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Plumas District Hospital isn’t required to go through an accreditation process, but it does so anyway.
The process costs tens of thousands of dollars and takes hundreds of employee hours to prepare for inspection, but hospital CEO Doug Lafferty says it’s worth it.
What is the Joint Commission?
The Joint Commission, which has gone by a variety of names since its founding in 1951, is a nonprofit organization that evaluates and accredits health care organizations in the United States.
Its stated mission is “to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.”
But that work comes at a price — an average of $46,000 for a hospital survey. Health care organizations renew their accreditation every three years with submitted documentation and onsite visits.
“It’s kind of like the Good Housekeeping Seal of Approval,” he said.
The hospital received its accreditation from the Joint Commission, the nation’s largest and oldest accrediting organization, which oversees more than 20,000 health care organizations in the United States.
Hospitals that are required to be accredited would lose Medicare and MediCal reimbursement if they do not achieve that goal. Government and district hospitals are not required to go through the accreditation process.
Plumas District Hospital has been accredited since the early ’70s. In the early years, hospital staff would prepare for a site visit every three years, and receive advance notice of when the surveyors were due to arrive.
Now, visits can occur in an 18-month window, with no advance notice.
“One of the goals of the Joint Commission is continuous readiness,” Lafferty said. Surprise visits ensure that the hospital maintains a constant state of preparedness.
Lafferty said that part of the reason he is a fan of the accreditation process is because, “if we never do it, we are only benchmarking against ourselves. This benchmarks us against hospitals across the country.”
He said the process, which includes extensive documentation and a site visit, also provides a great educational opportunity because the Joint Commission representatives share the latest in health care information.
Even though Lafferty has only been at PDH a short time, this is his 12th accreditation process, with the others occurring at much larger hospitals.
He has watched the Joint Commission evolve over the years, going from a situation where many of the surveyors were former hospital CEOs fond of saying, “When I was CEO, we used to …” to surveyors who are a “much younger, more active group.”
Additionally, the survey is less subjective. A computer tallies the results and notes submitted by the surveyors.
What if a hospital has issues that prevent it from being accredited?
Lafferty said that an entity is given 60 days to produce a written plan of correction.
For example, during this most recent site visit, surveyors determined that a refrigerator used to store vaccine at the clinic needed an improved thermostat monitoring system. Employees made the change and provided the appropriate documentation. If the offense is serious enough, the Joint Commission will make a second site visit.
Lafferty said that the process is also valuable to the employees, 75 percent of whom have never worked at a health care organization other than Plumas District Hospital.
He said it is of real value to the community because it assures patients that they are receiving a benchmark standard of care.
“The community should look at it as a really good thing,” he said.
Lafferty acknowledges that it is costly — $5,000 per year, and $20,000 to $25,000 for the survey. “Those are the hard costs,” Lafferty said and estimates that it costs double that in the hours that are dedicated to the accreditation process.
Tom Hayes, the CEO at Eastern Plumas Health Care, doesn’t think accreditation is worth the cost.
“We already have to go by certain standards,” Hayes said. “Medicare has standards of participation. There are also state and federal standards.”
Hayes said that the Department of Health Services sends in its own reviewers, which occurs “at least as frequent(ly) as the Joint Commission.”
Hayes said that he had the accreditation at other hospitals where he worked because of the need for reimbursements, but couldn’t justify the cost for Eastern Plumas.
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