HCFA reinvents validation program

20 hospitals join pilot study

The Health Care Financing Administration (HCFA) in Baltimore recently formed a work group to reinvent and improve its validation program to be more systemic. The program should evaluate presurvey, intrasurvey, and postsurvey activity. The charge is to directly measure the effectiveness of the surveyor. Access http://www. hcfa.gov/medicare/hsqb/hsqb4a.htm on the Internet to read more about Medicare's new Provider Certification Program.

The work group is piloting a study involving 20 hospitals in four states. Evaluation teams composed of federal and state surveyors observe Joint Commission survey teams in action. They evaluate their skills and conclusions about the hospitals' performance.

Representatives from the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, the American Osteopathic Association (AOA) and American Hospital Association, both in Chicago, and state survey agencies met with regional and central office HCFA staff and decided that the revised validation program should include an on-site assessment of how each organization manages its standards and survey procedures. The group is developing indicators of hospital performance, such as nutrition, medication use, and infection control, and survey team skills, such as teamwork, investigation, and follow-up.

Hospitals accredited by the Joint Commission or by AOA are permitted to participate in Medicare without a state certification survey by virtue of those agencies' deemed status. HCFA validates national accreditation programs by having a state survey agency conduct a validation survey of 5% of the accredited hospitals approximately 60 days after the accreditation survey.