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Using Quality Data to Improve ASC Operations
36 Plays3 hours ago
Quality data can be one of the most powerful tools an ASC has to improve both safety and operations. In this episode, Nina Goins, Executive Director of the ASC Quality Collaboration, explains how centers can use benchmarking data to uncover deeper operational issues, strengthen payer and board conversations, and build a stronger culture of quality. She also shares why measures like wrong-site events and unplanned hospital transfers matter so much, how ASCQC’s Safety and Quality Assessment can help centers benchmark best practices, and why a simple daily safety huddle can make a meaningful difference.
In our news recap, we’ll cover the latest wave of ASC development, Leapfrog’s expansion of public ASC quality reporting, new research showing how outpatient surgery growth is creating uneven access across communities, and why anesthesia remains one of the biggest operational risks to ASC growth.
Brought to you by HST Pathways
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Transcript
Introduction and Episode Overview
00:00:00
Speaker
Welcome to This Week in Surgery Centers. If you're in the ASC industry, then you're in the right place. Every week, we'll start the episode off by sharing an interesting conversation we had with our featured guest, and then we'll close the episode by recapping the latest news impacting surgery centers.
00:00:16
Speaker
We're excited to share with you what we have, so let's get started and see what the industry's been up to.
00:00:24
Speaker
Hi everyone, here's what you can expect on today's episode.
Interview with Nina Goins: Beyond Quality Reporting
00:00:27
Speaker
Nina Goins, Executive Director of the ASC Quality Collaboration, joins me to talk about how surgery centers can use quality data as more than just a reporting requirement.
00:00:39
Speaker
We get into what separates centers that simply check the box, from those that use benchmarking to actually improve their operations. A couple metrics that Nita likes to look at in particular and how national comparisons can help with things from internal improvement plans to payer conversations and more.
ASCQC Resources and New Host Introduction
00:01:02
Speaker
We'll also talk about ASCQC's safety and quality assessment, which opens May 1st, and the free tools and resources available that they have to help centers with best practices.
00:01:16
Speaker
And before we get started, a quick update. You'll also start hearing from my colleague Ryan Cohn on the show. He has some great ASC and healthcare care knowledge to bring to bear. He's going to be joining us as a new host.
00:01:30
Speaker
And after my conversation with Nina, he'll take over for today's news recap. And in that segment, he'll cover ASC headlines from the week, including new center development, why quality transparency is about to become even more visible,
00:01:48
Speaker
a new outpatient surgery study that was recently published and bit about anesthesia. So I hope everyone enjoys the episode and here's what's going on this week in surgery centers.
ASC Quality Data and Measures Discussion
00:02:08
Speaker
Hey Nina, it's great to have you on the podcast today. to start, can you give us a brief background about yourself and where you are now? Yeah, first of all, thanks for having me. I'm Nina Goins, the Executive Director of the ASC Quality Collaboration.
00:02:25
Speaker
If you're not familiar with us, we're a small, independent, nonprofit organization dedicated to advancing safety and quality for ASCs. Yeah, excited to jump into that further. So to start, can you share a bit about the quality benchmarking data published by the ASC Quality Collaboration?
00:02:46
Speaker
Yeah, and I may call the ASC Quality Collaboration ASCQC for short, so just wanted to remind listeners of that. We collect data on 11 quality measures from our member organizations that make up about 2,200 ASCs and over 2.5 million admissions per quarter.
00:03:08
Speaker
That's the largest ASC quality measure database available. And we post that data on our website each quarter for all ASCs to access for free.
00:03:19
Speaker
And we also post the specifications or definitions to ensure everyone understands the specifics of what is being measured and reported to promote standardization.
00:03:32
Speaker
And a quick backstory, lot of people don't know is about 20 years ago, leaders in the ASC space came together to develop ASC-specific quality measures to show the value of ASCs.
00:03:46
Speaker
And that was how the quality collaboration was established. And six of those measures that we developed are still used in the CMS ASC Quality Reporting Program today.
00:03:58
Speaker
Yeah, it's had such a huge impact on the industry. And the fact that CMS adopted that as well really speaks volumes to that. Now, Many ASCs track quality data because they have to for the CMS reporting.
00:04:14
Speaker
And for some, it may feel like a burden sometimes. But what separates centers that use this data to improve their ASC versus those that just check the box with it?
00:04:29
Speaker
Yeah, and I understand any extra work feels like extra work, but quality obviously should be part of our everyday operations. And high-performing centers that treat data as a strategic asset really do better. It's a way to learn and not judge information.
00:04:51
Speaker
Those high-performing centers dig into the data really to find this story and look at trends. It's more than just we're better or there were worse than we used to be. But why is that?
