HCFA on track to beef up oversight of facilities
HCFA on track to beef up oversight of facilities
The Health Care Financing Administration (HCFA) isn’t wasting any time addressing the "major deficiencies" and "significant weaknesses" detailed in the Office of Inspector General’s (OIG) four-volume report on the Joint Commission on the Accreditation of Healthcare Organizations and state agencies. That report was released July 20 following an exhaustive two-year examination by the OIG.
Eager to counter the litany of shortcomings outlined in the report, HCFA has already completed a not-yet-public "detailed action plan" to follow the four-point action plan included in the report.
In an upcoming revision of its conditions of participation (COP) regulations, HCFA will more clearly define its priorities for facility surveys of basic health and safety issues such as surgery mix-ups and medication errors. HCFA spokes-woman Michelle Robinson confirms that HCFA’s new COPs will be released this fall but added that it is "still very much in draft form."
She also says there is "no timetable for the development of performance measures because that is still very much in a preliminary phase." HCFA has directed peer review organizations to establish and develop measures that will provide benchmarks.
Three of the measures under development include mortality rates following surgery, infection rates following surgery, and the rate of beta-blockers prescribed for patients hospitalized after a heart attack.
HCFA’s Hospital Quality Oversight Plan, or action plan, lays out broad objectives. One objective is improving oversight of the Joint Commis-sion’s activities.
Specifically, the agency says it will consider supplementing or replacing current validation surveys with observation surveys that would be conducted concurrently with the accreditation survey. These surveys, Robinson adds, should look at both the Joint Commission on-site performance and the facility’s ability to meet COPs.
More unannounced surveys are possible
Also included in HCFA’s preliminary blueprint for the Joint Commission are these items:
• more unannounced surveys;
• more random selection of records;
• more "contextual information" about facilities provided to surveyors;
• more rigorous assessments of facilities’ internal continuous quality improvement efforts;
• greater capacity of surveyors to respond to complaints within the survey process.
HCFA says it will also redesign the survey data system — OSCAR — either by linking it to the Joint Commission’s accreditation survey data system or expanding it to include data on Joint Commission data survey results, complaints, sentinel events, and performance measures. The Joint Commission has identified surgical procedures and complications as one of five areas for which core performance measures will be developed. (For more information, see Same-Day Surgery, August 1999, p. 99.)
The Joint Commission has announced significant changes to its random unannounced surveys, including a modification that organizations will receive no advanced notice for random unannounced surveys.
Also, the window of time during which random unannounced surveys may be conducted will be nine to 30 months following the triennial full survey.
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