Reprinted with permission from Somnia Anesthesia

Anesthesia has always been a critical component of surgery. Improvements in the delivery of anesthesia, effective anti-nausea medications and broader options for pain management have contributed to the rapid growth of outpatient (ambulatory) surgery, which today accounts for more than 60% of all surgeries.1 A growing number of these are being done in nonhospital-based facilities such as ambulatory surgery centers and physician offices.2

With the increase in ambulatory surgeries and health reform’s focus on improved outcomes, ambulatory surgery centers (ASCs), office-based surgery facilities (OBSFs) and hospitals all face a high level of scrutiny from regulatory agencies. To help mitigate risk and to differentiate in the marketplace, anesthesia facilities can benefit from the creation of Clinical Quality Excellence (CQETM) programs.

Why Implement a CQETM Program

“In today’s healthcare environment, value is demanded from patients, facilities and payers and incorporates quality, accountability, transparency, and satisfaction,” says Hugh Morgan, Somnia VP of QM. “In our experience, facilities that build their practices with quality as the foundation see improvements in processes, outcomes and stakeholder satisfaction, thereby maximizing the value of their services.”


Clinical practice is at the heart of high-quality anesthesia care. Ultimately, clinical skills validate the clinical care and services you provide. Additionally, documentation and compliance with federal, state, and accreditation standards (e.g., with Health Insurance Portability and Accountability Act, Surgical Care Improvement Project, timeouts, single-dose vials, locked carts, syringe labeling, etc.) provide quantifiable evidence of your practice standards. By implementing a process to help ensure compliance with these and other regulatory requirements you can establish a baseline quality assurance.


An effective process leads to favorable outcomes. To demonstrate this, you need metrics and results, but you also need an understanding of how to use the information gathered to impact future outcomes. A highly functioning CQE program should make effective use of incident reporting, including root cause analysis, identification of influencing factors to promote best practices. Additionally, facilities must continuously measure clinical outcomes by participating with the Anesthesia Quality Institute for outcomes benchmarks data.


Since ambulatory surgeries are elective with many repeat customers, the success of your ASC depends upon positive word-of-mouth and good community standing. The importance of achieving satisfaction with your services (or a favorable perception of those services) extends to every stakeholder — patients, surgeons, facility staff and colleagues. Implementing a CQE program can help you deliver higher levels of satisfaction by building a culture of accountability and fostering an environment focused on patient-centric teamwork.

While it takes structure, committed resources, effort and focus, building and sustaining en effective and comprehensive CQETM program can deliver significant results, helping you achieve clinical excellence, enhanced performance and patient satisfaction.


2. Ambulatory surgery centers and physician offices are less expensive than hospitals for outpatient urological surgery: Health Care Costs and Financing. July 2013. Agency for Healthcare Research and Quality, Rockville, M.D.


About the author

McKesson Business Performance Services offers services and consulting to help hospitals, health systems, and physician practices improve business performance, boost margins and transition successfully to value-based care.