Patients give ambulatory surgical centers higher marks than hospital outpatient departments

The Leapfrog Group found a significant gap between the two in some areas. But Leah Binder, the group’s CEO, says both have room for improvement.

Patients reported better experiences at ambulatory surgery centers than in hospital outpatient departments, according to a new report from The Leapfrog Group.

The report looks at both ambulatory surgical centers and hospital outpatient departments before the COVID-19 pandemic (2019) and during the pandemic (from July 2020 to June 2020). The group, an organization focused on healthcare safety and quality, evaluated patient surveys submitted to the Centers for Medicare & Medicaid Services.

Patients offered higher marks at ambulatory surgical centers in a variety of categories, and that has been seen in previous reports by the Leapfrog Group. Most patients indicated positive overall experiences with their outpatient surgeries at both types of facilities.

Still, Leah Binder, president and CEO of the Leapfrog Group, said both ambulatory surgical centers and hospital outpatient departments had room for improvement.

“We want people to feel really great about where they have entrusted their lives,” Binder said. “That’s an area I’d encourage providers to work hard to create a better patient experience.”

The report indicated a drop in patient satisfaction regarding the communication about procedures during the pandemic, which the Leapfrog Group considers a key component in protecting patients. The decrease was seen in both ambulatory surgical centers and hospital outpatient departments.

“It’s absolutely critical to safety,” Binder said.

A real difference

More than 60% of all surgeries are performed in outpatient settings, so safety is of paramount importance to millions of patients.

The findings also suggest outpatient surgical care avoided some, but not all, of the declines in patient safety seen throughout the healthcare industry, the organization said.

Patients reported higher satisfaction with ambulatory surgical centers, particularly during the pandemic. Ambulatory surgical centers had a notable edge over hospital outpatient departments in two key areas: overall ratings and patients’ willingness to recommend the facility.

In the pandemic, 89.1% of patients gave ambulatory surgical centers high marks in overall ratings, while 85.2% gave top marks to hospital outpatient departments.

Meanwhile, 87.4% of patients said they’d recommend ambulatory surgical centers during the pandemic, while 82.4% indicated they’d recommend hospital outpatient departments.

The difference between ambulatory surgical centers and hospital outpatient departments in both of those key categories “is very significant,” Binder said.

“I think the difference between the two is a real one,” Binder said.

At the same time, Binder said overall ratings and recommendation marks in the high 80s for ambulatory surgical centers are not exactly stellar. “That’s not where you want to be,” Binder said.

“If it’s a place where you entrusted your life… you want to have a great experience,” she said.

In terms of communicating procedures, 91.7% of patients at ambulatory surgical center patients said they had good communication before the pandemic, but that figure dropped to 91.3% during the pandemic.

Meanwhile, 91.1% of patients at hospital outpatient departments reported good communications before the pandemic, but that number fell to 90.7% during the pandemic.

“Communication has never been a great strength of the healthcare system,” Binder said. “It’s always been a challenge for healthcare providers to communicate with patients.”

However, it’s an area where healthcare providers must do better, she said.

“Providers need to communicate with each other and communicate effectively with patients,” Binder said. When there’s a breakdown in communication, she said, “the patient’s life is at risk.”

Declines in safety

Federal officials have cited a sharp drop in patient safety, and pointed out some gains in previous years were wiped out by the COVID-19 pandemic. In an analysis published in the New England Journal of Medicine, leaders with the CMS and the CDC pointed to a sharp rise in infections and other worrisome indicators.

The federal officials urged healthcare organizations to focus on improving the safety of patients and employees. The officials also said the government could be looking at more oversight to drive improvements.

The Labor Department said in March it was launching a three-month period of increased inspections of hospitals and nursing homes treating COVID-19 patients.

The Leapfrog Group said it would like to see more transparency for all providers of same-day surgeries regarding patient satisfaction.

Hospital outpatient departments were more likely than ambulatory surgical centers to voluntarily complete surveys of patient satisfaction, the group said. Binder said she encourages all providers to offer more transparency about patient experiences.

Patients can learn more about the ratings and safety of hospitals and surgical centers by visiting the Leapfrog Group.

Binder also called on the Centers for Medicare and Medicaid Services to offer more accessible information for patients. CMS provides information but relies on spreadsheets that aren’t easy for many people to utilize.

“Let’s put it out there so people can use it,” Binder said.