AAAHC Institute releases benchmarking studies

Four reports issued by the AAAHC Institute for Quality Improvement, a subsidiary of the Accreditation Association for Ambulatory Health Care (AAAHC), offer insights into some of the most common outpatient procedures, including cataract surgery, colonoscopy, low back injection, and knee arthroscopy. Highlights of the studies include:

• Cataract extraction with lens insertion.

— Procedure times.

The median pre-procedure time (defined as patient check-in to start of the procedure) was 81 minutes (range 30 to 157 minutes). Organizations with the shortest pre-procedure times use processes that include standardized charting and sufficient staffing.

Average procedure times (defined as the time the procedure starts; i.e., incision, to the time the procedure has ended; i.e., dressing on) ranged from 5 to 38 minutes (median 14 minutes). Average procedure times were lowest for those that used IV plus peribulbar block for anesthesia (12 minutes) and greatest for those that used IV plus retrobulbar block (19 minutes).

The median discharge time (defined as end of the procedure until patient meets discharge criteria) was 13 minutes (range 6 to 31). Organizations with the shortest discharge times attributed practices such as streamlining paperwork and adequate staffing.

— Patient outcomes.

Ninety-six percent of patients were able to schedule their procedures as soon as they wanted. Ninety-nine percent said they had adequate understanding of the procedure. Ninety-nine percent said they were comfortable before the procedure and after discharge.

Eighty percent were contacted by their health care providers to assess outcomes within 14 days of the procedure. Ninety-five percent reported their vision was better post-surgery; and 95% returned to activities of daily living within one week of the procedure. Ninety-nine percent would recommend the procedure to friends or relatives with cataracts.

• Colonoscopy.

— Procedure times.

The median pre-procedure time was 60 minutes (range 14 to 130). Organizations with the shortest times use processes such as preparing paperwork before the patient arrives, PRN staffing and scheduling efficiencies.

Average procedure times ranged from 7 to 42 minutes (median 18).

The median discharge time was 39 minutes (range 10 – 71 minutes). Organizations with the shortest times attributed their results to the use of sedatives that allow patients to recover quickly, and sufficient recovery room staff.

— Patient outcomes.

Ninety-six percent of patients were able to schedule their procedures as soon as they wanted.

Seventy-four percent reported little or no discomfort during pre-procedure bowel preparation. Ninety-six percent reported little or no discomfort during the procedure.

Ninety-nine percent said they received written discharge instructions.

Ninety-nine percent said they would recommend the procedure to a friend.

• Knee Arthroscopy.

— Procedure times.

Median pre-procedure time was 90 minutes (range 60 to 164). Organizations with the shortest times attributed their results to preparing prior to the day of surgery and sufficient staffing.

Average procedure times ranged from 7 to 55 minutes (median 26).

Median discharge time was 68 minutes (range 40 to 132). Organizations with the shortest times attributed their results to educating patients pre-operatively and short-acting anesthesia combined with local anesthetics.

— Patient outcomes.

Ninety-one percent said they were able to schedule their procedures as soon as they wanted.

Ninety-nine percent said they experienced little or no discomfort during the procedure, and ninety-eight percent said they were comfortable post-discharge.

One hundred percent said they had adequate understanding of the procedure and had received written discharge instructions.

Ninety-seven percent had begun walking (with or without crutches).