1 00:00:00,080 --> 00:00:02,720 Hello, everyone. This is Madeline Ashley with Becker's 2 00:00:02,720 --> 00:00:05,120 Healthcare podcast series. Thank you so much for 3 00:00:05,120 --> 00:00:07,679 tuning in. Today, I'm thrilled to be joined 4 00:00:07,679 --> 00:00:09,839 by Wade Parker, field director for the Joint 5 00:00:09,839 --> 00:00:12,179 Commission's Ambulatory Healthcare Accreditation 6 00:00:12,559 --> 00:00:13,059 Program. 7 00:00:13,464 --> 00:00:15,464 Wade, welcome to the podcast, and thanks so 8 00:00:15,464 --> 00:00:17,545 much for joining us. So I would love 9 00:00:17,545 --> 00:00:19,144 to just kick things off right now to 10 00:00:19,144 --> 00:00:21,304 let you introduce yourself and and share a 11 00:00:21,304 --> 00:00:23,404 little bit about your background in health care. 12 00:00:23,464 --> 00:00:26,230 You bet. I am a registered nurse here 13 00:00:26,230 --> 00:00:28,390 in the state of Texas, currently licensed. I've 14 00:00:28,390 --> 00:00:30,649 been with the Joint Commission 16 years. 15 00:00:31,510 --> 00:00:33,429 The majority of that, I served as a 16 00:00:33,429 --> 00:00:35,530 full time field surveyor for ambulatory. 17 00:00:35,829 --> 00:00:37,129 And before that, 18 00:00:37,509 --> 00:00:40,469 let's see, after getting my nursing degree, my 19 00:00:40,469 --> 00:00:40,844 BSN, 20 00:00:41,645 --> 00:00:43,104 before getting my master's, 21 00:00:43,405 --> 00:00:46,065 I worked on the floor. I've 22 00:00:46,765 --> 00:00:49,344 worked in quality and risk at an ambulatory 23 00:00:49,405 --> 00:00:50,304 surgery center. 24 00:00:50,685 --> 00:00:53,085 Ran that ambulatory surgery center on the campus 25 00:00:53,085 --> 00:00:55,245 of Presbyterian Hospital of Dallas. That's where I 26 00:00:55,245 --> 00:00:55,950 hail from. 27 00:00:56,909 --> 00:00:57,409 And 28 00:00:59,070 --> 00:00:59,570 cancer 29 00:01:00,109 --> 00:01:02,850 director at the cancer center at UT Southwestern, 30 00:01:03,869 --> 00:01:04,369 Baylor 31 00:01:04,829 --> 00:01:05,329 Richardson, 32 00:01:06,030 --> 00:01:08,270 director of outpatient services where I was over 33 00:01:08,270 --> 00:01:10,784 ambulatory and GI and a couple other departments. 34 00:01:10,844 --> 00:01:13,004 And then before coming on with the Joint 35 00:01:13,004 --> 00:01:15,244 Commission, served as director of quality and risk 36 00:01:15,244 --> 00:01:17,164 management in the hospital. So I've been on 37 00:01:17,164 --> 00:01:18,765 the other side of the table. I know 38 00:01:18,765 --> 00:01:21,405 the challenges of being surveyed. I've been the 39 00:01:21,405 --> 00:01:23,564 point person at both the ambulatory surgery center 40 00:01:23,564 --> 00:01:25,959 and the hospital. So it's just a tremendous 41 00:01:25,959 --> 00:01:27,079 privilege to be on this side of the 42 00:01:27,079 --> 00:01:28,760 table and support the hard work that goes 43 00:01:28,760 --> 00:01:29,740 on every day 44 00:01:30,280 --> 00:01:31,740 and the ambulatory setting. 45 00:01:32,120 --> 00:01:34,040 Awesome. Thank you so much for sharing that 46 00:01:34,040 --> 00:01:34,540 background. 47 00:01:35,159 --> 00:01:36,760 So I just wanna kick things off by 48 00:01:36,760 --> 00:01:39,805 asking, you know, many organizations look at accreditation 49 00:01:40,104 --> 00:01:42,045 as as sort of a checklist procedure. 