CHAP offers private duty standards
CHAP offers private duty standards
While the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, surveys private duty agencies under its home health guidelines, the Community Health Accreditation Program (CHAP) has standards specific to private duty. (For information about what the Joint Commission is seeing in its surveys of private duty agencies, see story, p. 79.)"Private duty seems to be the area where people are most likely to go into the business when they haven’t had home care experience," says Terri Ayer, MS, RN, CNAA, president/COO of the Community Health Accreditation Program in New York City. "Sometimes they think it’s easier, and it’s not."
Surveyors see these problems in their private duty surveys, she says:
• Agencies cutting corners in checking employee references and in making sure aides have the right experience.
"Getting staff is a big problem because of the shortage of home health aides. CHAP comes down strongly on appropriate training and education for the staff. We also emphasize the importance of matching the skills of the employee to the needs of the patient."
• Lack of policies and procedures.
"A lot of private duty agencies tend to have an informal structure since much of it is not regulated," explains Ayer. "One of the things we help agencies do is put systems into place so they operate their business in a more effective and efficient way. We don’t care whether they buy their policies and procedures or whether they create their own as long as the agencies have them and they’re following them, and the staff know what they are. We also encourage organizations to do criminal records checks, but it’s not a requirement yet."
• Lack of backup systems.
If backup systems aren’t in place, that can create staffing problems, says Ayer. "What’s the backup system if someone calls in sick? Or what’s the system if you have a blizzard? What happens to the patients? How do you decide who is critical and who is not? And if you have an employee stranded in a patient’s home on a 24-hour case, does this employee know he or she has to stay there until he or she is relieved?"
CHAP uses these four key principles as the framework for all its standards:
1. The organization’s structure and function consistently support its consumer-oriented philosophy and purpose.
2. The organization consistently provides high-quality services and products.
3. The organization has adequate human, financial, and physical resources effectively organized to accomplish its stated purpose.
4. The organization is positioned for long-term viability.
"Everyone is looked at through the glasses of these principles," Ayer says.
These principles form CHAP’s accreditation standards. CHAP requires private duty agencies to prepare for its survey by going through a process of self-study using these CHAP standards and parameters.
"We provide the documents, and we provide telephone consultation as they go through the self-study," says Ayer. "The self-study walks them through all the things they need to have in place in order to be doing a good job with their business.
"The patients, the consumers, are our prime focus, and making sure they get the service they need is our primary goal," she adds. "We do that by making the organization better."
Even after an agency completes the self-study, sometimes the systems are still not in place by the time of the survey, especially if the agency has just begun operations. "If it has been in business for a while and has just decided to become accredited, you generally find a more stable organization. For a new organization, there’s a lot to deal with and to get in place. And once we’re on-site, we see things differently than we did looking at the piece of paper of the self-study."
A private duty agency seeking accreditation for the first time may be denied accreditation or have deferred accreditation if CHAP finds the agency seriously deficient in some areas, says Ayer. "If it is already accredited, we may withdraw accreditation or put it on formal warning. In a more normal course of events, however, we give agencies required actions with a time frame for completing them. We may do a focus visit in 60 to 90 days or six months. If it’s more of a paper compliance, we’ll ask for a progress report."
[For more information on the Community Health Accreditation Program, contact: (800) 669-1656, Ext. 242.]
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