Staying Vigilant Through the Pandemic (October 21, 2020)




ASCA Chief Executive Officer Bill Prentice talks with Rebecca Craig, chief executive officer of Harmony Surgery Center, and Janie Kinsey, administrator of Surgicenter of Kansas City, about how ASCs are keeping their patients and healthcare workers safe by strictly adhering to both pre-pandemic as well as new COVID-19 infection prevention protocols.

Narrator: 0:06
Welcome to the Advancing Surgical Care Podcast brought to you by ASCA, the Ambulatory Surgery Center Association. ASCA represents the interests of outpatient surgery centers of every specialty, and provides advocacy and resources to assist them and delivering safe, high-quality, cost-effective patient care. As with all of ASCA’s communications, please check to make sure you are listening to or viewing our most up-to-date podcasts and announcements.

Bill Prentice: 0:37
Hello and welcome. My name is Bill Prentice. I'm the CEO of the Ambulatory Surgery Center Association, or ASCA, and the host of this podcast. In a moment, I'll be joined by two very special guests, Rebecca Craig and Janie Kinsey. Rebecca is the CEO of Harmony Surgery Center and Peak Surgical Management in Fort Collins, Colorado. Rebecca is also a registered nurse and the immediate past president of the ASCA Board of Directors. Janie Kinsey is also a registered nurse who serves as the CASC-certified administrator of the Surgicenter of Kansas City. Janie is currently a member of ASCA’s Board of Directors and current vice president. I thank them both for their service. I've asked Rebecca and Janie to come on to the ASC podcast for a discussion about keeping surgery centers safe as we enter the seventh or eighth month of this pandemic, depending upon when you're counting from, and concerns that the colder months ahead and the flu season could intensify the spread of the virus. Rebecca and Janie, welcome, and thanks for joining us today.

Rebecca Craig: 1:36
Thank you, Bill, I appreciate you having me. Always a pleasure.

Janie Kinsey: 1:39
Thank you, Bill, glad to be here.

Bill Prentice: 1:41
Great. Well, as you both know, but some of our listeners may not, ASCs adopted a number of protocols starting back in March to prevent the spread of the virus in facilities. And these included such things as screening questionnaires, face coverings for patients and staff, social distancing, additional cleaning and air circulation procedures and, in many cases, essentially eliminating waiting rooms for family or friends. But, you know, what I think is often overlooked when we talk about these new protocols is that all of the rigorous infection prevention procedures that were already in place that I think really helped with the pandemic. And I would surmise that those have done most of the work in keeping patients safe. Rebecca, do you agree?

Rebecca Craig: 2:24
Absolutely. And I really appreciate you bringing up the stringent infection prevention processes and procedures that we have in place, even before COVID-19, which is why the ASC industry historically has had such low infection rates. It really did not take our industry much of a leap with the new protocols. And I would add that restricting family members or visitors is one of the new protocols that has actually been very beneficial. Any time that you can decrease traffic, it reduces the potential for spreading bugs to our patients.

Bill Prentice: 2:56
Janie, anything you'd like to add to that?

Janie Kinsey: 2:58
The only thing, I agree 100 percent with what both of you have mentioned already, would just be that when we continuously were changing during the beginning of the pandemic, that causes kind of a disruption and even a potential regression, and what our staff is used to doing and has done so well for a number of years and preventing infections and spread of disease in our surgery centers. So it's nice, as we, as Rebecca said, made that leap and got to where we are today. We're seeing that transition and just the adoption of those new protocols, and it's making a difference for our patients and our staff members.

Bill Prentice: 3:30
These are just some excellent points and I'd like to follow up. But if I may, however, I'd first like to ask you both to standby for just a moment so that we can hear a few words from the sponsor of today's podcast. We'll be back in just a moment.

