The importance of being accredited

Friday, August 31, 2007

LAKE FOREST, Calif. - The accreditation requirement associated with national competitive bidding has sent hundreds of providers scrambling to sign up for surveys. Not Apria Healthcare. Eighteen years ago, the Lake Forest, Calif.-based national provider, then known as Homedco, was the first to seek and obtain accreditation from the Joint Commission; it has remained accredited ever since. Earlier this year, as part of renewing its accreditation, Apria underwent 125 unannounced site visits in a 77-day period and scored in the 95th percentile--"a big feat," says Lisa Getson, Apria's executive vice president of government relations, investor services & compliance. Getson spoke with HME News recently about the importance of being accredited.
HME News: Why has accreditation always been such a priority at Apria?
Lisa Getson: The senior management team felt then and the senior management team feels now that accreditation is a very important part of our overall culture and business; that it has contributed to performance improvement and quality improvement at the company; and especially in the early years, when there were few other providers who were accredited, that it is a real differentiating factor.
HME: How has accreditation contributed to performance and quality improvement?
Getson: A big part of the Joint Commission's approach is ensuring that organizations have improvement processes in place. It wants to see where you started, what steps and actions you took to improve, and the end result. A great example for us is the resolution of patient concerns. Since we serve millions of patients, it's not uncommon to have a few who are dissatisfied. Formerly, we had a manual process of tracking concerns at the local level, which was rather inconsistent. First, we made that process consistent and then we automated the process. Now it records concerns in a database and issues automatic e-mails to the managers who need to resolve the concerns. That has led to higher levels of patient satisfaction scores.
HME: How does Apria make sure its 500 branches are up to speed with all of the company's policies and procedures?
Getson: We have audit and preparation tools and checklists to help branch managers make sure they have everything in order. Then they have regional and division clinical managers to support them (We have three divisions and 15 regions). The regional and division clinical managers take the lead in making sure all the branches complete any tools and checklists. We've also put together different modules on infection control, patient safety and other components, so rather than just delivering a six-inch binder to every branch and saying, "Here, read this," we have a lot of facilitated education.
HME: What does Apria have to work on, based on the results of its most recent site visits?
Getson: In the homecare environment and with a multi-site operation and thousands of employees, there are going to be a few areas that continue to need improvement. For example, Apria happens to do a lot of liquid oxygen, and employees who provide liquid oxygen need to take extensive safety precautions. Occasionally, a surveyor may observe an employee not using gloves. Or they might observe an employee washing his hands but not for the full length of time prescribed by the policy. Inevitably, someone gets nervous and doesn't follow the procedures.
HME: Does Apria support CMS's plan to require accreditation of all providers?
Getson: Yes, we believe it will level the playing field among providers of all sizes. We don't believe providers' objections that it is either too costly or too difficult for them. Whether you're with the Joint Commission, ACHC or CHAP, the fees and the time needed to prepare and stay in compliance are on a sliding scale based on size. To say that only large companies can afford accreditation is inaccurate and a disservice to the patients who are being served by all other-sized providers.
HME: Do you sympathize with providers who are scrambling to get accredited so they can participate in competitive bidding?
Getson: They've had three year's notice--it's called the MMA of 2003.