Accreditation

Tips to comply with operative procedures

Briefings on Accreditation and Quality, May 1, 2005

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Hospitals have difficulty complying with PC.13.20, the standard that requires planning for operative procedures and anesthesia. The JCAHO reports 18% of hospitals surveyed in 2004 received requirements for improvement for noncompliance. Experts say three of the standard's 12 elements of performance (EP) are the most problematic, and they offer their tips for compliance.

Assess and document patient needs

EP 7 requires you to assess your patients and document the findings. "Hospitals should be using [1-5 of] the American Society of Anesthesiologists' (ASA) patient classification system to assess their patients overall health," says William B. Costenbader Jr., MD, FACS, CPE, FACPE, consultant for The Greeley Company, a division of HCPro.

The hospital should then document the patient's classification and give it to the anesthesiologist so he or she can choose the correct plan of care for that patient, Costenbader says. The JCAHO does not specify the required elements of the assessment or how to document the assessment, however.

One way to assess patients is to create an anesthesia preop evaluation checklist using the 1-5 ASA classification system, with checkboxes beside each, so that it is thorough yet efficient to complete, says Tom McKibban, CRNA, MS, past president of the American Association of Nurse Anesthetists and nurse anesthetist for Susan B. Allen hospital in El Dorado, KS.

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