title: A Model for Integrating Ambulatory Surgery Centers Into an Academic Health System Using a Novel Ambulatory Surgery Coordinating Council.
abstract: An increasing volume of ambulatory surgeries has led to an increase in the number of ambulatory surgery centers (ASCs). Some academic health systems have aligned with ASCs to create a more integrated care delivery system. Yet, these centers are diverse in many areas, including specialty types, ownership models, management, physician employment, and regulatory oversight. Academic health systems then face challenges in integrating these ASCs into their organizations.
  
  
  
  Johns Hopkins Medicine created the Ambulatory Surgery Coordinating Council in 2014 to manage, standardize, and promote peer learning among its eight ASCs. The Armstrong Institute for Patient Safety and Quality provided support and a model for this organization through its quality management infrastructure. The physician-led council defined a mission and created goals to identify best practices, uniformly provide the highest-quality patient-centered care, and continuously improve patient outcomes and experience across ASCs.
  
  
  
  Council members built trust and agreed on a standardized patient safety and quality dashboard to report measures that include regulatory, care process, patient experience, and outcomes data. The council addressed unintentional outcomes and process variation across the system and agreed to standard approaches to optimize quality. Council members also developed a process for identifying future goals, standardizing care practices and electronic medical record documentation, and creating quality and safety policies.
  
  
  
  The early success of the council supports the continuation of the Armstrong Institute model for physician-led quality management. Other academic health systems can learn from this model as they integrate ASCs into their complex organizations.
authors.affiliation: L. Ishii is chief quality officer for clinical best practices, Johns Hopkins Health System, medical director for clinical integration, Office of Johns Hopkins Physicians, and associate professor, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland. P.J. Pronovost is senior vice president for patient safety and quality and director, Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, and professor of anesthesiology and critical care medicine, surgery, and health policy and management, Johns Hopkins University School of Medicine, Baltimore, Maryland. R. Demski is vice president of quality, Johns Hopkins Health System and Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland. G. Wylie is executive director, Johns Hopkins Medical Management, Johns Hopkins Health System, Baltimore, Maryland. M. Zenilman is chief quality officer for ambulatory surgery and professor, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Lisa
authors.initials: L
authors.lastname: Ishii
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Pronovost
authors.forename: Renee
authors.initials: R
authors.lastname: Demski
authors.forename: Gill
authors.initials: G
authors.lastname: Wylie
authors.forename: Michael
authors.initials: M
authors.lastname: Zenilman
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D006801:Humans; D008396:Maryland; D017146:Models, Organizational; D061214:Patient Safety; D011787:Quality of Health Care / Q000458:organization & administration; D013531:Surgicenters / Q000458:organization & administration*