...The Joint Commission on Accreditation of Healthcare Organizations, JCAHO, is a not for profit professional standard setting agency that was founded in 1951. It was formed to determine compliance with standards designed to ensure quality care to patients. The JCAHO early standard requirements reflected a minimal standard of care. Later it expected hospitals to strive for the highest quality standard of care. In the late 1980’s the JCAHO developed the indicator measurement system . These indicators focused on the outcomes of clinical care rather than standards of the hospital processes and departmental structures. In 1998 the JCAHO required hospitals to submit intra hospital outcome measures . The JCAHO reviews healthcare facilities, policies and procedures, training, competency and formulary. It reviews the pharmacy practice, drug use and records of a health care system. The JCAHO reviews for compliance and changes in regulations. It makes recommendations and can change or upgrade its standards for hospital, pharmacies or other health systems. It conducts these reviews every 3 years and may conduct random inspections if they get a complaint. In an attempt to change the perception of it’s reviews as a 3 year event, the JCAHO also conducts random reviews to ensure that standards are being met everyday and not just during scheduled reviews. The JCAHO reviews and accredits many health care organizations, but mostly home care organizations. JCAHO expects quality and...
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...Achieving and Maintaining Accreditation in Managed Care Name: Institution: Devry Table of Contents Introduction………………………………………………………………………………………3 Background……………………………………………………………………………………….3 Importance of accreditation…….………………………...………………………………………3 Accreditation Bodies……………………………………………………………………………...4 Literature review………………….…………………………………………………………….....4 Challenges that are experienced in achieving and maintaining accreditation…………………..…5 The role of the URAC as an Accreditation Body………………………………………………....5 How the URAC accredits healthcare institutions….........................................................................6 Quality assessment and control solutions in accreditation ……………………………………......8 Implementation of quality improvement and accreditation solutions…………………………......9 Justification…………………………………….…………………………………………………10 Summary and conclusion……………………….…...……………………………………………10 References ………………………………………………………………………………………..11 Achieving and Maintaining Accreditation in Managed Care Managed healthcare organizations and professionals encounter numerous challenges on a yearly basis in the course of offering services, whereas the state, stakeholders, and clients (patients) expect to be reassured that bodies that render managed healthcare services are well equipped to meet their demands. Accreditation is, therefore, a detailed evaluation process through which an independent professional...
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...Accreditation Options There are a variety of accreditation options that a medical management committee could choose from when considering their options for their healthcare organization to participate in. One consideration is whether to participate with a regionally or nationally accredited organization. Committee looking at their options are not only concerned about the healthcare organization. The patients they serve are also very important, as their expectations of the accreditations that are held by the organization they receive care in must be considered. The cost of the accreditation organization’s services, and what each bring to the table in terms of their processes and communication they deliver is vital. As of last year there are four accreditation options that are nationally recognized organizations that healthcare organizations can choose from if they are concerned with proving and demonstrating their compliance with the Medicare conditions of participation, they are: the Center for Improvement in Healthcare Quality, the Joint Commission, the Healthcare Facilities Accreditation Program, and Det Norske Veritas Healthcare Inc.,’s program (Thompson, 2013). Healthcare organizations must consider their needs when determining which nationally accredited organizations to enter into agreements with. Thompson (2013) states, “The Joint Commission dominates the field. In 2010–11, the report states, 90% of hospitals with so-called deemed status obtained it from the Joint Commission...
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...Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Sandy Markert HCS/212 March 31, 2013 Corinne McTier Joint Commission on Accreditation of Healthcare Organizations (JCAHO) The Joint Commission on Accreditation of Healthcare Organizations or JCAHO was founded in 1951 as a private nonprofit organization that established guidelines for the running and management of hospitals and health care facilities in the United States. According to its website (n.d.), JCAHO’s primary mission is, “To continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.” Through its onsite surveys, JCAHO accredits approximately 20,000 healthcare programs and facilities each year nationwide. The groundwork for the establishment of JCAHO began in 1910 when Ernest Codman, M.D. recommended an “end result system of hospital standardization” (The Joint Commission, n.d.), a process in which patients were tracked to determine if the treatment they received while in the hospital was successful or not and thus could be used to treat similar cases. In 1913 the American College of Surgeons (ACS) was established and adopted Dr. Codman’s “end result” system and by 1918 it began inspecting hospitals. These initial surveys determined that only 89 of the 692 facilities it inspected at the time met the minimum...
