The Joint Commission's Pearl Darling weighs in on the most challenging accreditation standards for ASCs


In April, The Joint Commission released its list of the top 10 most challenging ambulatory and office-based surgery standards for 2018. Pearl S. Darling, executive director of Ambulatory Care Services for The Joint Commission, spoke with Becker's ASC Review about what makes these standards so challenging.

Note: Responses have been lightly edited for style and clarity.

Question: Referring to the fire protection and emergency readiness standards, why are these standards often overlooked? Once this issue is resolved, how can ASCs stay compliant?

Pearl Darling: I would not say they are necessarily overlooked, but ASC administrators may not be familiar with the latest requirements and updates to these standards. Fire protection systems include all fire safety equipment and building features that goes well beyond just checking fire doors. The same goes for emergency management. For deemed ASCs, the CMS Emergency Management Final Rule added additional requirements with which many are not familiar. Development of a checklist that includes all these requirements and a calendar for frequency of required testing and maintenance would be very beneficial.

Q: Why do you think ASCs struggle with the standard that they must reduce infections associated with medical equipment, devices and supplies?

PD: In most cases, there is a lack of training and education for staff responsible for maintaining these equipment, devices and supplies, as well as not having or following the manufacturer's instructions for use.

Q: Do you see any common threads or trends in the standards ASCs struggle with year to year?

PD: Since most of our accredited ASCs choose the Medicare deemed option, a dedicated life safety code specialist is included as part of the survey team. Life safety has always been a challenge, but in 2018, it rose to the top.

Q: What do you hope ASCs will learn from having these challenging standards published and readily available?

PD: We encourage ASCs to use these top 10 challenging standards as a benchmark resource to support their ongoing patient safety and quality efforts.

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