How AAAHC advanced orthopaedic certification can help ASCs stand out from the pack: 6 Qs with Tess Poland, Senior Vice President of Accreditation Services

Tess Poland, RN, MSN, the Accreditation Association for Ambulatory Health Care's senior vice president of accreditation services, weighed in on the importance and significance of AAAHC's advanced orthopaedic certification in the increasingly crowded ASC market in an interview.

Here are the insights Ms. Poland shared with Becker's ASC Review:

Note: This article has been slightly edited for style and clarity.

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Question: With more total joint procedures moving to the outpatient setting, why are certification programs like the advanced orthopaedic certification important?

Tess Poland: The advanced orthopaedic certification indicates an organization has undergone a rigorous review on all aspects of their specialty care. The certification recognizes an organization's efforts to foster better outcomes for [patients during] total joints and spine.

The program is designed around improving outcomes, so the certification signifies the organizations commitment to providing high quality specialty patient care.

Q: What was the process like for developing the certification?

TP: The first thing we did was put together a technical panel [composed of] people who represented the industry. There were 16 members who had expertise in total joint and spine, including physicians, nurses, payers, physical therapists and administrators. They met weekly to develop the standards and conducted a comparative literature review to reinforce the standards The impacts on patient outcomes was the biggest focus.

Q: How can the certification can be a differentiator in an increasingly crowded market?

TP: The certification demonstrates high reliability, and a culture driven toward excellence, that in itself creates a competitive advantage over other ASCs. It also provides assurance to patients paying for services in the industry.

Q: Can you elaborate on the advanced orthopaedic certification survey being an "educational experience" for ASCs? What do you hope ASCs will learn from the program?

TP: What we've found based on feedback from organizations we have surveyed is the act of preparing for certification promoted team cohesiveness as staff worked toward earning that specialty certification. The standards lend themselves to greater consistency in care as it requires a systematic approach to service line delivery.

I hope ASCs will learn from the program the level of excellence that can be achieved and how facilities can improve patient outcomes as a result of these standards. The standards force ASCs to look at the episode of care, including post discharge, as well as the continuum of care.

What we hope to achieve through the educational process is having a look at the whole episode of care through prescreening, into the OR, to discharge back and then back into the community. Managing that whole continuum as it relates to the impact on patient outcomes [is important].

Q: Why do you think so many AAAHC-accredited ASCs expressed interest in the program?

TP: ASCs were seeking verification [to show] they provide an excellent level of service and care for patients undergoing total joint and spine procedures. The ASCs in our community that are accredited were requesting a certification that would enable them to demonstrate their level of excellence in providing care for specialty patients.
Another driver that has increased interest is payers. Advanced orthopaedic certification is preferred or required by payers. As an example, Blue Cross Blue Shield Association recently announced AAAHC advanced orthopaedic certification as a requirement for participation in its Blue Distinction Centers for Knee and Hip Replacement program for ASCs.

Q: What advice would you give to ASCs seeking the certification?

TP: Start by reviewing the eligibility criteria. The criteria ensure a few things, [including] if the facility is in good standing with AAAHC because certification builds on accreditation. So you want to make sure the facility is compliant with accreditation standards.

Part of the eligibility criteria is that the facility has completed 20 total joint and/or spine procedures. That ensures proficiency with nursing policies, and demonstrates a level of proficiency within the care team.

Another criterion is that [ASC] physicians have a median average of 50 procedures that have been completed, and they may be both within the ASC or in inpatient settings.
Second, identify who your core leaders are. At minimum, it must include a medical director and a clinical resource person that oversee the facilitation of the certification process that are both involved with reviewing policies and developing protocols.

Third, is to share the workload, and assign different tasks to your core leaders to oversee. Also, make sure you can pass a comprehensive assessment of your processes, policies and procedures, as well as anything else related to the certification standards.

Once you've done that, develop an action plan, and commit to weekly progress meetings until compliance in all standards has been achieved. That's important because this program raises the bar for quality of care and patient outcomes.

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