Narrator: 3:44
Underwriting for the Advancing Surgical Care Podcast is brought to you by The Joint Commission, an independent, nonprofit, standard-setting and accrediting body for ambulatory care organizations nationwide. For 45 years, The Joint Commission has helped ambulatory care organizations meet and exceed rigorous performance standards for improved patient safety and enhanced quality outcomes. Begin your journey today. Go to

Bill Prentice: 4:15
Okay, let's take a step back and talk for a moment about the COVID-19 protocols we were mentioning just before. Regrettably, we continue to see too many Americans either failing to comply with the basic protocols or just letting their guard down at a fatigue with this new normal. What are you doing to keep your staff vigilant and to keep your patients in compliance, Janie?

Janie Kinsey: 4:37
So with the staff, we continue to provide the why and the data about the pandemic and our local infection rates and hospitalization rates, and the bottom line is it's part of their job is part of the requirement for being employed. So that's fairly simple to control that within the ASC environment just by mandating it. At this point we have a few months behind us with the new protocols and with our patients that are a little bit cynical about not being able to have their family with them or why they have to wear a mask while they're in our facility, we just remind them that with that history, we've been very fortunate not to have patients or staff members getting sick or infected with the virus, and really many of the other viruses that are common during particularly this time of the year when we're entering into fall in the beginning of flu season. So just communicating is the bottom line.

Bill Prentice: 5:30
Of course, always the best way to try and get those points across. Rebecca, can you tell us anything about the experience at your surgery center? And do you have any advice for other ASC administrators who are working hard to stay vigilant and make sure that their team stays on top of everything?

Rebecca Craig: 5:47
My advice would be to stay strong, it's definitely a challenge as there's a spectrum of beliefs out there. I understand patients, staff and physicians are getting tired of wearing masks and social distancing. But what we're doing is working. So I think I'd say keep strong and then the other thing is just think ahead and ask your staff for ideas whenever possible. We are a large, multi-specialty facility here and we've struggled to find space for staff to social distance during lunch breaks and just at regular breaks. Thankfully, as we had the summer months going on so many staff opted to go to eat outside, but what we've been working on, and what I would hope that other folks are, thinking ahead. We're trying to figure out creative options during the winter months of how the staff is going to take their break and have their lunch and social distance, and be comfortable. So this is going to be even a bigger issue for smaller ASCs. I mean, I look at our space and I don't know how other folks are doing it. But I think again, think ahead, look forward. And I think I just have to say I'm confident that people are going to find ways because we're so many high performers in this ASC industry, so I'm confident that they're going to do that.

Bill Prentice: 7:01
I mean, those are great points. Janie, have you faced that challenge of thinking about with a winter coming and make it harder for people, the staff to be socially distant during breaks and things like that?

Janie Kinsey: 7:12
We have. We've had some brainstorming sessions that include putting the little heaters out on our patio so we can continue to eat outside. But in all seriousness, that is a challenge and one of the things that makes ASCs so efficient and such a popular choice for physicians to perform is that we don't have a lot of wasted space and a lot of available space to extend that. So it does require just some creative thinking on all of our parts.

Bill Prentice: 7:41
Very interesting. Well, I'm eager to hear both of you tell me your thoughts on whether or not it would make sense to add any COVID-19 virus protocols or measures to our benchmarking surveys. You know ASCA has a really substantial clinical financial and operational benchmarking program, and I'm wondering since we don't know how long this pandemic will be around, but I think we can certainly foresee it existing at least half of the way into 2021, should we be putting some measures on there, some questions so that we can kind of see how we're doing and allow ASCs to compare what they're doing in terms of whether it's processes or outcomes related to COVID? Rebecca, why don't I start with you?

Rebecca Craig: 8:21
I think adding to our benchmarking survey is a great idea. And I think it'll provide us even more data to show the excellent results and the safe outcomes, even during a pandemic. So I would definitely be in favor of that. Also, I feel it is beneficial to have different team members performing random audits, and/or utilizing a checklist I think would be helpful to promote a safe environment.

Bill Prentice: 8:45
That's great. And then obviously, since the beginning of the pandemic, ASCA on its website has been putting up checklist and different protocols for ASCs to use to try and keep themselves and their patients safe. So I'd encourage our listeners to look there. Janie, anything you'd like to add to that thought?

