeping patients safe from harm by helping ASCs and other types of providers address these risks. That’s why The Joint Commission has developed goals that focus on common problem areas and why AHRQ has developed a new toolkit specifically designed to help ASCs reduce patient harm that can result from those problems.

The more than 2,100 freestanding ambulatory care organizations accredited by The Joint Commission are required to comply with rigorous standards and National Patient Safety Goals (NPSGs) that focus on problems in the ambulatory setting and how to solve them, including those related to: 

  • identifying patients correctly
  • using medicines safely
  • preventing infection
  • preventing mistakes in surgery

New Toolkit Offers Guidance
AHRQ’s new “Toolkit to Improve Safety in Ambulatory Surgery Centers” can help Joint Commission-accredited ambulatory care organizations adhere to these NPSGs. The toolkit, developed as part of a national implementation project, is based on the core concepts of AHRQ’s Comprehensive Unit-based Safety Program (CUSP) — a multifaceted approach combining improved teamwork, communication and patient safety culture that speeds frontline clinicians’ adoption of evidence-based practices to reduce harm. CUSP has been used in hospitals and long term care facilities to significantly reduce infections and other patient harms.


The toolkit combines proven practices with insights from staff experiences at more than 650 ASCs across the country. Through a step-by-step implementation guide, ASC staff learn how to use an ASC-specific safe surgery checklist and other interventions to improve care. Topics in the toolkit cover:

  • teamwork and communication
  • coaching clinical teams
  • patient and family engagement
  • sustainability

Unique Resources Available 
Several resources are available in the toolkit, including PowerPoint presentations, videos, facilitator notes and checklists. These materials are uniquely fashioned for the ASC setting, but are customizable to ensure they reflect facility-specific needs. A patient brochure “Getting Ready for Your Ambulatory Surgery” also is available to help patients know what to expect before, during and after surgery.  

All patients deserve to receive the safest and highest quality care whether in the ambulatory or another health care setting. We hope your ASC will join The Joint Commission and AHRQ in working toward this goal by making the more than 23 million surgeries performed in ASCs safer. 

We’d love to know your thoughts on this toolkit. Please feel free to email and let us know how we can further help to reduce harm. 

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