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ASC directors and physicians can act proactively in building a positive public image for their center. There’s no need to wait until bad news occurs or a disaster strikes to think about public relations. Below are some strategies for promoting an ASC in the community and answering patient and public worries after negative media coverage:
• Write a letter to patients. After negative media coverage, some ASCs might send patients a letter or make one available when they enter the surgery center. Its first paragraph could reference the recent USA Today story about ASCs. The letter also might note that not all the safety facts and information were included in the article.
Providing details of that missing information might be helpful, says Trista Sandoval, vice president of business development and physician relations at Pinnacle III.
“The surgery center could say, ‘Here’s what we’d like you to know: Most surgery centers are highly regulated by the state and federal government. We report to the Centers for Medicare and Medicaid Services [CMS] annually, which reviews patient outcomes and experiences. We report on quality measures. We conduct investigations and implement corrective action plans,’” she explains. “The letter can go into how our nurses and physicians are licensed and board-certified and what that means for patient care.” The letter also might outline the ASC’s risk of infections and encourage anyone with concerns to ask to speak to the administrator.
• Explain the center’s safety drills and training procedures. “Statistics aren’t as helpful to our patients, so we show the training we put staff through so they can see what happens in an emergency,” says John Goehle, MBA, CPA, CASC, chief operating officer of Ambulatory Healthcare Strategies.
Surgery centers rarely experience an emergency. The best way to practice for one is by conducting a drill and handling any issues that arise, he says.
“For example, we did a drill where the doctors opened up a code cart and simulated having a patient in cardiac arrest,” Goehle recalls. “The doctor reached for a trach set to intubate the patient and found everything disorganized — all thrown at the bottom of the cart.”
The emergency drill became a quality improvement project. The ASC reorganized the cart to make it easier for doctors to use.
“The patient would have survived — even if we had to bend down to get the equipment, but we found a way to make it faster and more convenient,” Goehle reports.
Surgery centers managed by Pinnacle III tout their track records of patient safety, Sandoval says.
“We let patients know that we are meticulously regulated by oversight bodies and undergo rigorous accreditation, which puts safety first and foremost,” she says. “ASCs can highlight these credentials and emphasize safety. And they should be open to talking with their patients about it.”
ASC staff can explain to patients what it means to employ physicians who are board certified and a facility that is credentialed, she says. “It helps patients feel comfortable about the care they receive at the center,” Sandoval adds.
• Explain to patients how transfers work. One of the confusing things in the USA Today article about adverse outcomes in ASCs was the suggestion that an ASC has somehow failed when surgery patients are transferred to EDs, says Bill Prentice, CEO of the Ambulatory Surgery Center Association (ASCA).
“It leaves readers with the idea that any transfer is a bad transfer,” Prentice says. “But many transfers occur before surgery. A patient might have an elevated heart rate, and the doctors say this should be looked at before we perform the surgery.”
This nuance between transfers that happen before surgery and those that occur during or after surgery is not clear to the general public, and physicians can explain how this works if a patient asks questions about transfers.
• Prepare an action plan. Surgery centers should appoint a person to handle public relations when there’s a disaster or bad publicity. The administrator or director of operations could be in charge. This person should use information provided by the ASCA and other ASC organizations, Sandoval suggests.
“In times like this, you need a united front. Having the industry behind you is important,” she says.
The administrator should set up an action plan that includes providing front-line staff with answers and preparing them to properly deal with patients’ concerns and questions, she says.
“Ensure your messaging targets patients’ concerns,” Sandoval says. “Front desk staff could hand patients a letter, for example.” Or, they could be trained to respond with words that are simple and honest, such as, “Yes, we’re aware of recent news that has been cited. We value quality and welcome inquiries on safety measures,” she says.
ASC surgeons could tell patients about the center’s own record of safety and quality, as well as the industry’s record, Prentice suggests.
