Chapter 15 - PI in HealthCare

20 terms by blissfuldaisy 

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Accreditation

The act of granting approval to a healthcare organization based on whether the organization has met a set of voluntary standards developed by an accreditation agency

Certification

The act of granting approval for a healthcare organization to provide services to a specific group of beneficiaries

Compliance

The process of meeting a prescribed set of standards or regulations to maintain active accreditation, licensure, or certification status

Compulsory Reviews

The examination of a healthcare facility and its processes and infrastructures as required by state laws and regulations

Conditions of Participation

A set of regulations published by the CMS to outline requirements of approved programs providing healthcare services to beneficiaries of Medicare/Medicaid programs

Deemed Status

The term used for the assumption by CMS that an organization meets the Medicare/Medicaid Conditions of Participation as a result of prior accreditation by AAAHC, AOA, CARF, or the Joint Commission

Document Review

An in-depth study performed by accreditation surveyors of an organization's policies and procedures, administrative records, human resources records, and other similiar documents

Exit Conference

A meeting that closes a site visit during which the surveyors representing an accrediting organization summarize their findings and explain any deficiencies

Licensure

The process of granting a healthcare organization or an individual healthcare practitioner a license to practice

Opening Conference

A meeting conducted at the beginning of the accreditation site visit during which the surveyors outline the schedule of activities and list any individuals whom they would like to interview

Quality Improvement Organizations (QIO)

Private or public agencies contracted by the CMS to undertake examination and evaluation of the quality of healthcare rendered to beneficiaries of federal healthcare programs

Site Visit

An in-person review conducted by an accreditation survey team; the visit involves document reviews, staff interviews and other activities

Survey Team

A group of individuals sent by an accrediting agency to review a healthcare organization for accreditation purposes

Tracer Methodology

A process Join Commission surveyors use during the on-site survey to analyze an organization's systems; by following individual patients through the organization's healthcare process as experienced by patients

Voluntary Reviews

An examination of an organization's structures and processes conducted at the request of a healthcare facility seeking accreditation from a reviewing agency

CARF

Commission on Accreditation of Rehabilitation Facilities; 1966

AOA

American Osteopathic Association; 1945

NCQA

National Committee for Quality Assurance; 1991

AAAHC

Accreditation Association for Ambulatory Health Care

RFIs

Requirements for Improvement

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