Janie Kinsey: 9:04
No, I do think that adding both the benchmarking and a checklist is helpful, particularly for independent surgery centers that maybe don't have a corporate partner helping to develop those things and remind them. I think it serves maybe, as a reminder. I think it's easy to get in the weeds as we're changing so rapidly the protocols and just trying to keep up. So what we are hearing is that as folks are being surveyed, and the last couple of months as surveys have started up again, is that they are looking for specific information about how we manage COVID and how we are continuing to manage it. So I do think that could be helpful just as a reminder for members.

Bill Prentice: 9:42
That's great, we'll take that under advisement. We'll look to see whether we can add some things for for 2021. Let's talk about patients for a moment, both the ones you're seeing every day as well as the patients who you may not be seeing because they're delaying unnecessary procedure or surgery. And nationally we know that the total number of procedures is down for the year because of the initial guides to suspend care, particularly in March, April and into May and June, but also because of the new procedures and protocols that you've put in place to keep patients safe and ensure a clean environment has added a little bit of time to every procedure. So that slowed things down a bit. But it's also clear that a percentage of the population is still concerned about having surgery while the virus is still with us. So what are you telling patients? And what would you say to a patient who may be delaying an essential procedure? Janie?

Janie Kinsey: 10:34
Well, it's similar to what we would tell patients who aren’t a big fan of our new protocols. It's just a reminder of all the things that we've added for their protection. And the universal masking and the visitor limitations and all of our, as we've mentioned, the rigorous infection prevention protocols that were already in place. But ultimately, the choice to have surgery is a big decision. And we always defer to the patient. I mean, this isn't really anything new, we've always have the struggle with patients who, at the last minute kind of wonder if they're doing the right thing and get a little nervous. So it's the same reassuring measures that we've always used really.

Bill Prentice: 11:12
Thanks, Janie. Rebecca, what are you telling patients and what reassurances are you giving any reluctant patients that you or your doctors are talking to?

Rebecca Craig: 11:21
Bill, this is a tough one because it is hard to overcome the negative news that the public is bombarded with every day. But I would hope that I could educate future patients on the risks of postponing a procedure or surgery, and the negative impacts that it could have on their health. I absolutely agree with what Janie was saying, too. But I think I would also just try to educate them about the risk of postponing. I would reassure folks that the protocols in place are definitely keeping patients and staff and physicians safer than ever. We are also keeping up the patient video on COVID-19 that ASCA produced for us, and we have that on our website to let everybody know the strict protocols that we are following. I think that's been really helpful, too.

Bill Prentice: 12:04
That's great. Well, hopefully those messages are getting through to patients and their families and that we're gonna be able to keep them not only safe, but obviously healthy. We're just about out of time. I'd like to, again, thank Rebecca Craig and Janie Kinsey for participating in the podcast, for their contributions in helping to lead ASCA, Rebecca as your role on the board previously, and Janie in your current role, and to thank them both for what they do every day to keep their patients and their medical teams healthy and safe. Rebecca, thanks.

Rebecca Craig: 12:34
Well, Bill, thank you for having me. I really appreciate the opportunity and I just want to say thank you to all my ASC colleagues that are doing such a fantastic job. Keep up the great work. We are so proud of our industry and the excellence that we represent. We will all get through this together.

Bill Prentice: 12:49
Thank you. Janie, thank you as well.

Janie Kinsey: 12:52
Thank you.

Bill Prentice: 12:53
This concludes today's episode of the ASC podcast. As always, if anyone listening has thoughts or suggestions for future podcasts, please don't hesitate to share your thoughts with us. I'd also like to thank our sponsor for the Advancing Surgical Care Podcast, The Joint Commission, a leading accreditation organization helping to keep outpatient surgery as safe as possible for both patients and the healthcare professionals who care for them. Until next time, please wear a mask, practice social distancing, wash your hands, so we can all stay safe and healthy.