With the White House announcing the Guidelines for Opening up America Again, Ambulatory Surgery Centers (ASCs) should be ready to go when your state provides specific guidance. Have you taken the appropriate steps to prepare?
If not, you need to start today! This week we discuss the steps ASCs should take to be properly positioned from a medication management, patient safety and regulatory compliance standpoint as facilities start to reopen.
Following your state and local guidance will be critical in paving the road back to resuming elective surgeries. Although every state’s timing will be slightly different, we all know that sooner than later, ASCs will be resuming operations and providing the high-quality care patients are accustomed to. What steps have you taken to ensure your organization is ready? In a recent post titled Using Downtime Time Wisely During the COVID-19 Pandemic: Tips for Healthcare Facilities I discussed the steps you could take to improve your organization while elective surgeries are on hold. Now that we are preparing to resume, you should focus on the following items to ensure a smooth transition. Keep in mind these are items that often come up on surveys by licensing and accrediting agencies, including the Centers for Medicare and Medicaid Services (CMS), Accreditation Association for Ambulatory Health Care (AAAHC), The Joint Commission (JC), but will be under additional scrutiny as a result of the COVID-19 pandemic.
Policy and procedure: Are you adding new processes as a result of the pandemic? Or making changes to current procedures? Will you have new policies on handling a public health crisis? Take the time you have now to review existing policies, determine future changes and develop new processes. Don’t forget to provide education on new policies and procedures and update your official policy and procedure book.
Infection control/antibiotic stewardship: We know that infection control and antibiotic stewardship is already an area of focus evidenced by recent surveys and the increased number of deficiencies. Do you have someone acting as your infection preventionist? Your infection preventionist should be working hard to ensure you have all these areas covered. For additional information on antibiotic stewardship, and the impact of COVID-19, please read a recent post I wrote “The Coronavirus & Antibiotic Stewardship: Advice from a Consultant Pharmacist”.
Drug shortages: Drug shortages have been happening for years, so this is not a new problem. However, this is a problem with exacerbating factors. We now have drug shortages happening for many different reasons. Some of the most common reasons include delays in manufacturing, shortages in raw materials, medication discontinuations, increased demand and sometimes even hoarding. The most affected drugs are antibiotics, anesthetics, muscle relaxants and controlled substances. Have you assessed your needs and prepared alternative strategies for dealing with potentially unavailable medications? Now is a good time to assess your positioning and inventory. Also, try to anticipate your needs based on the likely increase in procedures once you open. For additional guidance on handling drug shortages, read this post on Ten Steps to Dealing with Drug Shortages. Don’t forget to check the FDA list of extended use dates to assist with drug shortages.
Compounding pharmacies: One way to help mitigate the drug shortage issues that will continue to plague us, is to consider using compounding pharmacies to obtain medications. The FDA has recently announced relaxing some of the compounding restrictions to allow compounding pharmacies to provide alternatives to unavailable drugs. As was the case before, each ASC should engage in a proper vetting process to ensure they are working with a company that is state licensed, FDA 503B registered and all FDA inspection findings have been reviewed. This process takes time and expertise, but your consultant pharmacist should be able to walk you through the process. We routinely assess compounding pharmacies and provide guidance for our facilities. Now is a good time to do your due diligence so that you can minimize the impact of shortages on your day to day operations.
Education: Education is an ongoing and never-ending process. Did you use downtime to effectively assess and educate your staff? Remember to document all training and education provided. Since this is an ongoing requirement, it’s never too late to get started. Ensure you have completed required assessments to meet regulatory compliance, but also provide additional education to bolster areas of weakness. Train your staff now so when business ramps back up, the training and paperwork is done and your full attention is on patient safety.
There are many things that can be done to prepare to resume surgeries. If you have not already started working on the items listed above, you are falling behind and in danger of not being prepared. If you have questions or need help getting prepared, please reach out and we will walk you through the process.
The Consultant Pharmacists at OctariusRx provide guidance on safe medication management, survey readiness and cost savings to ambulatory healthcare facilities/surgery centers, senior care facilities and pharmacies We also help individual patients optimize their medications to improve their quality of life and save money. Contact us for assistance.