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...abbreviation for Joint Commission on Accreditation of Healthcare Organizations is a non-for-profit organization that seeks to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations. It is an organization made up of individuals from the private medical sector to develop and maintain standards of quality in medical facilities in the United States. Although JCAHO has no legal enforcement power, and has no official connection to the US Government regulatory agencies, many medical facilities rely on JCAHO accreditation procedures to indicate to the public that their particular institution meets quality standards”(JCAHO). JCAHO and its policies have taken on a real importance in the medical field, despite the lack of official government sanction. The Joint Commission is an independent, private sector in the United States that administers accreditation programs for hospitals and other healthcare-related organizations. The Commission develops performance standards that address crucial elements of operation, such as patient care, medication safety, and infection control and consumer rights. Most state governments require that healthcare organizations be accredited by the Commission as a condition for licensing and Medicaid reimbursement. JCAHO evaluates and accredits approximately 18,000 health care organizations, including hospitals; ambulatory...
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...Regulatory Agency Paper University of Phoenix HCS 430 October 22, 2012 This paper will better inform how the Joint Commission Accreditation of Healthcare Organizations (JCAHO) came into existence. The JCAHO is responsible for the accreditation of healthcare organizations nationwide. JCAHO’s goal is to ensure that specific guidelines are meet and that the organizations operate in a safe manner for their patient’s and its employees. The Joint Commissioned Accreditation of Healthcare Organizations (JCAHO) came along side of the American College of Surgeons (ACS) which established its program in the early 1900’s until 1952. This agency was responsible for on-site inspections of hospitals. Only a few hospitals meet the requirements of the minimum standard. The start up of JHAC was governed by Arthur W. Allen who sat on the chairman of the American College of Surgeons (ACS) (Saulf, 2005). In 1952 the ACS officially transfers its hospital Standard Program to JHAC this was the start of hospital’s accreditation. In 1953 JHAC publishes their standards for hospital accreditation. As time moves on congress passes the social security amendments in 1965 making this one of the hospital’s provision to be in compliance with the Medicare conditions for the hospital’s to participate in the program. In 1971 the accreditation for long term care is established. The social security act amended that the Secretary of the U.S.Department of Health and Human Services (DHHS) validate JHAC findings...
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...December 24, 2010 Commission on Accreditation of Healthcare Organizations In today’s world there are many industries affected by the tough economical times. However, the one industry that has not been drastically affected is the health care industry. No matter how many industries suffer from layoffs and budget cuts, the health care industry will always be safe. People will always need health services and procedures regardless of the current happenings of the world. But what if the health-care industry had no rules to follow and could choose to exercise any liberties wanted? What if there was no standard operating procedure? The health care industry could charge any price for any service renderable and patients/consumers would have to pay those rates. Besides with health care, who else would a patient turn to for care? Potentially having no laws for health-care could be a nightmare. Thank goodness, there are standard rules and regulations in place to ensure the health care industry provides proper treatment to patients with good customer service as well. The organization most widely recognized which governs hospitals and provides guidelines for standard operating procedure is The Joint Commission (TJC) formerly known as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The Joint Commission is a United States bases non-profit organization that offers accreditation programs for a fee to subscriber health care organizations and hospitals. Because of the...
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...Regulatory Agency Regulatory agencies ensure health care practitioners and facilities promote safety, legal compliance, and quality patient services. If health care were not regulated of if accreditation were not required patients would not have a sense of comfort and safety. The regulatory agency the Joint Commission on the Accreditation of Healthcare Organizations commonly known as JCAHO, which “conducts periodic on-site surveys to verify that an accredited organization substantially complies with Joint Commission standards and continuously makes efforts to improve the care and services it provides” (The Joint Commission, 2010, p. 3). The JCAHO ensures that health care providers and facilities are maintaining the required standards of care in place by the regulatory agency. JCAHO is constantly improving the quality and safety of care provided in any health care facility. History of the Joint Commission of Health Care Organizations In 1910, Ernest A. Codman, M.D., found that many health care practitioners were practicing medicine that was outside their scope of training. It was then that he “proposed the end result system of hospital standardization. Codman thought that if hospitals were to track every patient and the patient were treated long enough it could be determined whether the treatment was effective and use the results to improve care” (2010, A Circular Century, p. 26). In 1913, the American College of Surgeons (ACS) was established and by 1917, the...
