Connecticut’s outpatient surgery centers fare well in preventing patient falls and wrong-site surgeries, compared to national rates, but poorly in avoiding patient burns and in ensuring that surgical patients get intravenous antibiotics, new federal data show.
In addition, many of the state’s 45 Medicare-certified centers perform significantly more surgical procedures than the national average, with eight centers reporting more than double the average caseload.
The data — recently made public by the Centers for Medicare & Medicaid Services (CMS) – show that Connecticut’s ambulatory surgery centers (ASCs) have a lower average rate of patients who suffer falls than the national average — .077, compared to .095. The data is from 2013 and 2014, the most recent years available.
The state’s ASCs also have a lower rate, on average, of patients who experience a wrong-site, wrong-patient or wrong-procedure error — .017, compared to the national average of .028. In 2014, the vast majority of Connecticut outpatient centers reported a rate of zero.
The likelihood that ASC patients will need to be transferred or admitted to a hospital also is lower in Connecticut than nationally — .368, on average, compared to .475. Still, 10 ASCs exceeded the national average in 2014, with the Hartford Surgery Center, the Coastal Digestive Care Center in New London, and the Norwalk Surgery Center having the highest hospitalization rates.
Meanwhile, Connecticut’s rate of patients suffering burns is more than twice the national average — .991, compared to .364 – and the second highest nationally, with electrosurgical burns the most commonly reported. Only a few centers reported burns in 2013 and 2014; most had rates of zero.
Connecticut also lags slightly behind the national average in timely administration of intravenous antibiotics for prevention of surgical site infections, the data show. The North Haven Surgery Center had the lowest rate in this category in 2013 — 871.4, compared to the national average of 960 — but improved in 2014, according to the data. In 2014, the Hartford Surgery Center had the lowest rate (939.4).
In terms of volume, on average, Connecticut’s ASCs perform about 24 percent more surgical procedures than the national rate (3,978), indicating that the centers are busier than those in many other states. Eight centers reported more than double the national average of selected surgical procedures in 2014. The three busiest were: the Endoscopy Center of Connecticut, Hamden (13,989 procedures); Danbury Surgical Center (11,438); and the Middlesex Endoscopy Center, Newington (9,685), according to the data.
In a statement, the Connecticut Association of Ambulatory Surgery Centers said it supports the release of the data and is “happy that information on the high-quality outcomes provided in Connecticut’s facilities is now publicly available.”
The group noted that in general, “complications are so low at all ASCs that two incidents instead of one in a year could push a facility over the national or state average.” The association added that it has concerns over the accuracy of some of the data, which it is examining further.
Also, the group said, the patient population at particular centers, which may be older or more frail, may “skew the results for some facilities.”
All of the state’s ASCs belong to a Patient Safety Organization, with the goal of improving patient safety and the quality of care, according to the statement.
Connecticut, like other states, has seen an increase in the number of freestanding surgery centers over the last decade. Nationally, from 2007 through 2011, the number of Medicare-certified ASCs grew by an average of 2.5 percent annually. The centers have submitted quality-of-care data to CMS since 2012, but it was not made available publicly until recently.
The Connecticut Department of Public Health licenses and inspects ASCs every two years.