Ignaz semmelweis was a 19th century Hungarian physician who discovered the cause of childbirth fever and introduced the concept of antisepsis. At one time the wealthy had their surgery at home and only the poor came to the hospital because the hospital was a hotbed of infection. This has some relevance to ambulatory surgery and with increased frequency more complex surgeries are being performed as an outpatient. This advances the quadruple aim of increased quality and safety, patient-centeredness, financial sustainability, and increasing respect for the medical staff but robust planning and institution of intelligent processes is necessary for ambulatory surgery centers to be successful. This article in Becker's ASC Review by Samii is entitled "7 critical steps for financial success in your ASC" but it covers more than just financial sustainability and I submit that it addresses all four aspects of the quadruple aim.
Having well planned processes in place clearly advances the quadruple aim. Proper patient selection Is key to quality and safety in an ambulatory surgery unit because patients with certain comorbid conditions may be more safely managed in the hospital. Having proper patient counseling preoperatively and postoperatively clearly improve patient safety and it also advances the aim of patient centeredness and patient satisfaction because it's a dissatisfier are when these things are left to chance. Having proper contracts with payers in place is important to avoid catastrophic financial loss because many of these implants are extremely expensive and an ambulatory surgery center cannot afford to assume their cost without proper reimbursement. The 4th aim of a contented and engaged staff is advanced by proper planning because, for instance, when the nursing staff can get home on time they have better work-life balance and are better able to perform at work. A happy staff translates into happy customers. This is The Ritz-Carlton model. Financial success supports the other three aims because without it the center cannot afford the resources it needs and proper infrastructure is important aspect of quality.
7 critical steps for financial success in your ASC