17 Most Challenging Ambulatory Care Standards for Community Health Centers

The Joint Commission has identified the 17 most challenging ambulatory care standards for community health centers in 2012. At least 20 percent of health centers were not in compliance with each of the following standards. The specific elements of performance that were not met are noted below each standard.

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Environment of care
1. Manage hazardous materials and waste.
•    Hazardous energy

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2. Medical equipment is maintained, tested and inspected.
•    Test and maintain medical equipment on inventory
•    Document testing and maintenance of sterilizers

3. Collect information to monitor conditions in the environment.
•    Evaluate each environment of care plan annually

Human resources
4. Verify staff qualifications.
•    Primary source verify licensed/certified/registered staff

5. Clinical privileges are granted to licensed independent practitioners.
•    Primary source verify training
•    Primary source verify licensure
•    Query National Practitioner Data Bank
•    Site-specific privileges
•    Give LIP written list

Infection control
6. Identify risks for acquiring and transmitting infection.
•    Identify risks based on services and populations
•    Prioritize and document identified risks

7. Reduce the risk of infections associated with medical equipment, devices and supplies.
•    Cleaning and performing low-level disinfection of medical equipment, devices and supplies
•    Perform intermediate and high-level disinfection and sterilization

8. Evaluate effectiveness of infection prevention and control activities yearly and when risks change.
•    Annually evaluate prevention and control activities and when risks change

Medication management
9. Safely manage high-alert and hazardous medications.
•    Identify in writing and have process to manage

10. Address safe use of look-alike, sound-alike medications.
•    Develop list and take action to prevent interchange

11. Medications are stored safely.
•    Store medications per manufacturers’ recommendations
•    Prevent unauthorized people from obtaining
•    Label with expiration date
•    Remove expired or contaminated medications and store separately

12. Safely manage emergency medications.
•    Emergency medications and related supplies are readily accessible

National Patient Safety Goals and Universal Protocol
13. Use at least two patient identifiers when providing care, treatment or services.
•    Two patient identifiers
•    Label specimen containers in patient’s presence

14. Comply with either the Centers for Disease Control and Prevention or World Health Organization hand hygiene guidelines.
•    Set goals

15. A time-out is performed before the procedure.
•    Conduct and document time-out before starting procedure

Waived testing
16. Staff and LIPs performing waived testing are competent.
•    At least two of four assessment methods used per person per test annually

17. Perform quality control checks for waived testing on each procedure.
•    Expired reagent
•    Check daily

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