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Health Advocacy > Quality Care and Accreditation > Flashcards

Quality Care and Accreditation Flashcards

1
Q

What are the characteristics of quality care?

A 
STEEP
Safe
Timely
Effective
Efficient
Equitable
Patient-centered
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2
Q

what is the pts perspective on quality care?

A

seen as a critique of a society with very set class systems and ideals

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3
Q

what is the clinicians perspective on quality care?

A

seen as a critique of a society with very set class systems and ideals

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4
Q

what is the management perspective on quality care?

A

seen as a critique of a society with very set class systems and ideals

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5
Q

what is the insurers perspective of quality care?

A

seen as a critique of a society with very set class systems and ideals

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6
Q

what are other aspects of quality care?

A

Structure, Process, Outcome

Patient/Client Satisfaction

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7
Q

what is the Intent of the HCAHPS/HHCAHPS (hospital & home health)?

A

Provide a standardized survey instrument and data collection methodology for measuring patients’ perspectives on care

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8
Q

what is asked in the HCAHPS/HHCAHPS survey?

A

questions about critical aspects of patients’ experiences
i.e. Communication with nurses and doctors, responsiveness of staff, cleanliness/quietness, pain management, communication about medicines, discharge info, overall rating, would they recommend

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9
Q

what is accreditation?

A

process which an institution/educational organization seeks to demonstrate that it complies with generally accepted standards

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10
Q

how is the process of accreditation regulated?

A

voluntary, self regulatory

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11
Q

what is the goal of accreditation?

A

Sets and promotes standards viewed as indicators of quality care

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12
Q

what does accreditation provide?

A

Performance measured against predetermined standards

Gives official recognition to sanction, authorize to certify or guarantee meeting required best practice standards

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13
Q

when is accreditation required?

A

to qualify for some reimbursement (e.g. Medicare), successful completion of the accreditation process may be required (Joint Commission)

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14
Q

what are the steps to get accredited?

A
  1. Site requests accreditation survey (initial visit, then f/u visits, on 3 year cycle)
  2. Site self-assesses against standards developed by accreditation agency, identify strengths/weaknesses
  3. Site implements plan to improve weakness
  4. On site accreditation visit (survey) conducted. F/U visits unannounced (Joint Commission) or scheduled (CARF) depending on agency
  5. During the accrediting visit, agency rates performance/compliance
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15
Q

who does CARF International accredit?

A

non-profit agency
Accredits programs in adult day care, assisted living, mental /behavioral health, community agencies, medical rehab facilities

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16
Q

How odes CARF International accredit rehabs?

A

Surveys and accredits rehab facilities via a peer review team, according to comprehensive, outcome driven rehab standards

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17
Q

how is CARF committed to quality care?

A

development of performance indicators which lead to EB outcomes

program evaluation

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18
Q

what is the goal of CARF international?

A

Established to assist consumers in identifying quality rehab programs and services

19
Q

what other body contributed to standard development process?

A

AOTA

20
Q

what is a 3-year CARF accreditation?

A

Organization satisfies all Accreditation Conditions & demonstrates conformance to all standards

21
Q

what is a 1-year CARF accreditation?

A

Organization satisfies Accreditation Conditions & conformance to many standards. Although deficiency in relation to the standards, there is evidence of commitment to progress and correction

22
Q

what is a provisional CARF accreditation?

A

Following the expiration of a One-Year Accreditation, awarded to organization that is still functioning at a One-Year Accreditation

23
Q

what is a CARF nonaccreditation?

A

Organization has major deficiencies in standards, & serious questions of benefits of services; serious questions of health, welfare, or safety of served; failed to conform to standards; or failed to satisfy Accreditation Conditions

24
Q

what is CARF preliminary accreditation?

A

Allows new organizations to est use of standards prior to direct services. Evidence of likelihood that the services will benefit the persons served. A full follow-up survey conducted 6 months after initiation of services

25
Q

who does the joint commission accredit?