50 00:01:42,424 --> 00:01:44,025 So I was just kinda curious, you know, 51 00:01:44,025 --> 00:01:46,825 can you elaborate on why it's important to 52 00:01:46,825 --> 00:01:49,465 to turn the survey process into meaningful and 53 00:01:49,465 --> 00:01:50,604 constructive engagement 54 00:01:50,905 --> 00:01:52,744 and what your process at the Joint Commission 55 00:01:52,744 --> 00:01:53,519 might look like? 56 00:01:54,079 --> 00:01:56,879 Absolutely. Thanks for that question. It's an awesome 57 00:01:56,879 --> 00:01:58,179 question. And, 58 00:01:58,640 --> 00:01:59,299 you know, 59 00:02:00,560 --> 00:02:02,959 some of the titles that Becker's have had, 60 00:02:02,959 --> 00:02:06,500 the speakers, they've alluded to the biggest challenge 61 00:02:06,560 --> 00:02:08,055 these days, one of the biggest, 62 00:02:08,614 --> 00:02:11,114 especially post COVID, during COVID, was staffing. 63 00:02:12,614 --> 00:02:15,094 So as organizations and having run an ambulatory 64 00:02:15,094 --> 00:02:18,134 surgery center, we had, managing general partners, limited 65 00:02:18,134 --> 00:02:19,275 partners with shareholders, 66 00:02:21,014 --> 00:02:21,914 busy surgeons, 67 00:02:22,830 --> 00:02:23,729 cost analysis 68 00:02:24,189 --> 00:02:26,689 and cross training and staffing issues. 69 00:02:27,949 --> 00:02:28,449 Accreditation, 70 00:02:29,469 --> 00:02:31,709 is one of the line items on these 71 00:02:31,709 --> 00:02:32,209 organizations' 72 00:02:32,669 --> 00:02:33,810 budgets. And 73 00:02:34,269 --> 00:02:34,995 every year, 74 00:02:35,394 --> 00:02:37,495 senior leadership at the Joint Commission 75 00:02:37,955 --> 00:02:41,254 work harder and harder to make the survey 76 00:02:41,314 --> 00:02:42,614 experience more meaningful. 77 00:02:43,474 --> 00:02:44,775 Checklists are important. 78 00:02:45,634 --> 00:02:48,610 Understanding what's inside the guardrails of the standards, 79 00:02:48,610 --> 00:02:51,189 many of them driven from actual adverse events, 80 00:02:51,250 --> 00:02:53,909 clearly the National Patient Safety Goals. Right? 81 00:02:54,449 --> 00:02:55,349 But secondarily, 82 00:02:55,889 --> 00:02:58,069 we need to understand the organization's 83 00:02:58,449 --> 00:02:58,949 goals. 84 00:02:59,264 --> 00:03:00,564 And Doctor. John Perlin, 85 00:03:01,264 --> 00:03:03,584 the CEO and president of the Joint Commission 86 00:03:03,584 --> 00:03:05,444 puts it like this. He says, the juice 87 00:03:05,745 --> 00:03:07,444 has to be worth the squeeze. 88 00:03:07,905 --> 00:03:09,664 Is the juice worth the squeeze? In other 89 00:03:09,664 --> 00:03:10,965 words, when organizations 90 00:03:11,424 --> 00:03:12,884 look back at their accreditation 91 00:03:13,185 --> 00:03:13,685 experience, 92 00:03:14,144 --> 00:03:14,884 the report, 93 00:03:15,479 --> 00:03:16,139 the engagement 94 00:03:16,599 --> 00:03:18,620 between the surveyors and the staff, 95 00:03:19,560 --> 00:03:21,960 was it value added? And Ken Grubbs, Doctor. 96 00:03:21,960 --> 00:03:24,280 Ken Grubbs says the same thing. Make sure 97 00:03:24,280 --> 00:03:27,044 the survey is meaningful and value added. 98 00:03:27,525 --> 00:03:29,224 So we start off right at the beginning, 99 00:03:29,365 --> 00:03:31,925 right in the opening conference, listening, listening to 100 00:03:31,925 --> 00:03:32,584 the organization's 101 00:03:32,965 --> 00:03:35,604 goals, listening to what would make it a 102 00:03:35,604 --> 00:03:38,344 meaningful experience. How did the last survey go? 103 00:03:38,884 --> 00:03:39,625 And what 104 00:03:39,939 --> 00:03:41,699 would we need to do to modify the 105 00:03:41,699 --> 00:03:44,360 agenda to make it value added and meaningful? 