00:05:03
Speaker
Do we have new physicians or staff where the case is done in the same room? Has any process has changed? And then, like I mentioned, integrating quality data into operations really makes a key difference.
00:05:17
Speaker
Sharing the data and talking about it consistently and telling the story. It's not just the numbers and we're better or we worse. And at last thing, I would say those that have an improvement mindset really use benchmarking to prioritize action, not just to validate their performance. They use that for their quality improvement.
00:05:40
Speaker
Those are great points. It just reminds me that most people working in ASCs got into healthcare because they wanted to make people's lives better. They care about that actual patient care and the quality that is coming through.
00:05:58
Speaker
So in some ways, focusing on this, like you're saying, is just getting back to their roots of why they even got into this in the first place. Yeah. And it's very easy, as we all know, in an ASC, it's fast paced. And it's very easy to just get caught up in the tasks and forget to embed quality in what you're doing and improving into every day.
00:06:26
Speaker
Not that we're not focusing on quality, but to talk about it, to actually talk about the outcomes and talk about any events. Yeah, that's right.
Using Data Strategically in ASCs
00:06:36
Speaker
So when looking at the data points that ASCs are required to collect, which are the top two in your mind that point to the biggest operational holes that should be watched very closely?
00:06:51
Speaker
Maybe ones where a small change can signal a much bigger operational impact that's happening. I would say two things, wrongs and unplanned hospital transfers.
00:07:05
Speaker
So with wrongs, whether it's wrong site, side, implant, et cetera, it's not just a never event, but it's a clear indication of a system failure.
00:07:16
Speaker
Almost always there were several steps missed that could have caught it or prevented it, but didn't. And that really could signal several things. A lack of psychological safety.
00:07:30
Speaker
Are team members afraid to speak up? Are there certain physicians that just demand speed and want to skip things? And is it just a rushed, complacent culture?
00:07:43
Speaker
And if that process isn't reliable, there's a really high chance that a lot of the other processes need attention. I just don't think we can overstate how important that consistent check and balance is.
00:07:59
Speaker
And then for unplanned hospital transfers, that's a really good operational indicator. Yes, most transfers are absolutely the right call. And transferring patients to a high level of care is the safest for the patient.
00:08:14
Speaker
But it could signal a deeper misalignment. Is the patient selection criteria valid and updated? And are people really following it? Are the pre-op assessment processes standard, like for medical clearance?
00:08:29
Speaker
Are the communication and escalation processes standard? And do people understand that if patient status changes, who they contact and when and not sit on something too long?
00:08:43
Speaker
And pre-op transfers are basically cancellations that will impact, obviously, the day, leading to dissatisfaction at the very least.
00:08:55
Speaker
And again some transfers are expected and good quality care. just important to dig into those causes and not just write it off as justified because stuff happens.
00:09:07
Speaker
Because you may really be missing an opportunity to improve. operations, not just safety. Yeah, those are good call outs. It reminds me of the idiom, a canary in a coal mine.
00:09:21
Speaker
It's a beacon that, hey, there's probably more going on here that that we need to look into. yeah that can really impact operations overall, the more you dig into that and really look at the causes.
00:09:35
Speaker
Yeah, totally. And getting to that root cause, some might call it like doing a root cause analysis. The examples you gave there are so helpful because those may be the things that when they're digging in, hey, why did this wrong side happen? You're going to get to that cause and then see, OK, we've got a lot more that we need to improve here. Love that.
00:09:59
Speaker
And ah another good point is don't make assumptions. It's easy to say, oh we did this or we did that. No, really ask questions of the staff to to pull out what's happening.
00:10:12
Speaker
Yeah. Beyond internal improvements like we're talking about now, where else can benchmarking data be used strategically? Yeah, benchmarking your center's quality metrics against national data is a great way to show the value that your ASC delivers.
00:10:32
Speaker
Internal data can show improvement or decline over time, but you could still be below average or actually be exceeding national data, but you wouldn't know without doing that comparison.
00:10:44
Speaker
And that can also help you prioritize what improvements you should focus on. It's easy to feel like you need to improve everything, but then when you compare to national data and you can say, oh, okay, we're not doing as bad as I thought in these areas.
00:10:58
Speaker
We're doing worse in these areas. And then using data that shows your performance compared nationally can help in negotiating better rates with payers even. You know, value-based care is still growing, but even if your payers aren't asking for that, you can introduce that conversation and show why you deserve better rates to continue delivering those great outcomes.
00:11:22
Speaker
And then another thing is many don't think about using quality benchmarking and growth planning, but it shows clinical readiness. You can highlight that when you're recruiting physicians and it will attract high quality staff. So share that as you're going through your growth planning.
00:11:40
Speaker
Yeah, great call outs.
