Accreditation Newsletters

Ambulatory Quality and Compliance Insider Briefings on The Joint Commission

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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Ambulatory Quality and Compliance Insider

Issue 3, March 5, 2003 - VIEW THE FULL ISSUE

• Clear communication and fines force docs to comply with reappointment

  The challenge never ends to recredential and reappoint practitioners within the two-year time frame...

• Appoint an information security officer to handle HIPAA regulations

  The Health Insurance Portability and Accountability Act's (HIPAA) newly published security...

• Make sure that your medical malpractice insurance policy protects you against l

  In the increasingly litigious field of health care, providers should gather as much information as...

• Network and know your community needs when starting your own ambulatory surgery

  The two most important concepts involved with planning a new ASC entail researching your community...

Issue 12, December 1, 2003 - VIEW THE FULL ISSUE

• Keep drapes and gauze wet to prevent fires in the OR

  Surgeons can control everything related to the heat source. For example, they can ensure that...

• As JCAHO chops abbreviation use, educate staff on how to comply

  Starting January 1, JCAHO-accredited organizations will no longer be able to use nine common...

• Credentialing, documentation key in survey

  The last time staff at the Cape Girardeau (MO) Outpatient Surgery Center underwent an AAAHC survey...

• States should adopt office-based regulations

  Momentum is building towards more states adopting regulations over office-based surgeries. In...

• Help staff know how to respond to clinical alarms

  Can your staff always hear the critical, clinical alarms in your facility, and do they know how to...

Issue 11, November 1, 2003 - VIEW THE FULL ISSUE

• Get basic information from all patients before ordering meds

  JCAHO surveyors will start using medication management as a system tracer in January 2004...

• Help staff discuss disappointing outcomes--From Briefings on Ambulatory Accredit

  Your issue: How much information should staff reveal when procedures go wrong? And if they provide...

• Culture care: Respect patient differences to improve safety

  For staff at the BryanLGH Medical Center in Lincoln, NE, awareness of cultural diversity is a...

• States crack down on office-based surgery practices

  More and more physicians perform surgeries in their offices-including increasingly complex...

Issue 10, October 1, 2003 - VIEW THE FULL ISSUE

• Help patients set personal goals to improve their health

  Diabetes, asthma, and depression are the most common ailments among the thousands of patients who...

• For best results, have clear objectives when hiring consultants

  Going through the accreditation process can sometimes seem overwhelming. Ambulatory surgery centers...

• Be thorough when obtaining informed consent

  Informed consent might seem like an annoying legal requirement you need to meet, but thoroughly...

Issue 9, September 1, 2003 - VIEW THE FULL ISSUE

• Infection control: Monitor compliance as well as the number of infections

  The JCAHO wants organizations to work toward eliminating health care-acquired infections (HAIs) and...

• Use CRNAs for cost savings

  Deciding between hiring an anesthesiologist or using certified registered nurse anesthetists...

• Recent survey took a look at continuing ed

  For the first time since the Physicians' Outpatient Surgery Center in Belpre, OH, was built in...

• Think you're an ambulatory surgery center? Double check with CMS to make sure

  Over the past several months, some ambulatory health care facilities started to wonder whether the...

Issue 8, August 1, 2003 - VIEW THE FULL ISSUE

• Universal protocol: Taking time out before the procedure is crucial

  Wrong-site or wrong-person surgery is devastating for everyone involved, including the surgeon and...

• Use FMEAs for more than just regulatory compliance, experts advise

  For some organizations, conducting a failure modes and effects analysis (FMEA) is something they do...

• Check out the National Quality Forum's best practices

  Deciding where to focus your patient safety resources can seem overwhelming, so you might want to...

• Picking the best person for security official role

  Editor's note: The following story is an excerpt from the new book, HIPAA Security Made Simple...

Issue 7, July 10, 2003 - VIEW THE FULL ISSUE

• Make physician profiles a learning tool to improve patient safety

  Do physicians in your center feel as though profiles are a tool to help them improve or a way to...

