Is Your Center Accredited?
How to integrate your patients' high expectations with the new billing considerations.
Mr. Sheppard: Accreditation is on everybody's mind these days. Over the past 18 months, the major commercial payers have begun demanding that facilities be accredited or on the path to accreditation.
Accreditation Gains Priority
Ms. Harmer: When I lecture about accreditation, I start by saying that accreditation is no longer a voluntary project. As far as third-party payers are concerned, it's a deal-breaker. If your facility isn't accredited, then they don't have a reason to start a relationship with you.
Ms. Acker:We talked before about what patients want to know. Well, I have patients ask me every week, "Are you accredited? I'm delighted to say "Yes," and I actually advertise that.
Mr. Brown: Most surgeons advertise that they are board-certified, and this isn't any different. A board-certified physician in an accredited facility says, "This is a quality facility," and that's what patients are looking for.
You May Already Be Ready
Mr. Sheppard: Accreditation is a major undertaking, especially in light of changes in the Medicare Conditions of Coverage. It seems the changes will have a significant impact on the nursing staff, in particular. Major changes are likely for the pre-op, post-op and discharge portions of the encounter, along with a whole series of new standards and conditions relating to quality assurance and performance improvement. What are your thoughts on this?
| As far as third-party payers are concerned, [accreditation] is a deal-breaker. If your facility isn't accredited, then they don't have a reason to start a relationship with you. — Barbara Ann Harmer, R.N., B.S.N., M.H.A. |
Ms. Acker: We're meeting most of these requirements already. If you run your facility to be Joint Commission-accredited, you meet most of these requirements through the Joint Commission guidelines. So I may be naïve, but I'm not terribly worried.
Ms. Harmer: I concur. If you've received certification from any of the major organizations — the Accreditation Association for Ambulatory Health Care, The Joint Commission on Accreditation of Healthcare Organizations or the Association for Accreditation of Ambulatory Surgery Facilities — you'll be fine. The organizations that didn't have to be state licensed or were licensed under dated guidelines might be missing the quality-improvement portion, and they'll need more time to get up to speed. Quality-improvement activities may include a peerreview program, performing quality-improvement studies and benchmarking comparisons, and a risk management program.
Getting certified and following a major organization's guidelines takes time. It's not something you just turn on. It's a maturation process, and there's a certain way that new guidelines and regulations need to be implemented, taught and put into practice. For those of us whose centers are accredited already, the new regulations and interpretation should be a nobrainer. We might be required to provide documentation to an external reviewer, but beyond that, I don't see any real issues.
Organizations Help Facilitate Accreditation
Mr. Sheffler: Accreditation is the way to go, and the way to get there is to join an organization like the Outpatient Ophthalmic Surgery Society (OOSS) or the Ambulatory Surgery Center Association, which was formed Jan. 1, 2008, when the American Association of Ambulatory Surgery Centers merged with the Federated Ambulatory Surgery Association (FASA). I think it's essential for all facilities to be members of organizations like OOSS, so they can see what others are doing and set benchmarks. You can get all the help you need to have a high-quality facility.
Ms. Harmer: Of course, from a nursing perspective, I'll cheerlead for the American Society of Ophthalmic Registered Nurses (ASORN). It's a professional networking advantage, and it offers education programs and materials, such as a book on core curriculum for ophthalmology.
| ASC Pearl: Networking Networking, joining organizations and generally raising your head above the trees to see what other people are doing is stimulating and enlightening. I've learned so much from other people, and there are so many new things to learn. If you get caught up in your own business too much, it really hurts your own clinic. Join the organizations, get accredited and go to the meetings. It's all very much a part of running a quality institution. — Lou Sheffler, C.O.O., American SurgiSite Centers |
| Does Your Staff Need More Training? Mr. Sheppard: For some surgery centers, preparing for accreditation may mean educating some clinical staff to a higher level. And once you're accredited, you need to maintain it as the standards evolve, which may mean keeping clinical staff abreast of new information. Where can clinical staff directors find training for themselves and their staff? Ms. Harmer: The challenge for many organizations is to make sure they direct their staffs to the appropriate resources when they can't do the training internally. A good deal of coursework is available online. I recommend starting with ASORN. Ophthalmology is its business. That said, although there are plenty of wonderful online experiences available, quality management improvement training is one area that I highly recommend learning face to face. You have to send people out of your facility for this experience. Mr. Brown: You also should talk to your vendors. They have a wealth of information, and they can bring their experience at other centers into your facility. So never forget them. |
Ms. Acker: When I first started in my role as CEO at Blake Woods, I belonged to OOSS and FASA. They practically did my homework for me. I could call and ask them anything, and they'd tell me. ASORN is the same way. ASORN sends a list of FAQs through e-mail every month, and there's always something that makes me think, "Wow!" or "Here's how we'll do this." I'm actually networking via the computer to get answers to everyday matters, and I have the opportunity to pick the brains of the best resources out there in mere minutes.
Mr. Sheppard: All of this is excellent advice regarding accreditation. Now, let's take a look at how to enhance your ASC and ensure its continued growth. OM
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