Global Health Care, LLC - AAAHC Medical Home Standards and … · 2011. 3. 10. · Tips/hints: Potential challenge: how very rural organizations respond to patient needs for specialty

IMPROVING HEALTH CARE QUALITY THROUGH ACCREDITATION

© 2010 Accreditation Association for Ambulatory Health Care, Inc. All rights reserved.

AAAHCMedical Home Standards

and ProgramsSam J. W. Romeo, MD, MBAMedical Director and Chair of the Medical Home Task Force, AAAHC

-----------------------------------------------------------------------------------

Jim Pavletich, MHA, CAEVice President & Chief Operating Officer, AAAHC

Standards


The AAAHC definition of Medical Home

Services are patient-centered, physician-directed, comprehensive, accessible, continuous and organized to meet the needs of patients servedThe Foundation of a MH is the relationship between the patient, his/her family, and the MH---- (Love, trust, empathy, medical ethics.)MH is the primary point of care for the patient

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Medical Home – broad perspective

The commitment to serving as a Medical Home

---should be express as a part of the organizations Mission, Vision, Goals and Objectives ---should be reflected in the organization’s governance and administrative structures.

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A note about “electronic data management”

“Electronic data management is continually assessed as a tool for facilitating the above- mentioned standards….”

Expectation is that IT (practice management/EMR/communications systems) are in place or appropriately anticipated for future development

The EMR is only a tool supporting the patient and Medical Home

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Medical Home Standards--- Relationship

Relationship:Communication, understanding and

collaborationStandards address:

Respect, consideration, dignity, privacy, confidentialityPatient rights and responsibilitiesPatient satisfaction/assessmentPhysician*-patient communication

* Refers to physician or physician-directed health care team

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Relationship (cont.)

Tips/hints:Accentuation of the added distinction/ attribute of satisfaction to include assessment CAHPS (Consumer Assessment of Healthcare Provider Systems) – AHRQMedical Home is an evolutionary processPatient enrollment process into the Medical Home

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Medical Home Standards--- Continuity of care

The Continuity principles include---Assuring continuity of care across settingsConsultations and referrals and hospitals, PT, OT, etc. cycles are closedClinical record entry documentation

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Continuity of care (cont.)

Continuity is captured in--

Clinical records: Majority of visits to identified provider/teamReferrals/consultations and follow-ups tracked and completedProvisions for after-hours and emergency careHospital/other follow-ups documented

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Continuity of care (cont.)

Tips/hints:

Not all services of a medical group/organization need to follow the Medical Home standards….

Examples: Occ. health, cosmetic services, sports medicine, etc.

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Medical Home Standards-- Comprehensiveness of care

Comprehensive care means---Full scope of services available—either provided or coordinated (primary through quaternary …wellness to prevention to disease management to end of life support) External resources known, utilized and recorded as appropriate

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Comprehensiveness of care (cont.) C

Comprehensive care is captured in---

Documenting evidence of patient education and patient self-managementMedical Home’s knowledge of available community health resourcesReferral/consultation practices and follow-up procedures

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Comprehensiveness of care (cont.)

Tips/hints:

Potential challenge: how very rural organizations respond to patient needs for specialty referral and after-hours servicesCapturing Core primary care services including health education and behavioral health services and after hours care.

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Medical Home Standards Accessibility

Accessibility addresses---Requirement for the Medical Home to have written standards to support patient access, i.e., how to access after-hours care, routine care, etc. Patient satisfaction with, and assessment of, their access to care

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Accessibility (cont.)

Patients access is assured by---

The organization’s written standards for supporting patient access — routine, after-hours, referrals, consults, etc.Patient satisfaction with and assessment of data related to perceptions of access (one must ask before one knows)

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Accessibility (cont.)

Tips/hints/challenges

Geographically isolated facilities may face challenges re: after-hours coverage when clinics close and staff disperse to “the city” and home24/7 coverage with limited staff.

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Medical Home Standards Quality

Quality Improvement address---Assuring physician direction and supervision of patient care teamUse of evidence-based guidelines and performance measures for clinical studiesIncluding studies specifically measuring compliance with the Medical Home standards (Access, continuity, comprehensive care)

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Quality (cont.)

Evidence includesClinical records: who is directing and supervising the patient’s care?

Quality improvement studies:Documentation of meeting the standards

of a satisfactory relationship, continuity, comprehensive care and 24/7 access

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Quality (cont.)

Tips/hints:

Recognize the “added” component of patient satisfaction, i.e., patient assessment – source of QI study?

Example: Why did a patient provide a response of 3 or 4 (on a 5-point scale) to a question re: “access” or “adequate time spent” or “answered your questions,” etc.?

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Cornerstone of the Medical Home!

The cornerstone of the Medical Home is the relationship between the Patient and the Provider/Provider teamThe patient must participate in that decision and have trust, respect, belief, committed & love.The Medical Home team must provide services that offer beneficence, non-maleficence, autonomy, and justice (Medical Ethics) with empathy & love.

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Next Steps

AAAHC offers two ways to be recognized as a Medical Home…

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Next Steps

AAAHC Medical Home Accreditation

Think of AAAHC Medical Home accreditation as the deluxe version - the thorough AAAHC accreditation process, reviewing your organization, your staff, your facility, your policies and procedures and the coordination of your care procedures,

PLUS - Chapter 27 of the AAAHC Accreditation Handbook for Ambulatory Health Care.

This represents the most comprehensive Medical Home survey process available, conducted at your facility by experienced AAAHC surveyors.

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Next Steps

AAAHC MEDICAL HOME ON-SITE CERTIFICATION

Through a pilot program, you can now achieve Medical Home certification without undergoing full AAAHC accreditation.

Our Medical Home certification includes an on-site visit by AAAHC surveyors - the ONLY Medical Home certification program to do so.

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Next Steps

To receive more information on AAAHC’s Accreditation program or the pilot Certification program…

1) Stop by Exhibit Booth #1

2) Visit www.aaahc.org

http://www.aaahc.org/

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Next Steps

At the Exhibit Booth…

Complimentary copies (on CD) of our Accreditation Handbook are available

Taking business cards for free distribution of On-Site Certification Standards

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Next Steps

www.aaahc.org

Contains an On-line Application for Survey that starts you down the road toward either Accreditation or Certification…

http://www.aaahc.org/

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Medical Home

Questions regarding Medical Home?

Documents

Global Health Care, LLC - AAAHC Medical Home Standards and … · 2011. 3. 10. · Tips/hints: Potential challenge: how very rural organizations respond to patient needs for specialty