106 00:03:45,780 --> 00:03:47,300 Oh, thank you so much for breaking that 107 00:03:47,300 --> 00:03:48,900 down. And I love that saying, the juice 108 00:03:48,900 --> 00:03:50,039 is worth the squeeze. 109 00:03:50,979 --> 00:03:51,639 I guess. 110 00:03:51,939 --> 00:03:53,000 Yeah. That's good. 111 00:03:53,594 --> 00:03:55,114 So also hoping you might be able to 112 00:03:55,114 --> 00:03:57,215 provide, you know, some insights into the background 113 00:03:57,435 --> 00:03:58,254 and and qualifications 114 00:03:59,114 --> 00:04:01,055 of your ambulatory survey team 115 00:04:01,354 --> 00:04:03,194 and, you know, maybe some more on what 116 00:04:03,194 --> 00:04:05,275 expertise they they bring to the process and 117 00:04:05,275 --> 00:04:06,574 and why is their viewpoint 118 00:04:06,955 --> 00:04:07,614 so important. 119 00:04:08,610 --> 00:04:10,610 You know, I remember years ago, I was 120 00:04:10,610 --> 00:04:12,689 a preceptor, and I came out with a 121 00:04:12,689 --> 00:04:15,250 brand new preceptee out of the dressing room 122 00:04:15,250 --> 00:04:17,649 into the, the break room at a busy 123 00:04:17,649 --> 00:04:19,730 ambulatory surgery center. A number of staff were 124 00:04:19,730 --> 00:04:20,389 on break, 125 00:04:20,769 --> 00:04:22,709 and we had just put on our scrubs. 126 00:04:22,995 --> 00:04:26,514 And the surveyor came out with surgeon's skull 127 00:04:26,514 --> 00:04:28,774 caps tied around their shoes, 128 00:04:30,035 --> 00:04:31,254 thinking those were 129 00:04:31,634 --> 00:04:32,295 shoe covers. 130 00:04:33,795 --> 00:04:36,355 I never saw that surveyor again, actually. I 131 00:04:36,355 --> 00:04:38,919 think they washed out and you have to 132 00:04:38,919 --> 00:04:42,680 have strong ASC, ambulatory surgery center background. You 133 00:04:42,680 --> 00:04:43,819 have to provide 134 00:04:44,519 --> 00:04:45,259 that credibility. 135 00:04:45,800 --> 00:04:49,240 When we have advanced diagnostic imaging centers, for 136 00:04:49,240 --> 00:04:51,259 example, that we accredit an ambulatory, 137 00:04:51,824 --> 00:04:53,745 we make sure we have a radiologist. In 138 00:04:53,745 --> 00:04:54,245 fact, 139 00:04:54,785 --> 00:04:56,245 our most recent addition 140 00:04:56,704 --> 00:04:57,204 has 141 00:04:57,824 --> 00:04:58,324 interventional 142 00:04:58,704 --> 00:04:59,204 cardiology 143 00:05:00,224 --> 00:05:02,884 background as a radiologist. So we utilize 144 00:05:03,985 --> 00:05:04,884 that expertise 145 00:05:06,100 --> 00:05:09,060 for cath labs, freestanding cath labs. So we're 146 00:05:09,060 --> 00:05:11,399 talking masters prepared nurses, CRNAs, 147 00:05:12,019 --> 00:05:13,000 nurse practitioners, 148 00:05:13,699 --> 00:05:14,600 medical doctors, 149 00:05:15,220 --> 00:05:16,360 many medical doctors. 150 00:05:17,620 --> 00:05:18,360 These candidates 151 00:05:19,024 --> 00:05:22,404 for ambulatory surgery center roles as field surveyors, 152 00:05:22,464 --> 00:05:23,204 they must 153 00:05:23,824 --> 00:05:26,245 have the background. They must understand the challenges. 