Joan Rivers’s death spurs new look at outpatient centers

But Kenneth Rothfield, chairman of anesthesiology at St. Agnes Hospital in Baltimore, said that the staffs of surgery centers may not be as prepared as they think they are.

“I don’t think it’s the venue that’s the most important thing,” said Rothfield, a member of the board of the Physician-Patient Alliance for Health & Safety, a nonprofit group. “ASCs traditionally have done simpler procedures in healthy patients,” while hospitals have routinely dealt with a broader — and sicker — mix of people. Hospitals, he said, are more likely to be fully equipped and to have staff members with greater experience handling emergencies. “Unless you have drilled for it, and trained for it, it can be hard to pull off.”

Postoperative infections in hospitals have been a source of concern for years, but little is known about the rates in surgery centers.

A 2010 report by CDC researchers examined 68 centers in three states, including 32 in Maryland, and found that two-thirds had one or more lapses in infection control. These included improper cleaning and sterilization of surgical equipment and the failure to wear gloves. The following year, the federal agency issued infection control guidelines for outpatient settings similar to those that apply to hospitals. Researchers estimate that on any given day about 1 in 25 hospitalized patients has one health-care-associated infection.