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2,000th facility accredited by AAAHC is a model ASC

Ambulatory Safety Monitor, March 3, 2005

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Sapling Grove Surgery Center in Bristol, TN, went through AAAHC accreditation for two reasons: A lot of payers began to require accreditation, and staff wanted an entity to review them and give pointers on how to improve.

The AAAHC accreditation process provided Sapling Grove with both, says administrator Kim Wishon-Powell, MBA. "We wanted to hear what kind of job we are doing," she says.

A job well done

Sapling Grove, the AAAHC's 2,000th accredited organization, impressed surveyors with its quality of staff, cleanliness of the facility, and extensive policies and procedures manual. A team of staff members worked on the manual to lighten the workload, and the book contains "everything potentially imaginable," Wishon-Powell says. Policies and procedures exist on everything from how to use a fire extinguisher to specific protocols for anesthesiologists.

The facility also boasts a 42% return rate for patient surveys. Wishon-Powell attributes high response to the fact that patients generally have good experiences there. Also, Sapling Grove makes survey returns easy by mailing them with self-addressed, stamped envelopes, she says.

Another selling point of the surgery center is its quality improvement plans and peer review process. Surveyors say they like what Sapling Grove chose to review. For example, the facility studies procedures done most frequently because repeated procedures are more likely to sustain errors. In one case, a wrong-site incident occurred and staff reviewed it extensively. "It was a physician error, but as a staff we decided we should have caught it, too," Wishon-Powell says. Now, before a procedure, staff make sure to verify a surgical time-out and correct site on flow sheets.

The facility conducts peer review on all incidents-not just on adverse events. For example, if staff transfer a patient to a hospital-the patient may be vomiting uncontrollably for no reason-regardless of fault, they perform a review. "By tracking everything and not just adverse events, we are able to identify trends before they become a problem," says Wishon-Powell.

Guidance is appreciated

Although Sapling Grove passed its survey with flying colors, AAAHC surveyors still offered areas for improvement. Specifically, they noted that physicians should date and initial normal lab results in the medical record and that staff should visually note allergies on the outside or in an obvious location inside the patient record. Surveyors also advised the facility to offer formal training on different chemicals in the surgery center and to conduct malignant hyperthermia drills so staff can practice the procedure.

The facility welcomed the accreditor's suggestions. "The AAAHC surveyors are educators. They aren't there to find wrong-doings and close facilities," Wishon-Powell says. "They are there to help your center."

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