In this episode of the Advancing Surgical Care Podcast, ASCA Chief Executive Officer Bill Prentice sits down for a conversation with Kathy Wilson, executive director of the ASC Quality Collaboration (ASC QC), to discuss the ASC QC’s current initiatives, long-range goals and recent engagement with The Leapfrog Group’s independent quality reporting efforts.
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 in 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 to the Advancing Surgical Care Podcast. I'm Bill Prentice, CEO of the Ambulatory Surgery Center Association. In a moment, I'll be joined by Kathy Wilson, the executive director of the Ambulatory Surgery Center Quality Collaboration, or ASC QC or Quality Collaboration. For anyone not familiar with the Quality Collaboration, it's an independent nonprofit organization that was established by the ASC community to develop meaningful quality measures for ambulatory surgery centers that could either be publicly reported or used to document the safety and quality of care in ASC facilities. In fact, the CMS Quality Reporting Program for ASCs was initially populated with measures generated by the ASC QC. Kathy became executive director of the Quality Collaboration in January of this year after the untimely passing of our dear friend and colleague Ann Shimek. Kathy previously served as vice president of quality and risk management at AMSURG, as well as assistant vice president in HCA's clinical services group. She earned her MHA and bachelor's degrees from Indiana University, as well as a nursing degree from Henry Ford Hospital. Kathy, welcome to the Advancing Surgical Care Podcast.
Kathy Wilson: 1:47
Thank you, Bill.
Bill Prentice: 1:48
So Kathy, I'm eager to talk about some of your current initiatives with the QC. But before we jump into that, can you share with our audience a little about your prior professional experiences and how it helped prepare you for your new position as executive director of the ASC QC?
Kathy Wilson: 2:03
Yes, sure Bill. As you mentioned, I've previously been involved in the ASC QC when I was at AMSURG and HCA. That actually goes back to 2007 and I participated in the first data collection that we posted publicly. So, I've been in on the data collection from the very beginning. I also served as the chairperson of the Technical Expert Committee and worked closely with a lot of the regulatory bodies and the measure developers and contractors on piloting the new measures. So, I had a lot of hands-on experience with developing the measures that we ultimately came to be reporting to CMS. It's really great to get reconnected with everybody and I think that my experience and my previous relationships have really helped make the transition a smooth one.
Bill Prentice: 3:00
Well, and I certainly remember, serving on the ASC QC board with you for a number of years, how involved you were and all the expertise from your background at HCA and AMSURG and other places, what you brought to the table there. So, we're obviously delighted to have you. But let's talk about the QC. And I recognize that you've only been the executive director for a few months now, but I'm eager to hear about what some of the goals you and the board have for the collaboration for the remainder of 2021 and beyond. Can you give us a little insight as to what the QC is up to?
Kathy Wilson: 3:33
Sure, I'd love to. We really are following a strategic plan that was laid out last year, but one of the biggest initiatives this year has been getting the new data platform up and running. It's required a great amount of effort but I'm really happy to say that we're rolling with that now and about to publish our first quarter data. And this is really streamlining the data collection process and it makes the data much more useful and visible. And it would ultimately support new measures as we develop those, too. We really have another goal to just advance the visibility of our quality data and the work of the ASC QC, so the new platform is enabling that to be much more visible but also usable by the participants. So, it's really getting down to a completely different level of granularity, and as we proceed with this, we know that the transparency of the data and the access to it really promotes quality improvement among the participants. That's also going to translate into the visibility on the public posting on the ASC QC website. So, it's benefiting not just the participants in the data collection, but also surgery centers across the country that access that data. We really are looking forward to expanding our membership, too, and there's been a lot of attraction to the ASC QC from this new platform.
Bill Prentice: 5:09
Kathy, I have a follow-up question about that. But before I do so, let's take a short break to hear a message from our podcast sponsor and we'll be back in just a minute.
This episode of the Advancing Surgical Care Podcast is brought to you by Somnia Anesthesia, a national perioperative anesthesia management company, bringing advanced anesthesia and pain management techniques to surgery centers for 27 years. Somnia’s anesthesiologists and nurse anesthetists integrate fully with ASC clinical teams to deliver safe, high-quality care. Learn how they do it at somniainc.com.
Bill Prentice: 5:51
Kathy, you were talking about this new platform for collecting data and I know that historically the Quality Collaboration has relied on the management companies to provide that data in bulk. Will this new platform allow, eventually, for individual ASCs to also provide data and take advantage of that platform?
Kathy Wilson: 6:10
We would love to see that come about and having it on this platform is going to make that much easier because the data collection process is entirely different than it's been in the past. So, yes, a long-range plan we would be able to open this up to have different types of participants than we've had in the past.
Bill Prentice: 6:31
Excellent. Well, making health quality data accessible to patients has been a top priority for ASCA and the Quality Collaboration forever. And while quality reporting is certainly better today than it has ever been, I think you would agree with me that we still have a long way to go to make those quality reports accessible and intelligible to individual patients. Specifically, what do you think we need to do to improve the usefulness of the data that's being reported today, let alone the data we want to collect in the future?
Kathy Wilson: 7:03
You're right, Bill. I think we've all experienced trying to track down information about new providers or new facilities. I've certainly just gone through this having relocated to a new town. We've got to work on having meaningful measures that are accessible, and that we understand, that the public understands, and that the payers understand. So, accessibility is also so important. So we have a lot of measures for CMS that we report to CMS, but it's almost impossible to pull those out of the CMS website. And they've committed to making it more easily accessed. But for sure, we've got to get to the point where you can get to that easily, there are explanations and understanding of the measures, and we've got to go back a step, really, and have measures that are based on evidence and that have been tested and are significant to our setting. So, we've got to get input from stakeholders on our measures and make sure that they're significant and they're ones that can contribute to us improving. So, there's still a lot of work to do.