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...The role of the Joint Commission Accreditation is a process in which an entity, separate and distinct from the health care organization, usually non-governmental, assesses the health care organization to determine if it meets a set of standard requirements designed to improve quality of care. In other words, an accrediting body is an independent 3rd party that measures and rates the regulations, safety guidelines, and practices of a service or business—in this case, medical facilities. Think of it as a stamp of approval verifying the authenticity and quality of services. A restaurant in the US can’t open unless it passes certain health inspection codes, and a lawyer can’t begin practicing until he or she has passed a qualifying exam. The same is true with medical practitioners and facilities. They must demonstrate to accrediting bodies that they possess the personnel, resources, training, experience, and regulatory understanding to provide quality medical treatment to patients. Hospitals that lack accreditation are hospitals worth avoiding. However, JCAHO is not the only accrediting organization out there. There are agencies that focus on region, specialty, and country (healism.com). Which facilities can be accredited Joint Commission for the Accreditation of Healthcare Organization (JCAHO) has been accrediting Managed Care Organizations for more that 10 years. The Joint Commission network organizations throughout the United States, including...
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...Assignment 1-2: Accreditation by the Joint Commission Using a current Joint Commission Manual for any of the Joint Commission’s (JC) accreditation programs and the JC’s Website (www.jointcommissions.org) respond to the following questions. 1. List the accreditation programs and the types of facilities accredited by each accreditation program. * Ambulatory Care Accreditation Program – This accreditation program was established in 1975. Organizations accredited by this program are free standing ambulatory care organizations like surgical, medical/dental and diagnostic/therapeutic services in a variety of settings like, ambulatory surgery centers, military clinics, recovery care/short stay, sleep centers, teleradiology, telemedicine diagnostics, etc. Currently there are approximately 1,900 such organizations. In addition there is the Primary Care Home Medical Certification for Joint Commission accredited ambulatory care organizations. This certification focuses on care coordination, access to care, and how effectively a primary care clinician and interdisciplinary team work in partnership with the patient (and where applicable, their family). * Behavioral Healthcare Accreditation Program – This accreditation program began in 1975. Organizations providing services for people with developmental and intellectual disabilities, mental health and chemical dependency. Some of these organizations are: Addictions Center, Crisis Stabilization (24-hour acute care setting), Outdoor...
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...Quality Oversight in Health Care Organizations HCA 497 Ms. Gloria Wilson September 17, 2012 Introduction A considerable amount of emphasis has been placed on the quality that is provided by the US health care system and substantial investments have been made for research to address the concerns that relate to health care quality. Promoting quality of care is essential for every person within healthcare organizations, from top-level management to non-clinical personal. The quality of care that is provided by every health organizations is not only the core of the whole health care industry, but the reputation of each health care organization (Baily, M., Bottrell, M., Lynn, J. & Jennings, B., 2006). According to the Institute of Medicine quality can be defined as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (Jost, 2003). The oversight of quality in healthcare is acknowledged as a main obligation to healthcare organizations. The purpose of this paper is to discuss organizations and or agencies that provide quality oversight; in addition to, other stakeholders and the role they play in health care. Joint Commission for Accreditation of Healthcare Organizations The Joint Commission for Accreditation of Healthcare Organizations is a, not for profit organization that was established in 1951and evaluates and accredits more...
