Eye on Accreditation: Bob Floro, Director of Home Care Accreditation, Joint Commission

Fast Stats
Phone: (630) 792-5771
Web site: www.jointcommission.org
Approved for: All products and services described in Section 1834(a)(13) of the Act; prosthetic devices, orthotics and prosthetics described in Section 1834(h) of the Act; and items described in Section 1842(s)(2) of the Act.

How does your organization differ from other deemed accrediting organizations?
The integrity with which our accreditation decisions are made is of extremely high value to us at the Joint Commission. We make our accreditation decisions based on data, fact and a compilation of specific issues that are directly observed in the field. Our decisions are made based on our observation of patient care, as opposed to the observation of policies, procedures, practices and processes. The standards and the survey process that we apply to the accreditation product are all developed, devised and created with collaboration within the industries that we serve. The HME industry and the respiratory care industry all have input through both our advisory councils as well as our professional technical advisory committee. In fact, the American Association for Respiratory Care (AARC) actually has a seat on our professional technical advisory council.

We maintain the utmost integrity in our relationships with our organizations and with the consistency in which we award accreditation decisions. You will, for instance, never find a Joint Commission accredited organization that has received consultation from the Joint Commission and then received accreditation. We feel that is a high conflict of interest and we would never do that.

Through our relationship with the industries that we serve, we have created standards and survey processes that are more relevant to the industries than in the past.

How long does it typically take for a respiratory provider to become accredited with the Joint Commission?
The short answer is plus or minus six months. What resources does the organization have to commit to preparing for accreditation and then meeting the intent of the accreditation requirements? Organizations could do it as quickly as three to four months. We find typically they take six to eight months. It also depends on whether they use consulting services or not.

What are the common pitfalls to accreditation?
Organizations that are new to accreditation generally do not understand or embrace continual process improvement and performance improvement processes. We have to teach them about aggregating and analyzing data and then using that data to create process improvement within their organizations. The other issue is almost mechanical in nature. Organizations take a look at the accreditation manuals and they simply hit the wall. They don't know how to approach it. What we attempt to do is give them the resources in terms of personnel that can help them overcome some of those anxieties.

I really want to applaud the respiratory care DME industry because they do have their arms around how to do things right. Folks that are out there providing that level of service to patients, generally speaking, have overcome most of the obstacles and are doing an outstanding job.

What typically is the easiest part of accreditation for respiratory providers?
The technical aspects of providing oxygen, CPAPs, ventilators — most respiratory care companies already have their arms around how to provide that equipment effectively, safely and efficiently. Most respiratory care providers fully understand that it's a collaborative effort between caregivers outside the institutional setting. They are very good technically at providing and matching the patients with the right pieces of equipment and the right services. When we go in and we look at a respiratory company, we don't see many issues with inappropriate pieces of equipment.

What factors should respiratory providers consider when looking for an accrediting organization?
They must make sure that the accreditor is going to bring value to their organization. Simply looking at CMS's quality standards and then charging them to validate that they meet CMS's quality standards is only one component of accreditation. When the organization is looking for an accreditor, they need to make sure that there is an effective return on investment (ROI). A very small organization is going to spend $3,500 with us over a three-year period, and they're going to spend $3,500 with many other accreditors as well. Do they get the same value from those accreditors as they get from the Joint Commission? Can they walk into a hospital, for instance, and generate referrals based on their accreditation status with another accreditor or does Joint Commission accreditation bring them closer to the referral table?

This article originally appeared in the Respiratory Management March 2008 issue of HME Business.

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