ASCs Face Fresh Challenges as the Market Evolves

The ambulatory surgery center (ASC) landscape has changed dramatically in the past five years, especially during the pandemic and post-pandemic years. Today, the evolution continues with new challenges that confront all OR leaders who strive to grow their businesses, add new specialty lines, and tackle the economic headwinds. Working with trusted partners makes the journey easier and paves the way for both short-term and long-term success.

Outpatient Surgery Magazine spoke with Jenny Bender, MPH, BSN, RN, CIC, Clinical Science Liaison, PDI, to forecast what the coming year may look like and how teams can prepare for their own growth.

Q: How has the ambulatory surgery landscape changed in the past year since the pandemic and post-pandemic?

The ambulatory surgery landscape is expanding faster than ever before, as the pandemic pushed the population to seek care outside of the traditional acute care environment whenever possible. Some reports project that ASCs will see a 25% increase in volume by 2032 and will experience a patient volume that is 15 million higher in 2029 than it was in 2019.¹ In addition to seeing more people, ASCs will see more complexity — they will see more complicated procedures and patients with more comorbidities.²

Q: As more complex surgeries head to the ASC environment, how is this affecting how they do business?

As ASCs perform higher volumes and more complex surgeries, they must invest in their technology, equipment and sometimes additional staff — including specialty surgeons, anesthesiologists and expanded nursing care teams. Additionally, the increase in volume may require more facility space, specifically the operating and recovery areas, as well as finding or creating a dedicated location for a trained workforce to reprocess the equipment used for each procedure. While ASCs may send equipment out to a central sterile processing location or a hospital, there may be others who also reprocess on site.³

These kinds of capital investments can be a challenge, especially for stand-alone ASCs that may not have the financial backing of a large health system. In addition to capital investment on workforce and technology, ASCs have increasingly had to focus on patient experience and outcomes, competing with hospitals for elective surgeries.

The challenges here largely center around regulatory compliance — maintaining accreditation and compliance requires a huge effort — and insurance reimbursement challenges.

Q: What are leaders looking for from their industry partners?

Leaders in the ambulatory surgery setting look for quality, reliable products that are FDA- and EPA-approved from industry partners that share aligned goals such as patient safety and high-quality care. Additionally, they want partners to allow them to maintain and operate within the same standards of quality of care and patient safety that you would find in a hospital environment. ASC leaders also expect competitive pricing, a consistent supply chain, and streamlined ordering and inventory management.

Ambulatory surgical centers may need tailored support and customization. For example, centers may share ordering with a large health system and are looking for a bundled offering, or they are a stand-alone center without a large warehouse to store supplies and need a “just-in-time” delivery model.

Just like any healthcare partner, ambulatory leaders are looking for staff training programs, continuous education, documentation support, and clinical and technical support from their industry partners.

Q: What does PDI see as its mission for the ASC community and how do you fulfill it?

PDI’s vision is to be a global infection prevention innovation leader and trusted advisor to our customers. This is PDI’s higher purpose that drives our mission, to lead the fight against preventable infections and help save lives. This is no different in the ambulatory surgery community – preventing infections is as essential in the ambulatory surgery center space as it is in any environment. Although practice in an ambulatory surgery center may vary from other care settings, the basic building blocks of infection prevention in the surgical setting remain the same — sterilization and disinfection, SSI (surgical site infection) bundle compliance, hand hygiene and environmental cleaning.

PDI manufactures interventional and patient care products, and environment of care cleaning and disinfection products to help ASCs provide a layered approach to infection prevention. When ASCs partner with PDI, together we help reduce the spread of infection and preserve the well-being of those affected by our products. That is our commitment to the people who count on PDI, every day.

Q: What are the products and services that PDI has developed to meet what are seen as specific ASC needs?

PDI strives to bring innovative products to market. within the Interventional/Patient Care and Environment of Care space. For interventional/patient care, PDI is focused on nasal decolonization as a tool to reduce the risk of surgical site infections (SSIs) with a speed that can be a great benefit to the ambulatory environment. Profend® swabsticks are a povidone iodine intranasal antiseptic that is 99.7% effective within 10 minutes of application. Nasal decolonization has been a well-known infection prevention strategy for decades, but PDI’s Profend® swabs have a similar efficacy in minutes instead of days.⁴

For the environment of care, PDI is well known for its surface disinfection wipes — our Super Sani-Cloth® wipe (“purple top”) is the number one disinfecting wipe in health care and continues to be a fan-favorite.⁵ However, we find that customers are also choosing Sani-Cloth® Prime, our disinfectant, with a one-minute contact time.

PDI has an increased focus on sustainability, innovating with science-based, sustainable materials and processes related to our applicators, chemicals, packaging and manufacturing with a goal to achieve carbon neutrality for purchased electricity and direct emissions. Lastly, PDI offers unique support through our in-house clinical team, including myself, with over 100+ years of experience.

Q: What are the most important trends for ASC leaders and industry partners today? In the next five years?

The most important trends ASC leaders need to be tracking right now are related to changes and challenges we have seen in this space during the pandemic and post-pandemic years. ASC leaders are seeing a significant increase in patients and a shift toward more complex procedures, emphasizing technology integration, workforce development, training and staff retention. At the same time, they remain focused on regulatory standards, including infection control and patient-centered care to maintain their competitive edge.

Over the next five years, I predict significant growth in the ASC market share. ASCs will experience an increase in both procedures and patient volume. As a result, specialty ASCs focusing on fields like gastroenterology, cardiology and ENT are likely to see substantial growth.

PDI will remain a trusted advisor in the ASC setting, providing tailored infection prevention solutions for each customer site. For more information about PDI’s infection prevention products and solutions, visit https://pdihc.com. OSM

References:
1. 2021 Impact of Change® Forecast Highlights COVID-19 Recovery and Impact on Future Utilization. https://vizientinc-delivery.sitecorecontenthub.cloud/ api/public/content/96eee6ee0c054f4f8a2881f3db422858
2. Young S, Osman B, Shapiro FE. Safety considerations with the current ambulatory trends: more complicated procedures and more complicated patients. Korean J Anesthesiol. 2023 Oct;76(5):400-412.
3. Healthcare Purchasing News. Shifting strategies and sites for reprocessing success. June 23, 2023 https://www.hpnonline.com/sterile-processing/article/53062560/shifting-strategies-and-sites-for-reprocessing-success
4. Mangalea, M. R., Halpin, A., Haile, M., Elkins, C. A., & McDonald, L. (2024). Decolonization and Pathogen Reduction Approaches to Prevent Antimicrobial Resistance and Healthcare-Associated Infections. Emerging Infectious Diseases, 30(6), 1069-1076. https://doi.org/10.3201/eid3006.231338.
5. Q2 2023 Clarivate Data