Case Study: How the Leapfrog ASC Survey Gives Surgery Centers Credibility Through Accountability
In the following interview, Leapfrog president and CEO Leah Binder has a discussion with Coronado Surgery Center Owner and Medical Director Dr. Mike Crovetti.
Leah: What drove your ASC to choose to participate in the Leapfrog ASC Survey initially?
Dr. Mike Crovetti: I was familiar with Leapfrog from working in hospitals and knew the Leapfrog Hospital Survey. I love when we can grade things. If I could summarize what Leapfrog does for us, it’s credibility through accountability. Leapfrog is going to hold you accountable for your patient safety measures, your outcomes, your quality, and your patient experience. I love that. We work very hard every day and in every board meeting we talk about how we can be better. Now we are actually being held accountable and there’s that stamp of Leapfrog on our successes and on the things we can do to improve as well. Everyone can always do better. The patient is always the focus for us.
Leah: I appreciate that bold approach and it’s to the benefit of your patients that you’re focused on being better. Congratulations on expanding to another location in 2022. Can you tell me more about how you’re designing your ASC with Leapfrog standards in mind?
Dr. Mike Crovetti: When you’re building a new site among many other ASCs in the Las Vegas valley, you have to find ways to set yourself apart. As we’ve gone through the Leapfrog Survey, we’ve found that it’s very extensive. We’ve been working hard with our administrators and nurses to assign small committees to help us accurately report to the Survey and to make sure we are meeting Leapfrog’s standards. One area of the Survey is on handwashing, which is critical to patient safety. Part of that standard is that you need to have a sink 20 feet away from every bed. As we go through our plans for our new location, we are making sure there’s a sink 20 feet from every patient bed. There was one that was 23 feet, but now it’s 20 feet. I’m one of those guys who likes to be the best at everything. So when we go to do the Survey for our new location once it’s open, we want to make sure all Leapfrog standards are met. Even our preliminary board meetings are already focused on patient safety measures, which is fantastic.
A note of clarification: It is very important to have sinks near patient beds. However, the recommendation to have a sink 20 feet away from each patient bed is preliminary and not currently part of Leapfrog’s hand hygiene standard. See Leapfrog’s ASC webpage for more details.
Leah: We look forward to seeing the results too after you open your new facility. Your patients will greatly benefit from your strategic planning. How has Leapfrog participation helped you recruit and retain surgeons, nurses, and other staff?
Dr. Mike Crovetti: It amazes me that we have very little turnover in our staff and clinicians. The Leapfrog Survey has made them look at important things like handwashing. Initially we were reporting surveillances every quarter, but now we are reporting every month to meet Leapfrog’s minimum. When you start looking at your protocols and safety measures, people start paying even more attention to quality and safety. Everybody wants to be part of something great – that’s just human nature. So putting the Leapfrog stamp on our work and knowing that everyone is participating really helps. Not only is leadership watching them, but they are watching each other. It’s created this work-together environment where everyone is involved and working toward the same common goal. And we all know our end goal is to always be working to improve quality and safety for our patients.
Leah: What about transparency? That’s a core part of Leapfrog’s mission. We started with publicly reporting hospitals and now we are working with ASCs toward a higher level of transparency. How has participation in Leapfrog’s Survey and prioritizing transparency in general helped your business expand?
Dr. Mike Crovetti: We started joint replacement surgery in an ASC setting in 2010 when nobody thought you would ever do a hip or knee replacement outside of a hospital. As a result of making such a bold move, we had a big target on our backs. Everyone was watching to see what kind of mistakes we were going to make and what kind of complications we were going to have. After every 500 patients, I report our results to payors through a white paper. This is how I first demonstrated my commitment to transparency. We’ve now had over 3,500 patients. This has led to a partnership opposed to an adversarial relationship with payors. They use us as the gold standard in town. In fact, Aetna actually uses us as the gold standard for our entire region. I think our willingness to be transparent plays a big role in that. Secondly, we’ve used transparency in some of the new contracting we’ve been doing. We are contracting directly with employers, for which our pricing is transparent as well. We have 22 different ortho bundles that participate in our ASC. Patients can shop our bundles using tools, like Carrum or Bridge Health, to compare our pricing with another area or region. We are an ASC and not a hospital so we are able to have more favorable pricing than larger organizations. Our transparency is both in pricing and in patient outcomes.
Leah: This is a way to turbocharge your competitiveness. Employers want transparency and that’s what you’re offering through the great items you just outlined and also by participating in the Leapfrog ASC Survey. This is what employers want.
Dr. Mike Crovetti: That’s right. I didn’t realize how large of a health care spend some of these large companies endure. Giving 8-10% off, sometimes 22%, in a discounted, higher-quality delivery really impacts their bottom line. It also really impacts the health care of their employees who love options where you can get something better at a better price.
Leah: Make no mistake – employers want quality. I know a lot of employers and work with them every day. If you ask an employer what they want, they’ll say they want quality and excellence first. They’d also like a decent price and full transparency about all of it. You’re clearly leading the way about all of it.
Dr. Mike Crovetti: We have 60+ employees at our center and, when it comes time for me each year to look at their health care, I actually sit down with my staff and go over the benefits. We look at all the plans that are available and our leadership team chooses the plan our employees want. Sometimes it costs a little more to get them a better plan. Imagine an employer that has 1,000, 10,000, or even 100,000 employees they care about. It’s important to get high quality care at a good price.
Leah: What advice do you have for other ASC leaders interested in embarking on this journey?
Dr. Mike Crovetti: Get involved! Good owners aren’t just owners who write checks and look at operations at a very high level. When you get involved, you’ll be amazed at what you see. There are things that are going on that you have no idea about. Hand them the Leapfrog ASC Survey to complete and give them a couple of months, because it’s very extensive. You’ll realize your staff is already doing awesome things and already doing patient safety things you don’t know about. Secondly, you’re making your staff part of something when you participate in the Leapfrog ASC Survey. Everyone wants to be part of something great. The Leapfrog Survey has brought my staff together with the goal of making patient safety better. There’s no more important goal you can have.
Leah: Thank you, Dr. Crovetti, for joining me today and for the inspiring message you have for your ASC colleagues and for your own team as well. I want to salute you and your team for truly putting patients first and for your incredible transparency. You’ve inspired us at Leapfrog. Thank you.
Dr. Mike Crovetti: Thank you for holding us accountable for great quality care. I really appreciate the opportunity to talk to you today.