3.2 Accreditation Standards and Requirements Flashcards
Accreditation is usually a __________process, provided by an _________ organization, in which trained peer reviewers evaluate a healthcare organization’s compliance with nationally accepted standards, as well as the accrediting body’s pre-established performance standards.
voluntary, external
Although accreditation is technically voluntary, it is often________to be eligible to receive reimbursement form Medicare, Medicaid, and many third party payers.
required
___________is also often required by local, state, or federal regulations.
Accreditation
___________is regarded as one of the key benchmarks for measuring the quality of an organization.
Accreditation
An____________body might review the organizational structure, policies and procedures, quality outcomes, performance improvement, patients’ rights, professional improvement, leadership, fiscal operations, and clinical records, as well as compliance with federal, state, and local laws
accrediting
_______________(CARF) standards focus on improved service outcomes, client satisfaction, and quality service delivery.
Commission on Accreditation of Rehabilitation Facilities
Each _________, CARF updates its standards to ensure they are relevant and guide excellent service.
year
As a credentialing body for case management, ________believes that effective case management puts the consumer at the center of all healthcare decisions, and that this is essential to ensuring consumers gets the right _____, in the right____, at the right_______.
URAC, care, setting, time
The ___________________________(NCQA) provides accreditation for healthcare organizations and managed care organizations.
National Committee for Quality Assurance
They also sponsor, support, and maintain a collection of standardized performance measures known as the ______________________(HEDIS).
Health Plan Employer Data and Information Set
The ____________________(NQF) is a not-for-profit, nonpartisan, membership-based organization whose mission is to improve the quality of healthcare.
National Quality Forum
____________________________(QIOs) work under the direction of CMS; they are a group of health quality experts, clinicians, and consumers, organized to improve the care delivered to people covered by Medicare.
Quality Improvement Organizations
The CMS uses __________________or CQMs, to ensure that healthcare systems deliver effective, safe, efficient, patient-centered, equitable, and timely care.
Clinical Quality Measures
____ ________ are standards that have been shown through scientific evidence to improve patient outcomes, and they set the standard for care.
Core Measures
The_____________________________(AHRQ) publishes and disseminates national clinical practice guidelines.
Agency for Healthcare Research and Quality
