Image by Gerd Altmann from PixabayAmbulatory surgery centers (ASCs) are facing mounting pressure to prove clinical excellence as payers pivot toward value‑based contracts and higher‑acuity cases migrate to the outpatient setting.
Yet because ASCs are different from the hospital setting, they require different benchmarking standards.
Nina Goins, executive director of the ASC Quality Collaboration, said her coalition’s new safety and quality assessment, national benchmarking data, and ASC‑specific performance measures can help. Ambulatory Surgery Center News caught up with Goins to discuss how outpatient centers can document value, spot hidden pitfalls in data reporting, and train teams for complex cardiovascular and total joint procedures.
This interview has been edited for length and clarity.
ASC News: I would love to know a little bit more about some of your goals for ASC QC as director, and we can take things from there.
Goins: The Quality Collaboration is a national organization dedicated primarily to advancing the quality and safety of care in ambulatory surgery centers.
We are not‑for‑profit and a coalition of industry leaders, ASC management companies large and small, accrediting bodies, state associations, national organizations like ASCA and AORN, and several IT software vendors. We all come together to promote transparency, drive performance improvement, and advocate for quality and safety, particularly quality measurement, in the ASC setting.
Our work focuses on developing standardized quality measures tailored specifically to ASCs.
When we formed in 2006, we worked with CMS to develop those measures, which were far more in‑depth than many people realize. Today, we maintain national quality benchmarking with more than 2 million encounters per quarter submitted by our members. It is the only clinical quality benchmarking available for ASCs, and it is free on our website. We also provide resources, toolkits on infection prevention, fall prevention, endoscope reprocessing, and more, because we want to elevate quality for all ASCs.
Hospitals are so heavily regulated. Why is it important to develop quality benchmarks specifically for ASCs?
ASCs operate differently, so our measures need to focus on ASC‑specific issues like patient falls or how we define a hospital transfer. Those definitions can get complicated, so it is important that we agree on how we measure and report them.
We work closely with CMS, CDC, and others to ensure we all collaborate on ASC‑appropriate measures.
Could you share a few of your priorities as director?
We just launched an ASC Safety and Quality Assessment this year, and more than 400 ASCs completed it. It is another benchmarking tool centers can use with their boards or in payer negotiations, critical as we move toward value‑based care.
How does ASC growth tie in with value‑based care, and how can these metrics support that shift?
In my view, adoption has been slower than expected. In acute care, CMS has linked payment to quality for a long time. ASCs are a bit behind, but payers increasingly want proof of value. ASCs already deliver high‑quality, efficient, cost‑effective care; now we need to demonstrate it with data. Quality measures and the Safety and Quality Assessment help us do that by comparing ASC outcomes nationally.
Across the board, or even in niche areas, what quality concerns show up most in your data?
Inconsistent data capture and reporting tops the list. You cannot fix what you do not measure. Sometimes centers collect data without enough quality‑assurance checks, so we see reporting that looks off.
There is no ill intent; staff are busy or make keystroke errors. Our job is to flag anomalies and help validate their data before publishing.
What can administrators or medical directors do to combat those issues?
Foster a culture of learning and psychological safety. ASCs run lean. Unlike hospitals, we do not have large quality departments, so everyone must understand the importance of accurate data.
Promote transparency, encourage staff to report errors, and review the data together. It is not just a task; it directly impacts patient care.
Anything else we should know about ASC QC?
Our stakeholders truly collaborate. Organizations like AMSURG, SCA, and USPI sit at the same table to share knowledge and elevate the industry together. While ASCs deliver safe, high‑quality care, we must guard against complacency. Serious complications are rare, so it is easy to underestimate the need for rigorous protocols.
Staff turnover, burnout, and the move to higher‑acuity cases, like cardiovascular, total joints, those add complexity. Continuous vigilance and thorough staff training, including for interim staff, are critical.
With higher‑acuity procedures moving into ASCs, how can centers ensure staff are prepared?
It can be more complicated than expected. Beyond protocols, collaborate with physicians, reach out to other centers, and connect with ASC QC or ASCA.
Learn from others’ experience, everything from whether your sterilizer is large enough to how to train staff. Communicate, ask questions, and do not hesitate to say, “I’m not sure; let’s talk it through.”
