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Managed Care-Accreditation

Managed Care-Accreditation

Sample Answer 

Managed Care-Accreditation

The Purpose of Accreditation

The purpose of accreditation for healthcare organizations is to provide a benchmark for measuring the performance of the organization in terms of adherence and compliance to healthcare regulations and laws and keeping up to date with the current industry standards. Research shows that the process of accreditation has improved the general quality of care in most healthcare facilities (Alkhenizan & Shaw, 2011; Desveaux et al., 2017). In particular specialty areas, accreditation programs have been said to improve patient outcomes. The accreditation process can influence quality through coherence, collective quality improvement action, and organizational buy-in (Desveaux et al., 2017). Accreditation could make patients feel safer in the hands of a healthcare organization due to the credibility that comes with it. An accreditable organization usually acknowledges the basic human rights of patients. Some of the key features of an accreditable organization include the treatment of patients with the utmost respect, dignity, and consideration, providing appropriate privacy to patients, and treating patient records and disclosures in confidentiality, hence giving patients the opportunity to refuse or approve the release of records except when such records are required by law. The main purpose of accreditation is to assure the safety and quality of patients. With a focus on the quality and safety of patients, there is no doubt that accreditation has enhanced the quality of care.

The Process of Accreditation

Accreditation Association for Ambulatory Health Care is a private, non-profit organization formed in 1979 (Primary Care Collaborative, 2012). It is a leader in developing standards to promote and advance patient safety, value for ambulatory healthcare, and quality of care through peer-based accreditation research, education, and processes. A certificate of accreditation is usually awarded to organizations that have been found to be in compliance with the AAAHC standards. The accreditation process involves a survey conducted by the AAAHC on organizations. Organizations need to confirm that they are eligible for a survey: the organization has been providing healthcare services for a minimum of 6 months before the survey, is in compliance with applicable state, local, and federal regulations and laws, and is either a legally constituted or formally organized entity that mainly provides healthcare services (AAAHC, 2016). An organization should then review the types of surveys that are available and apply for an on-site survey. Payment and survey scheduling should then be done, and pre-survey responsibilities and preparation of the applicant organization done. Once the survey is done, the organization is notified in relation to the accreditation decision. The AAAHC Accreditation Committee reviews the information collected during the survey, and once the organization is found to have been in compliance with applicable standards, it is given a 3-year accreditation.

Standards to be Met

A survey of the ambulatory care organization is usually conducted by surveyors who have been chosen by the AAAHC. These could be dentists, pharmacists, physicians, and ambulatory healthcare facility administrators, among others. Some of the standards that need to be met include the following: In terms of quality improvement, the organization needs to demonstrate that continuous improvement takes place by conducting quality improvement studies with data collection showing an improvement in quality (AAAHC, 2020). An accreditable organization must maintain active, organized, integrated, and peer-based quality improvement (AAAHC, 2016). Secondly, the organization needs to have a written risk management program or policies. Thirdly, suppose a patient’s specialty or primary care provider or the healthcare organization is located in a different place. In that case, timely summaries, as well as pertinent records necessary for the continuity of patient care, need to be available (AAAHC, 2020). Fourthly, the organization needs to have safeguards in place to safeguard patients and others from cross-infection. The organization needs to provide healthcare services while complying with safe practices for staff, patients, and others, and the program needs to control and prevent infections and any communicable diseases and offer a sanitary and safe environment of care (AAAHC, 2016). Lastly, the administration controls, procedures, and policies adopted by the governing body need to be implemented to facilitate the efficient and orderly management of the organization (AAAHC, 2020). These standards are very rigorous and comprehensive, outlining all the relevant information and expounding on information that needs further clarification.

Survey Results

As long as the AAAHC presently accredits the network organization, the organization may advertise or employ “accredited by AAAHC” marks in order to inform its clients as well as the general public about the accreditation status (AAAIHC, 2016). The AAAHC maintains a searchable list of presently accredited organizations on its website. Representation of the AAAHC accreditation to the public needs to accurately reflect the AAAHC accredited organization. This information is made accessible to the general public, third-party payers, medical organizations, patients, managed care companies, state and federal agencies, and insurance companies.

The knowledge of the information on accreditation could be particularly beneficial to patients as it gives them a sense of safety. The rigorous and comprehensive manner in which the AAAHC conducts its surveys makes a successfully accredited organization highly credible and trustworthy. According to the AAAHC (2010), the credibility that comes with accreditation from the AAAHC is beneficial to organizations since patients are very savvy and often ask if an organization is accredited. Since an accredited organization is linked to high safety and quality of care, patients tend to trust them more.

References

Accreditation Association for Ambulatory Health Care (AAAHC). (2010). Introduction. Retrieved from http://www.youtube.com/watch?v=xu-Ffub6WHk

AAAHC. (2016). Accreditation Handbook for Ambulatory Health Care. Retrieved from https://www.castleworldwide.com/idev/guidelines/ccnresources/AAHC%20Accreditation%20Handbook%20for%20Ambulatory%20Health%20Care%202016.pdf

AAAHC. (2020). Moving Forward with Enhanced Standards. Retrieved from https://www.aaahc.org/wp-content/uploads/2020/07/Moving-Forward-with-Enhanced-Standards-Webinar-Slides_Final.pdf

Alkhenizan, A., & Shaw, C. (2011). Impact of accreditation on the quality of healthcare services: a systematic review of the literature. Annals of Saudi medicine31(4), 407-416.

Desveaux, L., Mitchell, J. I., Shaw, J., & Ivers, N. M. (2017). Understanding the impact of accreditation on quality in healthcare: a grounded theory approach. International Journal for Quality in Health Care29(7), 941-947.

Primary Care Collaborative. (2012). Accreditation Association for Ambulatory Health Care, Inc. Retrieved from https://www.pcpcc.org/executive/accreditation-association-ambulatory-health-care-inc#:~:text=The%20Accreditation%20Association%20for%20Ambulatory,processes%2C%20education%2C%20and%20research.

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Question 


Managed Care-Accreditation

Watch the following video in preparation for this assignment:

Accreditation Association for Ambulatory Health Care (AAAHC). (2010). Introduction. Retrieved from http://www.youtube.com/watch?v=xu-Ffub6WHk

Use what you learned from the video, the module’s required readings, and your own research to answer the following questions in your paper.

  1. Discuss the purpose of accreditation. Has the process of accreditation really improved the quality of care being provided to patients?
  2. Identify and discuss the process of accreditation for the chosen agency.
  3. Discuss some of the standards they look for when they go on-site. Are the standards rigorous or vague?
  4. Do these agencies make the results of their surveys public? How could knowing this information be beneficial to patients?

Length: Submit a 3-page paper.

Managed Care-Accreditation

Managed Care-Accreditation

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