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Why We Chose to Pursue Joint Commission Accreditation

by John Kulin, DO, FACEP

“Why?” That is the question I often get when I tell colleagues about pursuing Joint Commission accreditation for our urgent care center. Many of you might remember Joint Commission from the hospital setting; hospitals were required to be Joint Commission Accredited if they wanted to be paid by Medicare. More important, Joint Commission set a standard for patient quality and safety that the hospitals had to meet.

Well, a few years ago, Joint Commission began accrediting urgent care centers under their Ambulatory Care program. As competition increases for all of us in the health care marketplace, it is important to set ourselves apart from competitors. While we all believe in our center, we need to be able to distinguish ourselves where it counts: patient safety and quality. Achieving Joint Commission accreditation not only helps set us apart with patients and insurers, but it validates and enhances the quality and safety standards we employ.

It also challenges us. Don't get me wrong, I have a great staff. But like a kid in school, we all need to be challenged to do our best, lest we get into a rut and stagnate. When complacency happens in medicine, you’re at risk of providing worse than just poor customer service; you’re potentially risking the health and well-being of thousands of lives.

Accreditation process

The accreditation survey consisted of three straight days of our center facing intense scrutiny. In the midst of this, I began to question my own sanity for undertaking the project. While we saw our normal volume of patients, the surveyor went through our facility with a fine-toothed comb, trying to be as unobtrusive as possible to patient care. She reviewed patient records, human resource files, and policy and procedure manuals, in addition to questioning and observing staff on all of the above. Every medication vial and lab test was inspected and scrutinized. She educated us and, in turn, we educated her.

There were some dark times during the survey process, but also some bright spots. One of my favorite moments occurred during a data session that involved chart reviews related to different areas of patient care. The surveyor would ask me to pull charts related to various issues — we would start with something as simple as a urine culture result, using what is referred to as a tracer methodology. We then reviewed the patient visit, including intake, exam, follow-up, and documentation, as well as post-visit communication of the results to the patient and their primary care providers.

With our cloud-based EMR, I was able to run reports based on her questions and instantly “pull charts” (digital records, of course) for her review. I ran reports for her based on patient demographics, vitals, lab testing, x-ray — essentially every imaginable patient parameter for our practice.

In the end, we passed our survey and became the first urgent care center in New Jersey to receive Joint Commission accreditation in the Ambulatory Health Care Accreditation Program. During those three days, I spent more than 27 hours with the surveyor. My staff and I came away emotionally and physically exhausted, but happy and proud of our performance.

So, returning to the initial, oft-asked question: Why? To prove to ourselves, our community and our competition that our urgent care center is the real deal. That the fruit of our labors have not gone unnoticed. And to push ourselves to another level that we might not have even thought we were capable of achieving.

Dr. Kulin is an athenahealth client and the CEO of The Urgent Care Group, PA in Manahawkin, NJ.

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