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...Healthcare Regulatory Paper Joint Commission in Prisons Rein Denise Fox 06/04/2012 The health care industry has to have a good leadership foundation to carry out rules, regulations, and procedures. It is important for the success of any organization. In a healthcare organization, good leadership is more than just important; it is significant to the organization’s success. The Joint Commission is an organization which requires that the health care industry provides and maintains a safe environment for patients. If the health care industry does not have good leadership, the industry will suffer the consequences and not meet standards. The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) monitors health care organizations and ensures the facilities meet standards and then awards the facilities with accreditation. When the health care facility does not meet standards of JCAHO then the public will ponder on accreditation status and if the health care facility meets quality service; as well as standards of a safe environment. The paper will include the history of JCAHO, source of authority, structure, responsibilities, and its effects on health care. The paper will also include an example of the agency which carries out JCAHO duties. The Joint Commission was founded in 1951 and the organization’s mission is providing appropriate health care for the public, by evaluating, and inspiring the organizations to surpass in providing secure and valuable care...
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...1 CH E S EME NC © National Health Insurance Scheme ISBN 978 2397 24 5 REVISED October 2012 2 TABLE OF CONTENTS Foreword Acknowledgement Introduction Definition of Key Terms SECTION ONE (PROGRAMMES) * Introduction * Formal Sector Social Health Insurance Programme * Definition * Roles and responsibilities of Healthcare Facility under the Formal Sector Social Health Insurance Programme * Roles and responsibilities of HMO under the Formal Sector Social Health Insurance Programme * Roles and responsibilities of NHIS under the Formal Sector Social Health Insurance Programme * Organization of Health Services * Guidelines For Public Sector And Organized Private Sector * Membership * Contributions * Waiting Period * Scope of Coverage * Registration of Employers and Employees * Rights and Privileges of Beneficiaries * Procedure for change of primary healthcare provider/addition of dependants. Guidelines For Armed Forces, Police And Other Uniformed Services * Definition * Membership * Contribution * Scope of Coverage Benefit Package (Formal Sector Social Health Insurance Scheme) * Primary Healthcare Level * Secondary Healthcare Level * Tertiary Healthcare Levels * * * Exclusions For...
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...Kinder International Healthcare Consultancy Pvt. Ltd. KIHC Service Provision in Management Consultancy NABH accreditation consultancy Develop SOPs, Policies, manuals etc. Organization assessment audit Business process re-engineering Operational and Retainer Management Consulting Hospital Setting up - Women and Children Care o Conceptualization o Designing and Implementation o Staff Recruitment o Commissioning Kinder IVF o Centre design and setting up o Kinder IVF Protocols o Staff Recruitment o Quality Management NABH accreditation consultancy We are continually seeking ways of improving our services to our valued customers in all business processes by expanding our overall service and now with the addition of “Quality Consultancy Service”. We guarantee quality assurance of an organization by ensuring that the structure, processes and outcomes of the organization are commensurate to the needs of the national and international accreditation norms. Our strength is systematic and working approach of which each steps is bounded by a predefined time scheduled time frame systematic working approach with high level of quality outcome. frame. As a result achievement of the accreditation within a guided by Page 1 of 4 To help the clients to achieve Quality Accreditations as a bi‐product of improvements in service quality, KIHC provide following scope of services: Perform initial Assessment of existing policies, standard operating procedures, processes and infrastructure...
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...TUI University Michael Reeves MHM505 – Introduction to Quality Assurance Module 1 Case Quality Assurance (QA) can be defined as those activities that contribute to designing, mentoring and the improvement of quality healthcare. In defining the quality we need to develop the standards that will be used to measure the effect of the quality of work we are striving towards. The standards does not have to be clinical it can be administrative, good standards are usually reliable, realistic clear and valid. With the amount of medical mishaps that we experience on a daily basis it is very important that we have a quality Assurance team in place. In fact an entire department should be available just to focus on quality operation within the hospital. With a solid quality assurance program I know that a hospital will be able to save even more money and resources by avoiding law suits that arise from malpractice. I would base my argument on areas such as communication, situational awareness and the importance of quality patient care. In my opinion the aspect of quality assurance that is most important is safety, this falls in the range of focusing on the patient or putting focus on the system or even the processes that are in place. It is obvious that the purposes of health care services are to generate customer satisfaction and operate with the least amount of money possible. Focusing on the client does...
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