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Best practice: Use mock tracer methodology to improve service NOW

Staff Development Weekly: Insight on Evidence-Based Practice in Education, February 26, 2004

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Regardless of whether your JCAHO survey is next month or next year, it's not too early to test your staff's survey preparedness with tracer methodology. Using tracer exercises, the accreditation and regulatory standards department for the Sentara hospital system in VA ascertains what services may need improvement and thereby helps staff progress to continuous survey readiness. Deloris Cooper, RN, the manager for three of Sentara hospitals' accreditation and regulatory standards departments, vouches for the effectiveness of this evaluation method. "With tracer [methodology], we focus on the patient, which makes sense to staff because we look at something real." Cooper and her staff held general training sessions on the basic concepts of tracer methodology for all accreditation and regulatory compliance leaders. The accreditation department staff then used patient medical records to demonstrate how tracer methodology works. For example, using an actual emergency department (ED) medical record, an accreditation and regulatory standards staff member demonstrated how surveyors would use the chart to follow patient care across the entire episode of care. For instance, the staff member indicated that a surveyor may ask an ED nurse the following questions:

• How do you obtain medication allergy information from a trauma patient?
• What medications would a patient such as this one receive in the ED?
• Who would order the medications in the ED for this patient, and how does that process work?
• Does the pharmacy review the orders in an emergency situation?

Functional leaders oversee the tracer exercises. The leaders identify problem areas, actions they have adopted for improvement, and any other recommendations.

To read more on tracer methodology, go to Briefings on JCAHO (BOJ). The cost is $10. Subscribers to the online version of BOJ have free access to this article. Subscribers to the print newsletter can find this article in their February issues. For the cost of just three stories, you can get the entire February issue of BOJ, click here to choose between the PDF and HTML versions for just $30. BOJ online subscribers have free access to this issue, and print newsletter subscribers can find this issue in their mailboxes.

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