ASC Safety and Quality Assessment Overview
00:11:42
Speaker
So I'm very excited about the quality and safety assessment that the ASC QC is opening soon.
00:11:52
Speaker
Can you talk about that a bit for those not familiar and maybe talk about how it's tying into what we've been discussing so far? Yeah, we're excited about that too. The ASC Safety and Quality Assessment is another tool for centers to use to benchmark best practices.
00:12:11
Speaker
This tool we created is a concise 20-minute self-assessment that covers safety and quality practices, not quality outcomes.
00:12:23
Speaker
Things such as governance, quality improvement, infection prevention, patient experience, and It's free and open to all ASCs. And like I said, only 20 minutes. so I really encourage centers to take the time to complete that as it's another way to demonstrate your commitment to safe, high quality care.
00:12:44
Speaker
And I'll also add that the 2026 assessment this year runs from May 1st through June 15th. So hopefully, the time this podcast airs, it'll be perfect timing for people to be aware of that and complete that.
00:13:02
Speaker
Yeah, that's the goal. In some ways, it this this new assessment reminds me of a way for centers to focus on the inputs.
00:13:13
Speaker
It's as you said, the measures are more like the outputs. Hey, here's the data of what happened. Here's how can you think about the daily work that we're doing? And also, are you following best practices? Yeah, you know, to ensure that you can continue me to have those great outcomes.
00:13:31
Speaker
Yeah. And you have some great toolkits available that talk about some of those best practices. Can you speak to those as well? Yes, we have a lot of resources on our website, again, free to all ASCs because our goal is to ensure that we're impacting high quality safe care.
00:13:53
Speaker
so we have tool kits ranging from wrong site prevention, endoscopy best practices, hand washing, just all sorts of things. So please jump on there. We have also access to other resources, external resources. So we have a lot of links that that you can go and visit.
00:14:14
Speaker
Yeah, super. And for the centers that are hearing this and considering participating in this new ASC quality and safety assessment, what's the value that they'll get out of it? and How do they actually participate given the time window they have?
00:14:32
Speaker
Yeah, so couple things. They will receive a certificate of completion and then a what we call a badge to post on the website.
00:14:43
Speaker
Again, just showing your commitment to quality. And I wouldn't overlook that because people visit the website and that is just another indication that quality is important.
00:14:54
Speaker
And then each center receives a dashboard or a report with their results and comparing to national data. Like last year, our inaugural year 2025, we had nearly 400 centers complete. So it's a really good data set to compare those practices.
00:15:14
Speaker
This survey or assessment is really a credible ASC-specific quality comparison that can be used to build trust with patients and providers and payers. We mentioned that a little bit.
00:15:29
Speaker
Payers may not be aware of it because, as I mentioned, it launched in 2025. We're working on getting the word out to them. But we do have a flyer on our website you could download and provide to the payers. But speaking to your data and how, one, you're doing enough to compare nationally and showing how your outcomes are performing along with this assessment can really be a motivator to improve rates.
00:15:58
Speaker
And I'll say everything is strictly confidential. We do not publish any results. It's all about helping centers understand their performance, how they compare nationally, and then identify opportunities for improvement internally.
00:16:14
Speaker
And as far as accessing the assessment, they can find a link to the assessment on our webpage, ascquality.org. And we'll also post on our LinkedIn site. So make sure to follow us to get alerts for that.
00:16:30
Speaker
Super. I can also see this being a great topic for discussions with the board of directors to be able to talk about the results and the fact that you're even going through the process that you're wanting to value quality in this way.
00:16:47
Speaker
So I hope people go and talk to their board about this after they complete it too. 100%, 100%. Let them know. And they want to know too what the results are and how you're performing. So it's great. Great.
00:17:02
Speaker
Yeah. Awesome. Last question for you here. We do this every week with our guests. What is one thing our listeners can do this week to improve their surgery centers? I love that you guys always ask that. I think that is so valuable to hear what people say.
00:17:18
Speaker
My recommendation would be a daily safety huddle. And there's lots of information on how to do a safety huddle, but it doesn't have to be complicated.
00:17:29
Speaker
i think some people, because there's so much detailed information out there, they think it's gonna be too hard to do and people won't be interested. But I say, start small, take five minutes, ask about lessons from yesterday, whether they're patient safety or operational,
00:17:47
Speaker
ask what risks are there today. You could have equipment concerns or high-risk patients or high-risk cases. There's lots of benefits to doing that and being sure that you're consistent in asking those questions.
00:18:01
Speaker
Everyone is aligned, strengthens safety culture, it encourages that prevention mindset. And ASCs over the years that I've worked with that have been hesitant to start those have always come back and said they find so much value and wish they had started sooner. So that's my recommendation for this week. Great advice. Thanks so much, Nina.
