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How Safe Is the Operating Room? NJ Website Has the Answer

Health department posts safety reports for surgical centers online.

The state Department of Health on Wednesday launched a website that allows the public to examine inspection reports for 260 ambulatory surgery centers. The agency said the goal is to eventually provide the public with online access to all safety reports of healthcare facilities, including hospitals.

The announcement by Health Commissioner Mary E. O'Dowd drew praise from consumer watchdogs and from ambulatory surgery centers (ASCs). It comes as legislation is being crafted to bring all surgical facilities under uniform licensing and inspection by the health department.

Credit: Amanda Brown
State Sen. Joseph F. Vitale (D-Middlesex), chairman of the Senate health committee.

That measure is being reworked by Sen. Joseph F. Vitale (D-Middlesex), chairman of the Senate's health committee. The measure was pocket-vetoed by Gov. Chris Christie last month, in part because it exempted one-room surgery practices from a tax that is levied on multiroom ambulatory surgery centers.

Vitale yesterday praised O'Dowd for the decision to post the ASC inspection reports online. "I think it's great to give consumers the information they need and provide a level of transparency."

The website includes the health department's inspections of about 40 unlicensed, one-room surgeries conducted with a federal grant in 2009 and 2010. The result of those inspections became the basis of an analysis by the New Jersey Health Care Quality Institute that concluded that unlicensed, one-room surgeries had significantly more safety violations than the licensed and inspected multi-room ASCs.

"We are thrilled that O'Dowd and her team are making this commitment to quality and transparency," said Catherine Purnell, director of clinical and policy advocacy for the institute. "This is a big step. It is something that I don't think any other state has done and it's really going to benefit consumers. Now they can compare one surgery center to another."

Vitale noted there will not be any new reports on the more than 100 single-room surgeries until his bill makes its way through the legislature. The agency is making the information public "because that is what the health department should do. Clearly, they are taking their responsibilities seriously. This is important information the public should know."

Vitale said he is confident he will be able to fashion amendments to his surgery-licensing bill "and get something passed in short order. It is my goal not to tax the singles if we don't have to. I'm trying to design a process that would allow us not to levy" the tax.

Larry Trenk, president of the New Jersey Association of Ambulatory Surgery Centers, also welcomed the new website. "Our association has long been a proponent both of compliance and transparency related to licensed facilities, so we're very pleased by the advent of this new website," he said. "Any additional source of information for consumers is extremely beneficial."

But Trenk said he is concerned that "people will take some of the reports out of context and not realize that the deficiency had been corrected rapidly."

Multiroom ASCs, which are licensed and inspected by the health department, "have a very high rate of compliance as evidenced by patient satisfaction levels, outcomes, and the number of complaints the DOH has received over the years from ASCs," he said. Of the average 2,600 complaints received annually by the state health department for all categories of licensed facilities, about 10 per year are specifically related to an ASC.

Mark Manigan, an attorney for Brach Eichler whose clients include ASCs, said the industry supports transparency. "It's good for consumers, and we think the more light shown on this, the better it looks. And we look forward to the department following through on its commitment to provide the same kind of transparency for all healthcare providers."

According to the state health department, ambulatory surgery centers perform procedures that require less than a 24-hour stay. Common procedures include colonoscopy screenings, cosmetic surgery, and eye, knee and shoulder surgery.

"We are giving consumers easy access to more information so they are empowered to make more informed healthcare choices," O'Dowd said. "Inspection reports are another tool that consumers can use when making healthcare decisions."

Consumers can search the website for facilities, and review and compare inspection reports for the past three years. They can also view corrective action plans surgery centers have filed with the department to rectify any deficiencies found during inspections.

Inspections look at whether a facility met state or federal standards on infection control, medication management, staffing, record keeping, patient rights and maintaining sterile equipment. Facilities cited for deficiencies must submit a plan of correction to the department within 10 days detailing how problems will be corrected.

"Inspection reports offer a snapshot in time," O'Dowd said. "Consumers should bear in mind that a facility's deficiencies may have been corrected by the time a consumer views the report online. But, inspection reports serve as a valuable tool for consumers to discuss with their healthcare providers or with a facility they are considering using."

There are several different kinds of ASCs: 145 are licensed by state, 143 single-room operating rooms are in the process of registering with the health department, and about 150 are not licensed or registered with the department. The physicians who operate the one-room practices are regulated by the Board of Medical Examiners, which oversees the practice of medicine.

A spokesman for the health department said the ASC reports are just the beginning of what the department intends to provide through the website. "The department will be populating the site with quality data and inspection reports from all licensed healthcare facilities, as they become available. Until the data is available online, this information is accessible through the OPRA [Open Public Records Act]. But the website shows when the inspections took place which can help individuals narrow their request for information."

Ward Sanders, president of the New Jersey Association of Health Plans, said publishing the information "not only gives consumers a useful tool in shopping for where best to receive care, it also acts as a great motivator for facilities to improve."

According to Kerry McKean Kelly, spokeswoman for the New Jersey Hospital Association, "We have always believed that there should be a level playing field, with all types of healthcare providers bound by the same rules and regulations regarding inspections, patient safety, and quality of care standards. And so it should be with public reporting."

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