Source: North Jersey.com
Part 1
Fifty-two people died at New Jersey “same day” surgery centers between September 2008 and January 2017, according to an open-records request.
More than 1,200 “events” — a neutral term that refers to death, falling into a coma during or after surgery, or serious preventable injuries that result in disability or other harm — were reported between September 2008, when the state began keeping count, and September 2017.
But those numbers likely understate the problems — because only half of New Jersey’s 300 surgical centers are required to report to the state’s Patient Safety Reporting System. Due to a quirk in New Jersey law, surgery centers with only one operating room haven’t been licensed by the state Department of Health and haven’t been required to report their patient-safety data.
It’s estimated a million procedures — from colonoscopies to cataract surgery, face-lifts to pain injections — are performed each year at ambulatory surgery centers in New Jersey, about 325,000 of them on Medicare patients. Soon, patients at these centers may be able to go home just hours after a total hip or knee replacement as Medicare expands the scope of what it will pay for outside a hospital.
Most people find that their surgeries or other procedures go well. More than half of the licensed same-day centers report no problems to the state. The industry trade group is proud of the quality of care they offer.
Patients should have fewer concerns about health-care-acquired infections, he said, because “you don’t have issues that happen in an acute-care hospital with long-term patients who are very, very sick.” And patient satisfaction, measured by industry surveys, is high, he said. However, surgery centers are subject to:
- Lacking the resources of a hospital for dealing with emergencies;
- Accepting patients who ought to receive a hospital’s more intensive monitoring and post-operative care;
- Not vetting their doctors and other professionals as rigorously as hospitals do, even not requiring specialty board certification;
- Being lax in enforcing the state regulation that requires physicians to maintain hospital privileges for procedures they perform in non-hospital settings;
- Being inspected less frequently, with the results not always being made public.
There were 38 surgery-related deaths reported at the state’s 72 hospitals in 2015, among some 670,000 inpatient and outpatient operations. Hospital patients are often sicker and frailer, and the surgery often much more complex, than at a surgical center.
That same year, 12 deaths and 161 serious preventable adverse events were reported by about 160 licensed surgery centers. Again, no data are available about deaths and “events” at the unlicensed centers.
“Any sentinel event, any occurrence, is taken very seriously,” says Andrew Weiss, past president of the New Jersey Association of Ambulatory Surgery Centers. “We’re not trying to obscure or obfuscate data. We totally support transparency.”
But there is a long way to go.