Care cer­ti­fi­ca­tion process re­quires ded­i­ca­tion, fo­cus

DSC process re­quires ded­i­ca­tion, fo­cus

Modern Healthcare - - Front Page - Roger Ray Roger Ray is a physi­cian and ex­ec­u­tive vice pres­i­dent and chief med­i­cal of­fi­cer of Caroli­nas Health-Care Sys­tem, Char­lotte, N.C.

The Joint Com­mis­sion’s Dis­ease-Spe­cific Care (DSC) Cer­ti­fi­ca­tion Pro­gram, launched in 2002, is a vol­un­tary, struc­tured eval­u­a­tion of a clin­i­cal pro­gram that delivers care to a de­fined pa­tient pop­u­la­tion across their con­tin­uum of care. The goal is to im­prove per­for­mance and main­tain im­proved out­comes over time.

Or­ga­ni­za­tions ac­cred­ited by the Joint Com­mis­sion may seek cer­ti­fi­ca­tion for vir­tu­ally any chronic dis­ease or con­di­tion. The cer­ti­fi­ca­tion re­quire­ments ad­dress three key ar­eas: com­pli­ance with con­sen­sus-based na­tional stan­dards, ef­fec­tive use of ev­i­dence-based clin­i­cal prac­tice guide­lines to man­age and op­ti­mize care, and cre­at­ing an or­ga­nized ap­proach to per­for­mance mea­sure­ment and im­prove­ment ac­tiv­i­ties.

Dis­ease-spe­cific pro­grams that suc­cess­fully demon­strate com­pli­ance in all three ar­eas are awarded cer­ti­fi­ca­tion for a twoyear pe­riod. At the end of the first year, the or­ga­ni­za­tion is re­quired to at­test to its con­tin­ued com­pli­ance with stan­dards and pro­vide ev­i­dence of per­for­mance im­prove­ment ac­tiv­i­ties. To main­tain cer­ti­fi­ca­tion, there is an on­site re­view con­ducted ev­ery two years.

At Caroli­nas Health-Care Sys­tem, ded­i­cated qual­ity-im­prove­ment re­sources help fa­cil­i­tate and de­velop the foun­da­tion for con­tin­ued im­prove­ment to meet the cer­ti­fi­ca­tion re­quire­ments. There are sev­eral key roles or pro­cesses that can in­crease the like­li­hood of achiev­ing suc­cess­ful cer­ti­fi­ca­tion.

A project cham­pion. We have found this role to be crit­i­cal in the DSC process. This usu­ally is a se­nior level ad­min­is­tra­tor or chief med­i­cal of­fi­cer—some­one who can ef­fec­tively de­fine the vi­sion and is di­rectly ac­count­able for clin­i­cal care within the or­ga­ni­za­tion.

Pro­gram­matic iden­ti­fi­ca­tion. Se­lect a pri­or­ity clin­i­cal area that has a high level of clin­i­cian suc­cess and en­gage­ment for growth and dif­fer­en­ti­a­tion. Make sure the pro­gram has strong buy-in ad­min­is­tra­tively and adds clin­i­cal value.

Mul­ti­dis­ci­plinary team. Iden­tify op­er­a­tional lead­ers, ser­vices and key stake­hold­ers that are per­ti­nent to the clin­i­cal pro­gram. Keep them en­gaged in ev­ery ac­tiv­ity within the process. Com­mon ex­am­ples in­clude nurs- ing, phar­macy, lab, di­etary, pas­toral care, res­pi­ra­tory ther­apy, imag­ing, in­for­ma­tion ser­vices, phys­i­cal and oc­cu­pa­tional ther­a­pies and case man­age­ment.

Strong physi­cian en­gage­ment. Iden­tify at least one physi­cian cham­pion, prefer­ably an in­di­vid­ual with sig­nif­i­cant in­flu­ence within that spe­cialty. Ob­tain a com­mit­ment from the physi­cian cham­pion and es­tab­lish a meet­ing sched­ule to fa­cil­i­tate his or her high level pro­gram­matic in­volve­ment. Re­cruit ad­di­tional sup­port­ing med­i­cal staff to fur­ther en­hance the ev­i­dence-based care ap­proach.

Op­er­a­tional fo­cus. De­velop a rep­re­sen­ta­tive team of staff lead­ers and mem­bers who pro­vide care to this pop­u­la­tion daily. Iden­tify a clin­i­cal op­er­a­tions leader such as a nurs­ing di­rec­tor to over­see process-im­prove­ment mile­stones. Ded­i­cated fa­cil­i­ta­tion. With each project, it is im­por­tant to have a fa­cil­i­ta­tor to as­sist the team by keep­ing the work “on task.” The fa­cil­i­ta­tor is typ­i­cally an in­di­vid­ual fa­mil­iar with qual­ity-im­prove­ment method­ol­ogy, as well as data man­age­ment in­ter­pre­ta­tion and anal­y­sis. Hav­ing a close link to the ac­cred­i­ta­tion and pa­tient-safety re­sources is help­ful.

A tool kit. An­other key to suc­cess in­cludes the devel­op­ment of a tool kit that pro­vides tem­plates of sup­port­ing doc­u­ments com­piled di­rectly from the DSC cer­ti­fi­ca­tion man­ual. The in­for­ma­tion is trans­lated to a Man­age­ment Ac­tion Plan that in­cludes re­view dates, mile­stones and an ac­count­able leader for each item to be achieved. It con­tains the sup­port­ing doc­u­ments and check­lists to keep the team mov­ing for­ward in prepa­ra­tion for re­view day. This is par­tic­u­larly help­ful for ob­tain­ing cer­ti­fi­ca­tions at mul­ti­ple lo­ca­tions.

Caroli­nas Health-Care Sys­tem has 19 DSC cer­ti­fi­ca­tions, with more in the works. We have found that the DSC cer­ti­fi­ca­tion pro­gram un­der­pins that work across de­fined pa­tient pop­u­la­tions and can be a valu­able tool for hos­pi­tals to for­mal­ize their qual­ity-im­prove­ment ef­forts.

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