A

health care organizations, including hospitals, home health agencies, long-term care facilities, assisted living programs, ambulatory care providers, laboratory services

26
Q

what is the goal of the joint commission?

A

ensure quality of care via `performance improvement process, National Patient Safety Goals and identification and prevention of sentinel events and development of program standards

27
Q

what is the purpose of National Patient Safety Goals (NPSG)?`

A

Promote specific improvement in patient safety

Highlight problematic areas in health care delivery and offer EB solutions

28
Q

what is a sentinel event?

A

“unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof; require need for immediate investigation and response “

29
Q

what are examples of sentinel events?

A

Patient death
Paralysis, coma or permanent injury due to medication error
Wrong site surgery;
Patient commits suicide within 72 hours of being d/c from a hospital setting providing around the clock care

30
Q

what are the joint commission standards?

A

Separate standards for Hospital, Ambulatory Care, Behavioral Health, Home Care and LTC

emphasis on pt safety, quality of care, performance improvement

31
Q

How Might an OT Dept Demonstrate Compliance with this competence to perform standard?

A

Development of job descriptions, initial and annual competency checklist, quarterly monitoring of staff competency via staff chart audits, compliance audits, observation, peer feedback, patient incident
Annual OT competency reassessments to include observation of specific skills related to high volume, high risk procedures
Inclusion of OT competency assessments on annual performance evaluations

32
Q

How Might an OT Dept Demonstrate Compliance with on going education standard?

A

Develop annual OT competency in-services on environment of care, infection control, age-specific competences, NPSGs
Survey OT staff on learning needs and based on survey results, develop inservice training modules.
Institute tracking system for all in-services OTs attended, including how they relate to learning needs assessments

33
Q

what does a joint commission unannounced full survey provide?

A

credibility of the process
Make the accrediting process more continuous
Includes document review, interviews, facility inspection and observation of care
Provide safe, quality care at all times not just for survey preparation

34
Q

what does joint commission “tracer methodology” provide?

A

Maps out/follows care to an active patient
Seeks to answer whether the care being provided is

Consistent with practice standards, organization’s polices, medical record

35
Q

what occurs during the tracer?

A

Observe actual care given
Review medical record of patient whose care was observed
Interview providers of care identified in medical record

36
Q

what care does the tracer look for?

A

Environment of care, infection control, staff communication about patient, compliance w/ written policies and procedures

37
Q

what does the tracer look for in medical records?

A

Legibility, timeliness, accuracy, compliance w/ written policies and procedures

38
Q

what does the tracer look for in the personnel files?

A

Credentials, orientation, competency assessment, review timeliness and content of performance evaluation

39
Q

what is joint commission preliminary accreditation?

A

Health Care Organization (HCO) demonstrates compliance w/ selected standards used in the surveys conducted under the Early Survey Policy

40
Q

what is joint commission accreditation?

A

HCO compliant w/ all standards at the time of the on-site survey or has successfully addressed all requirements for improvement

41
Q

what is joint commission accreditation with follow-up survey?

A

HCO is not in compliance w/ specific standards & requires follow-up survey w/in 30 days to 6 months

42
Q

what is joint commission contingent accreditation?

A

HCO fails to successfully address all requirements of the Accreditation w/ Follow-up Survey decision. In most cases, a follow-up survey in 30 days will be required

43
Q

what is joint commission preliminary denial of accreditation?

A

Justification to deny due to: threat to health or safety for pts; failure to resolve requirements of Accreditation w/ Follow-up Survey status after 2 opportunities; failure to resolve requirements of Contingent Accreditation status; noncompliance w/ Joint Commission.

decision subject to review/appeal before determination to deny accreditation

44
Q

what is joint commission denial of accreditation?

A

HCO has been denied accreditation. All review & appeals have been exhausted

Health Advocacy (9 decks)

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