Common deficiencies cited by AAAASF and how to fix them — Advance directives

In our ongoing series, Becker's ASC Review spoke with American Association for Accreditation of Ambulatory Surgery Facilities' Associate Director of Accreditation Jeanne Henry about the organization's commonly cited deficiency related to advance directives.

Jeanne Henry: We often find that records lack the patients acknowledgement of advance directive receipt. AAAASF Standards 600.020.025, 600.020.026 & 600.020.027 require ASCs to provide the patient or, as appropriate, the patient’s representative with written information concerning its policies on advance directives, including a description of applicable state health and safety laws, and, if requested, official state advance directive forms. ASCs must inform the patient or, as appropriate, the patient’s representative or surrogate of the patient’s right to make informed decisions regarding the patient's care. The information must be documented and located in a prominent part of the patient’s current medical record, regardless of whether or not the individual has executed an advance directive.

ASCs may ensure compliance with these standards by adopting and adhering to a policy identifying the importance of documenting patients responses to advanced directives in every medical record prior to providing care. By initially educating staff and holding annual in-services, the ASC may be reassured that everyone is aware and following the procedure.

Many states have launched electronic advanced directive registries, making the process of obtaining and maintaining patient directives very effective. The registries allow health care providers statewide the ability to know that a patient directive exists and makes that directive available to them. AAAASF expects this new initiative to have a positive effect on ASC compliance with the advance directive requirements.

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