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Arm your staff with surveyor slang to prepare them for survey

Accreditation Connection, November 23, 2004

At Northwestern Memorial Hospital, Cynthia Barnard, MBA, MSJS, CPHQ, director of quality strategies, and Jodi Eisenberg, CPMSM, CPHQ, coordinator of accreditation and licensure at the Chicago hospital spent a lot of time coaching staff before their April survey on how to interpret JCAHO terms and how to ask surveyors to clarify questions. Barnard is well aware that surveyors assume that caregivers will understand their JCAHO terminology, so she was not surprised when surveyors asked clinical staff about their "familiarity with the National Patient Safety Goals [NPSG]."
 
"I don't ordinarily teach patient safety practices by the JCAHO names, or that those particular goals are necessarily more important than our other safety efforts," says Barnard. When staff check patient identification, for example, they do not think of it as complying with NPSG #1, but as a step critical to patient safety, she says.

However, Barnard did quiz staff about their patient identification practices during Northwestern's survey preparation this year. It led to excellent results, she says. "It's just one example of the kind of vocabulary practice that can be crucial to a smooth survey."

Take a three-pronged approach to preparation
Barnard's goal for the survey was to meet and exceed JCAHO compliance. To that end, her survey preparation drills were threefold:

1. Conduct patient and system tracers. Offer staff sample survey questions so they become familiar with surveyors' formal vocabulary. "Staff can practice describing what they do in a comfortable and articulate manner," says Barnard. For example, a surveyor may ask, "How does your manager know you are competent to do your job?" The question can be intimidating, but with a little practice, staff can readily describe how the manager recruited, oriented, and mentored them, and how he or she offers ongoing education and supervision, she says.

2. Host "Lunch and Learns." Each month, Barnard and Eisenberg thoroughly reviewed one topic, such as patient safety or environment. They would host five or more lunches or breakfasts, featuring 40 minutes of content, including videos and slides, and 15 minutes of discussion and practice tracer questions. Attending staff represented every department and unit and learned from each other's answers. Managers or department representatives took checklists and other tools back to their departments to share with their staff. "People loved it," says Barnard.

3. Quiz managers with weekly e-mails. Three months before survey, Barnard began e-mailing practice questions and answers to managers to share with their departments-for example, "What are you doing to ensure medications are administered to the correct patients?" and "What are you doing to improve quality in your department?" The point is to familiarize people with official JCAHO-speak. "People already know the answers, just not in that terminology," says Barnard. Managers posed the questions to staff during meetings or as part of Jeopardy! games. Barnard was right on target-surveyors asked every one of her 30 questions.

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