AAAHC institute releases new benchmarking data
New reports issued in 2012 by the AAAHC Institute for Quality Improvement offer performance measurement and benchmarking data for four of the most common outpatient procedures: cataract surgery, colonoscopy, low back injection, and knee arthroscopy.
The reports include data such as preoperative techniques, complications, non-routine procedures, anesthesia, wrong-site surgery prevention and patient outcomes. They also include information about factors such as staff and supply costs. The studies were performed between January and June 2012. The procedures are:
• Colonoscopy. Data were submitted on 2,086 cases by 61 organizations. Combined, the organizations perform more than 241,220 colonoscopies annually.
— Pre-procedure times ranged from 12 to 97 minutes (median 62). Organizations with the shortest procedure times used processes that included preparing the patients and paperwork prior to arrival and having patients arrive only 15 to 30 minutes prior to the time the procedure is scheduled.
— Procedure times ranged from 9 to 27 minutes (median 18).
— Discharge time ranged from 13 to 62 minutes (median 36). Organizations with the shortest discharge times attributed their results to use of short-acting anesthesia.
— Total facility time ranged from 57 to 166 minutes (median 121).
— Patient outcomes. Follow-up surveys with patients found that:
- 97% indicated that they were able to schedule their procedures as soon as they wanted;
- 100% said they had an adequate understanding of the procedure;
- 76% said they experienced little or no discomfort during their bowel preparation;
- 99% said they experienced little or no discomfort during their procedure;
- 99% said they were comfortable post-discharge;
- 100% said they received written discharge instructions;
- 98% said they would recommend the procedure to a friend;
• Knee arthroscopy. Information on 796 cases was submitted by 33 organizations. The organizations perform a total of more than 18,706 procedures annually. The five most frequent indications for the procedure were joint line tenderness, painful catching/popping/locking, effusion, positive McMurray' s test, and arthritis.
— Pre-procedure times ranged from 24 to 115 minutes (median 90). Organizations with the shortest pre-procedure times attributed their results to practices such as calling their patients the day before the procedure to remind them of their appointment time and making sure patients understand the pre-procedure requirements.
— Procedure times ranged from 17 to 42 minutes (median 27).
— Discharge time ranged from 48 to 113 minutes (median 71). Organizations with the shortest discharge times attributed their results to factors such as having patients leave the OR as they are waking up so their comfort level can be assessed as soon after the procedure as possible.
— Total facility time ranged from 119 to 246 minutes (median 192).
— Patient outcomes. Follow-up surveys with patients found that:
- 88% were able to schedule their procedures as soon as they wanted;
- 99% had an adequate understanding of the procedure;
- 99% experienced little or no discomfort during the procedure;
- 99% were comfortable post-discharge;
- 100% received written discharge instructions;
- 96% had begun walking (with or without crutches);
- 98% would recommend the procedure to a friend or relative.
• Pain management — low back injection. Information was submitted on 488 cases by 25 organizations that perform nearly 52,491 procedures annually.
Pre-procedure times ranged from 16 to 102 minutes (median 53). Organizations with the shortest pre-procedure times attributed their results to processes that included sufficient staffing and preparation prior to the procedure day.
Discharge time ranged from 9 to 48 minutes (median 25). Organizations with the shortest discharge times attributed their results to sufficient staffing.
Total facility time ranged from 49 to 166 minutes (median 92).
— Patient outcomes. Follow-up surveys with patients found that:
- 93% indicated they were able to schedule their procedures within a reasonable time;
- 99% said they had an adequate understanding of the procedure;
- 82% reported that they were performing their usual daily activities;
- 77% indicated that their pain had improved;
- 6% had reduced their pain medications;
• Cataract extraction with lens insertion. Sixty organizations submitted information on 1,884 cases. These organizations account for more than 120,734 cataract surgeries performed annually.
— Pre-procedure times. The pre-procedure time (defined as patient check-in to start of the procedure) ranged from 26 to 143 minutes (median 83). Organizations with the best pre-procedure times attributed it to policies such as optimal staffing, chart audits prior to admission, procedure room supply and use efficiencies, and standardization of forms.
— Procedure times. Average procedure times (defined as the time the procedure starts; i.e., incision, to the time the procedure has ended; i.e., dressing on) ranged from 6 to 34 minutes (median 14). Average procedure times were lowest for those that used IV plus topical or peribulbar (15 minutes) and greatest for IV plus retrobulbar block (25 minutes).
— Discharge times. The median discharge time (defined as end of the procedure until patient meets discharge criteria) was 21 minutes (range 9 to 57). Organizations with the shortest discharge times attributed their results to practices such as appropriate patient education and preparation, minimizing sedation for most patients, streamlining paperwork, and adequate staffing.
— Facility time. Facility time is the time the patient checks into the facility to the time the patient meets criteria for discharge. Overall, facility times ranged from 62 to 216 minutes, with a median of 118 minutes and an average of 122 minutes.
— Patient outcomes. Follow-up surveys with patients found that:
- 97% were able to schedule their procedures as soon as they wanted;
- 99% had an adequate understanding of the procedure;
- 99% were comfortable during the procedure, and 98% were comfortable post-discharge;
- 94% reported that their vision was better post-surgery, and 4% said it was the same;
- 94% returned to normal activities of daily living (ADLs) within one week of the procedure.
In the results given, not every organization/patient answered every question. In most cases, patient outcomes are based on patient questionnaires administered in the days/week immediately following the procedures.
Organizations that participated in the AAAHC Institute studies all were volunteers, and most were accredited by AAAHC.
New reports issued in 2012 by the AAAHC Institute for Quality Improvement offer performance measurement and benchmarking data for four of the most common outpatient procedures: cataract surgery, colonoscopy, low back injection, and knee arthroscopy.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content