• Look for requirement changes in JCAHO patient safety standards

  The JCAHO recently revamped its accreditation standards for ambulatory centers in a...

• Long hours, increased responsibility highlight responses to BOAA's annual salary

  When it comes to salaries and how well your peers feel they are compensated for their jobs...

• Facility strives to stay a cut above the JCAHO's patient safety requirement for

  Facility strives to stay a cut above the JCAHO's patient safety requirement for site marking

Issue 6, June 11, 2003 - VIEW THE FULL ISSUE

• Properly verifying credentials key in hiring, privileging physicians

  You are always hiring new physicians and updating the privileges of existing staff. But how do you...

• Effective leadership necessary from medical director, board of directors

  Governance is one of the Accreditation Association of Ambulatory Health Care's (AAAHC) core...

• Streamline schedules to ensure smooth operation

  Do you have problems with scheduling? Are your procedures consistently delayed? Can you accommodate...

• Achieve accreditation and collect extra money

  Office-based surgery centers constitute a rapidly growing part of the health care world, especially...

• Be consistent when making follow-up calls to patients

  After a patient has an invasive procedure, you might call to see how the patient is doing. But if...

Issue 5, May 12, 2003 - VIEW THE FULL ISSUE

• Unannounced JCAHO surveys are looming in your future

  Some centers prefer to constantly prepare for a Joint Commission on Accreditation of Healthcare...

• Infection control: Easy ways to keep your patients and staff safe

  The Centers for Disease Control and Prevention (CDC) estimates that nearly two million patients per...

• Mock survey helps Iowa surgery center prepare for unannounced JCAHO visit

  Unlike most Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) surveys where...

Issue 4, April 2, 2003 - VIEW THE FULL ISSUE

• Effective communication helps reduce patient safety errors

  Medical error statistics consistently point to poor communication as a reason why many problems...

• New anesthesia standards help physicians avoid trouble

  Because administering anesthesia can be a tricky business, the AAAHC clarified several...

• A group of primary-care clinics in Washington state undergo a second perfect sur

  Complying with AAAHC standards is a way of life at the University of Washington Physicians...

Issue 9, March 7, 2003

• Make sure that your medical malpractice insurance protects you against liabili

  Make sure that your medical malpractice insurance protects you against liability

Issue 6, February 14, 2003

• OK surgical center gets a CMS survey surprise

  OK surgical center gets a CMS survey surprise

Issue 5, February 7, 2003

• A Michigan medical center gains more direction from the JCAHO on consistent docu

  A Michigan medical center gains more direction from the JCAHO on consistent documentation

Issue 3, January 24, 2003

• Here's expert advice on medical device reporting

  Here’s expert advice on medical device reporting

Issue 2, February 21, 2003 - VIEW THE FULL ISSUE

• Establish proper policies, procedures for disposing of patient records

  Establish proper policies, procedures for disposing of patient records

• At last, CMS adopts the 2000 Life Safety Code

  Enforcement starts in September Facilities that still reference the 1985 Life Safety Code (LSC...

• Benchmarking is critical to your quality improvement program

  Eight simple steps to outcomes monitoringOutcomes monitoring is a term that many people fear. But...

• JCAHO focuses for 2003 and beyond

  Editor’s note: This story is an expanded version of the fax express sent to your facility on...

• OK surgical center gets a CMS survey surprise

  The Centers for Medicare & Medicaid Services’ (CMS) surveyors arrive unannounced...

Issue 1, January 21, 2003 - VIEW THE FULL ISSUE

• A Michigan medical center gains more direction from the JCAHO on consistent do

  Clear documentation about patient education, honoring patient privacy, and adequately assessing...

• Establish proper policies, procedures for disposing patient records

  Since it’s expensive and takes up a lot of space to store patient records...

• From reporting to tracking: Expert advice on medical device reporting

  Your medical device reporting (MDR) provides the Food & Drug Administration (FDA) with...