Should we be performing PCI in ASCs?

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Subject: Should we be performing PCI in ASCs?

What does Medicare's approval of PCI in ambulatory surgery centers (ASCs) mean for patients?

A study of PCI in ASC settings published November 9 in JACC: Cardiovascular Interventions found significantly increased bleeding complications in propensity-matched analysis (OR: 2.49; 95% CI: 1.25 to 4.95; p = 0.009). “Commercially insured patients undergoing ASC PCI were less likely to undergo fractional flow reserve testing and had higher odds of bleeding complications,” than patients treated in a hospital outpatient department, concludes the study authors.

In an editorial accompanying this study, Gregory J. Dehmer, MD argued, “this study should be a warning, not necessarily to stop or change course, but rather to proceed with caution.” Because of its largely unproven nature, especially in the Medicare population, “Performing PCI in an ASC environment requires strict adherence to regulatory requirements and operational recommendations,” he wrote.

Bottom line, regardless of environment, supportive but rigorous third-party procedural review like that provided by ACE provides a crucial service to providers, systems and ultimately patients.

PCI in an ASC environment requires strict adherence to guidelines—accreditation can help.

“ASCs do not have the structure and support associated with a hospital,” says Peggy McElgunn, Esq., Chief Operations Officer of ACE, on the release of updated Cath/PCI standards with guidance for ASCs. “They are going to need the framework that standards provide.”

Bottom line, regardless of environment, supportive but rigorous third-party procedural review like that provided by Accreditation for Cardiovascular Excellence provides a crucial service to providers, systems and ultimately patients in providing third-party validation of quality along with helping organizations of all sizes, makeups and environments, with structured quality assurance guidance and requirements to ensure optimal outcomes now and in the future.

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Subject: Should we be performing PCI in ASCs?