HCPro.com: Ambulatory Quality and Compliance Insider

Whether you're complying with The Joint Commission's National Patient Safety Goals, meeting CMS requirements, or overcoming AAAHC survey challenges, maintaining highquality patient care is no small task. Every issue of Ambulatory Quality and Compliance Insider is packed with field-tested compliance tips you can implement right away and how-to advice from ambulatory experts across the country.

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July 2008 (Volume 8, Issue 7)	view entire issue

Avoid these pitfalls when survey time comes around
Stumbling over quality studies, credentialing, and peer review? How about primary and secondary source verification, making sure clinicians don't practice outside their scope, and risk management? If these accreditation challenges keep you up at night, you're not alone. Many of your peers struggle with those same standards too, according to two experts on the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC) standards.

Medication reconciliation challenges, confuses ASCs
Medication reconciliation is not only the most difficult National Patient Safety Goal (NPSG) surgery centers have to comply with, it has also created confusion among some in the field about who gets the medication list when the patient is discharged. "There has been variability among surveyors with this expectation," says Jan Allison, RN, director of quality and accreditation at Surgical Care Affiliates in Birmingham, AL. "There have been a few who expect the medication list to be sent to the next or primary provider of care. But most have not and are fine if you give it to the patient and tell the patient to bring it to their provider."

How to comply with critical-result reporting requirements
Keep your lists of critical tests and critical results and values short and minimize the number of handoffs between the testing area and the licensed practitioner if you want to pass muster during survey time, says Gayla Jackson, RN, BSN, author of Critical Test Results Troubleshooter: Practical Strategies and Tools for JCAHO Compliance, and a nurse manager at Mount Auburn Hospital in Cambridge, MA. Only 79% of ambulatory surgery centers (ASC) complied with the requirements for critical test reporting during the third quarter of 2007, the second lowest compliance rate of all of the National Patient Safety Goals, according to the Joint Commission (formerly JCAHO) Web site.

Proposed changes would make doctors mark the site
The Joint Commission's proposed changes to the Universal Protocol would make the National Patient Safety Goals (NPSG) much more prescriptive than they have been and require significantly more documentation. Perhaps most important of the proposed changes is the requirement that a staff member directly involved with performing the procedure mark the surgery site with his or her initials. "Most controversial is the insistence on having the surgeon mark the site," says John Clarke, MD, professor of surgery at Drexel University in Philadelphia, clinical director for patient safety and quality initiatives at the ECRI Institute in Plymouth Meeting, PA, and clinical director of the Pennsylvania Safety Authority.

Other recently-published articles from Ambulatory Quality and Compliance Insider:

Teamwork helps prevent surgical fires in ASCs

Proposed CfCs, public reporting top list of ASC concerns

Joint Commission cracks down on disruptive clinicians

New Joint Commission standards change scoring and eliminate FMEAs

Ensure proper training for propofol use in ASCs

Organized charts, documents spell success

Ask simple questions to manage your data

ASCs welcome clarification on medication reconciliation

Proposed changes would make doctors mark the site

How to comply with critical-result reporting requirements

Medication reconciliation challenges, confuses ASCs

Avoid these pitfalls when survey time comes around

Prevention, not punishment, key to patient safety

Nine healthcare professionals detail challenges

Ambulatory surgery center strides through seamless survey

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