“ASCs perform more than 20 million procedures and the overwhelming majority of their patients have safe, high-quality experiences,” he says. “The fact that so many patients have put their trust in ASCs over the years and have been rewarded with the outcome they expect is the actual barometer of safety and quality in surgery centers.”
• Collect metrics. ASCs that are accredited already are collecting the kind of data and metrics that demonstrate their safety and quality. Accredited surgery centers should be using their data to make improvements, Sandoval says.
“If you have not collected that data, now is an opportune time to become better,” she adds. “Collect data on safety measures, such as infection rates and hospital transfers.”
ASCs also can benchmark their safety and quality metrics against other surgery centers, Prentice suggests.
“With clinical, operational, and financial issues, they can benchmark themselves and make sure they’re staying at the top of their game,” Prentice says.
ASCs need even more opportunities and incentives to collect data, which is why the ASCA lobbied to create a CMS Medicare quality reporting program, he says.
“We wanted a neutral database to collect measures on what everyone agrees is important so we can learn from that,” Prentice says. “Now, we need a more comprehensive way of using these measures and using this data.”
The ideal regulatory change would direct hospital quality reporting programs, physician quality reporting programs, hospital outpatient surgery programs, and others to collect many of the same metrics so the data are no longer isolated, Prentice says, adding that this change would make it possible to compare across sector services.
Also, CMS should gather more outcomes metrics in the data it collects from hospitals. Currently, most of the data collected relate to processes, such as whether a certain activity was performed within a certain time frame.
“We report more outcomes measures than do hospital outpatient surgery centers,” Prentice says. “It makes no sense to me that both are not reporting on the same measures.”
• Try positive branding efforts. “Positive publicity reflects on a company’s culture and brand image,” Sandoval says. “We host community talks and highlight, from an educational standpoint, the types of procedures that can be performed in ASCs. We want people to have a clear understanding of who we are and what we’re doing.”
Community talks can be centered around awareness months, such as colon cancer awareness month in March, Sandoval suggests.
“Some colonoscopy practices will hold talks and let patients know the importance of getting their colon screened.”
It’s important to present simple educational messages, including telling people why they should undergo screening for colon cancer, giving them statistics, and noting that the surgery center is an appropriate place to undergo such a screening procedure, she adds. Surgery centers can improve branding through their own website and by posting their center’s positive news about awards, credentials, accreditation, and safety and quality outcomes. They can post information about their participation in any upcoming health fair and community activities.
“Anytime we introduce a new service, like new GI procedures, or new equipment, we call local newspapers and TV stations to talk about it and say this is the newest procedure here,” Goehle says. “Participate in health screenings and health information fairs. Have a table at the local health fair and give out handouts with your logo and pictures of your facility.”
Social media can be useful, too. For instance, Goehle uses LinkedIn to air a podcast about the ASC industry.
“Some ASCs invest in social media outlets,” Sandoval says. “Be consistent with your messages. Have one or two trusted individuals monitoring it to keep messaging consistent.”
The goal is to educate patients about the surgery center’s vision, mission, and values, she adds.
• Maintain persistent maintenance. “The strategy is to sustain persistent maintenance, ensuring all aspects of the business are running appropriately. Consistently deliver the best patient experience possible” Sandoval says. “Make sure you have all the tools, processes, information, and know-how to handle patient inquiries about safety.”
The ASC’s operational process should be tight, up to standards, and accredited, she adds.
“There always will be bad publicity, but highlight the positive, and make sure you provide quality patient care.”
Financial Disclosure: Editor Jonathan Springston, Editor Jill Drachenberg, Editorial Group Manager Terrey L. Hatcher, Author Melinda Young, Physician Editor Steven A. Gunderson, DO, FACA, DABA, CASC, Consulting Editor Mark Mayo, MS, and Nurse Planner Kay Ball, RN, PhD, CNOR, FAAN, report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study. Stephen W. Earnhart discloses that he is a stockholder and on the board for One Medical Passport.
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