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Module 6 (3)
ACCREDITATION, CERTIFICATION, AND STANDARDS
Terms in this set (20)
Benefits of Accreditation
● Improved patient outcomes
● Organizational learning
● Providing professional consultation and enhancement of staff education
● Ongoing support from the accrediting organization
● Decreasing liability costs and mitigation of the risk of adverse events
● Recognition by insurers and managed care organizations
● Increased financial capabilities
● Strengthening community confidence
AAAHC (Accreditation Association for Ambulatory Health Care):
2. types of organizations they accredit:
1. Aid ambulatory health services provide quality care for their patients
2. AAAHC accredits over 6,100 organizations including, among others, ambulatory
surgery centers, community health centers, medical home organizations, military health care
facilities, multi-specialty group practices, pain management centers, and women's health
Accrediting bodies cont:
AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities):
2. claim to fame:
1. provide accreditation to ambulatory surgical centers
2. has created one of the largest patient safety data reporting banks of safety cases.
Accrediting bodies cont:
1. provides certification in health care quality management and patient safety
Accrediting bodies cont:
ACHC (Accreditation Commission for Health Care:
2. Who did it merge with?
3. what areas of care does the new organization have deeming authority for?
1. focus on health care provided by small provider groups
2. merged with AAHHS- first merger of two organizations with deeming authority under CMS.
3. ACHC has CMS deeming authority for home health, hospice, renal
dialysis, home infusion therapy, and DMEPOS. The newly expanded ACHC adds deeming authority for hospitals, ambulatory surgery centers, clinical laboratories and
critical access hospitals.
Accrediting bodies cont.
ACR (American College of Radiology):
1. provide accreditation for imaging facilities
The Malcolm Baldrige National Quality Program:
1. provides recognition via annual awards to health care centers that exemplify the Criteria for Performance Excellence
CAP (College of American Pathologists:
1. provide accreditation to laboratories, Biorepository, Reproductive, and Forensic accreditation, advocates to protect patients from surprise medical bills and fighting to
both relieve regulatory burdens for pathologists and eliminate cuts to their reimbursement- lobbies congress
1. accreditor of health and human services including: Aging Services,
Behavioral Health, Child and Youth Services, Employment and Community Services, Vision
Rehabilitation Services, Medical Rehabilitation, and Opioid Treatment Program
1. accrediting body for home and community-based
health care organizations. CHAP has the regulatory authority to
survey agencies providing home health, hospice, and home medical equipment services
CIHQ (Center for Improvement in Healthcare Quality)
1. provides accreditation for a variety of acute care hospital settings and rehabilitation centers
has "Center of Excellence" designation
DNV GL Healthcare
2. general approach
are currently the only accreditation program to integrate the CMS Conditions of Participation
with the ISO 9001 Quality Management Program. In 2015, DNV GL Healthcare was approved by
CMS as only the second national facility credentialing organization for Ventricular Assist Device
(VAD) programs; providing a designation essential to hospitals seeking Medicare
reimbursement for VAD services
2. focus on a continuous QA approach rather than periodic inspections
HFAP (Healthcare Facilities Accreditation Program):
1. survey hospitals for compliance with Medicare Conditions of Participation and Coverage
provides accreditation for mental health and physical rehabilitation centers, clinical laboratories, ambulatory surgical centers. combined with ACHC and now is called ACHC.
IAC (Intersocietal Accreditation Commission):
1. provides accreditation for imaging and cardiac procedure locations
ISO (International Organization for Standardization):
1. sets forth guidance for any company looking to consistently meet customer requirements for services and products- applies these standards to health care.
The joint commission:
1. largest and oldest accrediting organization
provides accreditation for 25,000 health care organizations
NCQA: National Committee for Quality Assurance-
1. what is their method for improving health care quality?
1. NCQA's programs and services reflect a straightforward formula for improvement: Measure. Analyze. Improve. Repeat. NCQA makes this process possible in health care by developing quality standards and performance measures for a broad range of health care entities through measurement, transparency, and accountability. These measures and standards are the tools that organizations and individuals can use to identify opportunities for improvement.
HEDIS® (Healthcare Effectiveness Data and Information Set):
1. what is it?
2. how does it help health care organizations?
3. how many elements of care does it measure?
4. what things does it focus on?
5. reports it produces:
1. a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service
2. gives organizations information they need to compare heir performance to others.
3. 90 measure across 6 domains of care.
4. emphasizes various significant health care issues such as cancer, heart disease, smoking, asthma, and diabetes. Also measures patient satisfaction through the CAHPS survey system
5. State of Health Care Quality report: a comprehensive look at the performance of the nation's health care system
publishes health plan report cards that appear in national publications
The Compliance Team:
2. what does this focus on?
1. The Compliance Team is a nationally recognized accreditation organization providing the Exemplary Provider® branded accreditation services to healthcare providers. This accreditation model features healthcare's first comprehensive sets of plain language, operations-driven, quality standards along with expert led implementation guidance
2. focuses on the three the issues they believe matter most to patients—Safety-Honesty-Caring
1. programs it includes:
2. what do they accredit?
1. Patient Centered Medical Home program, Accountable Care Accreditation, and the Health Utilization Management Accreditation
2. they will accredit both whole organizations and programs within an organization
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