Bill Prentice: 8:16
Another thing that we've talked about in the past is the fact that with two competing ideas at work at the same time in terms of the Quality Collaboration, where we were creating ASC-specific measures because that was what we knew we needed to do to create a CMS Quality Reporting Program, which is something that we actually advocated for. But we also know that having these siloed measures applicable to each setting also makes it hard for a patient to be able to choose a site of service because they'd have to go and look at just ASCs over here and HOPDs over there. Don't we need to get away from these siloed measures and have measures that allow patients to compare quality and patient safety in all the different sites of service for which they could get that procedure?
Kathy Wilson: 9:08
For sure. And I'm pleased to hear CMS discussed this a lot. They want to see that across the sites of service. And for us, especially now, as procedures get moved from the hospital into the ASC space, it's even more important.
Bill Prentice: 9:27
Kathy Wilson: 9:28
So, those have got to be comparable.
Bill Prentice: 9:31
And the practical concern for our listeners about that is, while we can try and develop a measure, we're only able to test it in our site of service. So, we need somebody else's help if we want to test that measure of quality in the hospital or office-based or somewhere else. So, that's something that obviously we need the government's assistance on if we're ever going to make that come to fruition. Well, since we're on the subject of quality reporting, I'd be remiss if I didn't ask you about The Leapfrog Group and the recent announcement that you would be co-chairing their ASC Advisory Committee. And I've heard secondhand that they're soliciting ASCs to take the second iteration of their Leapfrog ASC survey. And as some listeners might remember, ASCA and the QC were really instrumental in helping Leapfrog find pilot centers to test their initial survey a few years ago. Unfortunately, they were less interested in soliciting our input on the survey itself, and some things that we thought were of concern about it. And some may recall that Leapfrog staff made some very disparaging and untrue statements about ASCs to the media upon the release of a report after that initial survey. Interestingly, after we conveyed our concerns about those statements and about their initial survey, we at ASCA really haven't heard anything from Leapfrog since. So with that in mind, I'm really interested to learn what the role of this advisory committee is expected to play, and what you've learned so far about the second survey?
Kathy Wilson: 10:59
Yes, Bill. I share some of these same concerns. We're all interested in advancing quality and transparency. So, when I was asked to be co-chair of their new ASC Advisory Committee, I really saw it as an opportunity to keep the lines of communication open with them, and to help educate them about the quality work that is going on in the ASCs, and not just the ASCs that are doing their survey. So, they're intending through the advisory committee to leverage the relationship that they have with participating ASCs, their participating ASCs, to advise the Leapfrog board and management on ASC safety, quality and efficiency. So, to get input from the centers that are already participating in their survey. We have asked them about including on this advisory committee perhaps some representatives of centers that do not participate in their survey.
Bill Prentice: 12:10
So, one of the concerns that I think we had was that we felt that some of the questions on their initial survey really weren't pertinent to ASCs or applicable. Is this advisory panel going to have any role in offering thoughts on subjects like that?
Kathy Wilson: 12:26
Unfortunately, this body is not going to be advising them on survey content, or scoring, or public reporting. But just through advising them about the work in the ASCs, I'm very hopeful that we can help influence some of the development of those survey items going forward. But it's clear that this will not be the body that develops those survey items. Although, we may have the opportunity to weigh in on what we feel are the most pertinent measures going forward.
Bill Prentice: 13:06
It certainly seems odd to me to have an advisory panel that isn't really set up to advise on the central purpose of the survey, but I guess I'm missing something there. But hopefully you'll learn more as you work with this group.
Kathy Wilson: 13:21
Right. I'm certainly hoping to.
Bill Prentice: 13:24
When will this advisory panel be meeting?
Kathy Wilson: 13:26
They're taking nominations now, and actually will be getting together not in-person until December at the time of their national meeting, but I'll be working with them, I'm sure, in the interim time and hoping to learn a lot.
Bill Prentice: 13:45
Well, I wish you well in that. Again, it seems just a little odd to me to wait to have an advisory panel meet until after you've been at this activity for a few years and have issued two different surveys, but maybe there's a method to that that I'm just not getting. Well, Kathy, is there anything else you'd like to tell our listeners about what the QC is up to before we adjourn?
Kathy Wilson: 14:07
Well, we are just really excited about our new data platform and, as I mentioned, we've just recently had two new management companies join. And we're certainly looking forward to expanding the membership during 2021 and going into next year. And we've just got a great body of knowledge and experience on both the board and the Technical Expert Committee who are very focused on patient safety and quality of care. And really in the end, it does come down to the patient and the care that we're delivering to our patients.
Bill Prentice: 14:48
That's great to hear. And again, for our listeners' benefit, having participated with the Quality Collaboration over the last decade, that has solely been the focus of the Quality Collaboration is what is best for the patient. And I have no doubt that that will continue under your able stewardship. So, Kathy, thank you for spending a few minutes with me and hopefully we can talk again soon about further ASC QC activities and other things that you're working on.
Kathy Wilson: 15:14
I look forward to it.
Bill Prentice: 15:16
Before closing this podcast, I would like again to acknowledge the support of our ASCA affiliate Somnia Anesthesia, a national anesthesia management company bringing advanced anesthesia and pain management techniques to surgery centers for over 27 years. Learn more at somniainc.com. So until next time, thanks for listening and please continue to follow your local public health guidance.