Are you evaluating your contracted services?

Data sources for evaluation

So how do you evaluate the quality of your contracted services? Frank Ruelas, MBA, principal of www.hipaabootcamp.com and director of compliance and risk management at Maryvale Hospital in Phoenix, has some tips.

His first is that you use what you might already be gathering. "For example, in some states it says that contracted services and their ongoing evaluation need to be part of your quality assurance program," he says. That is a "built-in factor we so often overlook."

"What I often tell people is look at some of the easiest data-capture activities that you have within your organization that could lend themselves to providing you insight into the questions: Are there any issues, good or bad, related to these contracted services?"

Use incident reports in your evaluation, he says. You also can use findings from your grievance process. Many contracted services need to fulfill state requirements for things such as licensure or certification. For example, vendor A might get a renewal of their license with a statement "with issues."

"That needs to be something that should prompt a call to action. It could be as innocuous as the administrator paid vendor A's licensing fee two weeks late. Or it could be they are on some type of probation," Ruelas says.

He also suggests querying the licensing entity, which often has public information on that provider. General input from staff is a great measure, he says. For instance, you may ask bedside staff about the performance of a dialysis provider. It might seem at first like isolated information or inconsequential comments, "but if you look at trends and if you look at patterns, they can be very indicative of the level of service your patients are getting," he says.

Also see what quality metrics the contracted service may already have in place, he says. "Once these are identified, place in the contract an expectation that the service provider is to show how it is meeting these metrics and to identify what options there are to address if the service provider should fail to meet these metrics," he says.