00:18:24
Speaker
Thank you. It was a pleasure.
ASC Industry Developments and Challenges
00:18:33
Speaker
As always, it's been a busy week in healthcare, so let's jump right in. First new center development is not slowing down. Becker's reported that at least 39 ASCs either opened, broke ground, or were announced in the first quarter of 2026, with activity concentrated in the South and Midwest.
00:18:50
Speaker
Just last week, Community Health Systems said it had already opened two de novo ASCs in Alabama this year, bought a majority stake in a center in Alaska, and signed a deal for another Alabama ASC.
00:19:02
Speaker
The takeaway here is that outpatient expansion is still a real investment priority. This is not just one company making noise, it's a broader signal that health systems and operators still see ASCs as a core growth engine.
00:19:15
Speaker
For ASC leaders, that means the opportunity is still strong, but competition in attractive markets is only going to keep increasing. Next, quality transparency in the ASC space is about to get a lot more visible. The LeapFrog Group announced that it's expanding its ASC public reporting program.
00:19:31
Speaker
and plans to rate the safety of nearly 4,000 ASCs beginning at late July. Benchmarking and quality conversations are moving even more into the public eye. If patients and employers can compare centers more easily, then quality data stops being just an internal boardroom metric.
00:19:47
Speaker
It becomes part of how centers build trust and differentiate themselves. For ASC leaders, that's a reminder that strong outcomes are only part of the equation. You also need consistent documentation, clear reporting, and a team that treats quality data as something operational and not just regulatory.
00:20:05
Speaker
This also fits really well with what Grant and Nina talked about earlier in today's episode. Another story that stood out to me was a new study highlighted by Penn LDI, looking at how surgery continues shifting outpatient.
00:20:18
Speaker
The big headline is that more than 65% of procedures are now being performed outside the hospital and outpatient volumes have continued growing by about 6% per year.
00:20:29
Speaker
But the more interesting finding is that the benefits are not being spread evenly. The study found outpatient procedure volume fell 6% among patients in lower income areas.
00:20:40
Speaker
while rising about 5.2% in higher income communities. It also found that while joint replacement costs dropped by roughly $6,000 to $7,000 per case, as more cases moved outpatient, patient out-of-pocket costs stayed largely the same.
00:20:56
Speaker
And that last part was very surprising for me to read, but a big caveat to the study is that they are comparing inpatient hospitals to all of outpatient, meaning HOPDs and ASCs are grouped together. So I believe that the small decrease in patient responsibility may be coming more from HOPD side than the as ASC side, because this isn't what we typically see with costs for patients when comparing an ASC to a hospital. I'm hoping that the authors of this study dig a little bit further and break it out by ASCs versus HOPDs in the future. And finally, anesthesia remains one of the biggest operational risks in the market.
00:21:32
Speaker
Recent Becker's reporting argued that many ASCs are still underestimating the shortage. And Becker's has also pointed to a previous workforce projection showing that nearly 30% of anesthesiologists couldn't leave the practice by 2033. What makes this story so important is that anesthesia shortages don't just create staffing headaches, they create downstream operational problems almost immediately.
00:21:56
Speaker
They can limit which cases the center is willing to schedule, reduce block utilization, force last minute changes, and put real pressure on growth plans overall.
00:22:07
Speaker
especially when centers are trying to expand into more complex outpatient procedures. So in other words, a center may have the surgeons, the demand, even the physical capacity to grow, but still hit a ceiling if anesthesia coverage isn't stable. So for ASC leaders, this isn't just a recruiting issue, it's also a scheduling issue, a utilization issue, and a long-range planning issue.
00:22:33
Speaker
Centers that can create more predictable schedules, stronger anesthesia partnerships, and a more attractive practice environment will be in a much better position to actually capitalize on outpatient migration. We've actually done some past episodes about anesthesia coverage. So if you're interested in this topic, I suggest going back and listening to a few of those episodes if you haven't done so already.
00:22:55
Speaker
The theme I keep coming back to for this episode is that the ASC market is still growing, but it's also getting more complex with new centers still opening, quality performance becoming more visible, the outpatient shift continuing and staffing pressure not going away.
00:23:11
Speaker
The opportunity is still there, but the centers that win are going to be the ones that pair growth with discipline and visibility and strong proactive execution. And that officially wraps up this week's news recap.
00:23:23
Speaker
Thanks so much for spending a few minutes of your week here with us. this episode was at all helpful for you, please share it with a colleague or a friend in the industry. That's seriously one of the best ways to support the podcast and help us reach more ASC leaders. I hope you a fantastic day and we'll see you again next week.