154 00:05:26,784 --> 00:05:29,425 Some I mentioned earlier with the surgeons and 155 00:05:29,425 --> 00:05:31,985 the staffing, they must understand the challenges that 156 00:05:31,985 --> 00:05:34,495 these organizations are going through every day. Yeah. 157 00:05:34,839 --> 00:05:36,519 And I want to look to the future 158 00:05:36,519 --> 00:05:37,800 a little bit too. So, you know, you 159 00:05:37,800 --> 00:05:41,740 recently updated the guidelines for emergency management standards 160 00:05:41,800 --> 00:05:44,360 at nursing care centers and this space is 161 00:05:44,360 --> 00:05:46,855 ever evolving. So, you know, looking ahead, are 162 00:05:46,855 --> 00:05:49,654 there any innovative approaches or new initiatives the 163 00:05:49,654 --> 00:05:52,235 joint commission is exploring to, you know, enhance 164 00:05:52,295 --> 00:05:54,235 the accreditation process? And 165 00:05:54,774 --> 00:05:56,855 and how can they really impact quality of 166 00:05:56,855 --> 00:05:57,355 care? 167 00:05:58,455 --> 00:06:01,574 Every year every year, we look at the 168 00:06:01,574 --> 00:06:04,290 voice of the colleague, we call it feedback 169 00:06:04,290 --> 00:06:07,350 from end users, feedback from our accredited organizations. 170 00:06:08,290 --> 00:06:09,990 We have an advisory council, 171 00:06:10,610 --> 00:06:14,069 multiple advisory councils. Actually, Ambulatory has 1, 172 00:06:15,134 --> 00:06:17,375 hospital has 1 where we get feedback from 173 00:06:17,375 --> 00:06:18,035 end users. 174 00:06:19,134 --> 00:06:20,814 And some of the things that we look 175 00:06:20,814 --> 00:06:23,074 at as we are going into the future, 176 00:06:23,134 --> 00:06:23,634 one 177 00:06:24,095 --> 00:06:26,834 falls into the form of an acronym, 178 00:06:27,900 --> 00:06:30,480 HELP, health equity for the H, 179 00:06:30,860 --> 00:06:33,199 environmental sustainability for the E, 180 00:06:33,580 --> 00:06:37,259 learning for L, and P, performance integration and 181 00:06:37,259 --> 00:06:39,600 improvement. Health equity, of course, social responsibility, 182 00:06:40,540 --> 00:06:42,074 patient safety. You know, 183 00:06:42,555 --> 00:06:43,455 patient safety, 184 00:06:43,995 --> 00:06:47,035 it's all about patient safety. Nothing more, nothing 185 00:06:47,035 --> 00:06:49,194 less. It has to the patient comes first. 186 00:06:49,194 --> 00:06:51,194 Patient goes away, we all go away. So 187 00:06:51,194 --> 00:06:52,735 patient safety comes first. 188 00:06:53,115 --> 00:06:55,514 Environmental sustainability, we have to look at, 189 00:06:56,475 --> 00:06:58,500 being equitable. And so we're 190 00:06:59,199 --> 00:07:02,000 trying not to ask organizations to print anything. 191 00:07:02,000 --> 00:07:03,520 If we can look at the computer, let's 192 00:07:03,520 --> 00:07:04,500 look at the computer. 193 00:07:04,800 --> 00:07:07,379 We're offering a sustainable healthcare certification. 194 00:07:08,160 --> 00:07:08,980 And in learning, 195 00:07:09,520 --> 00:07:10,420 let's leverage 196 00:07:10,895 --> 00:07:11,634 AI, leverage 197 00:07:12,175 --> 00:07:15,694 algorithms. How can we look at responsible use 198 00:07:15,694 --> 00:07:16,995 of health data? 199 00:07:17,694 --> 00:07:18,595 And we have 200 00:07:19,055 --> 00:07:21,235 responsible use health data certification. 201 00:07:21,694 --> 00:07:23,375 And then lastly, and this I think is 202 00:07:23,375 --> 00:07:24,754 probably the most important 203 00:07:25,055 --> 00:07:27,289 because some of the feedback we receive 204 00:07:27,589 --> 00:07:29,689 is how can we improve consistency 205 00:07:30,229 --> 00:07:30,729 internally 206 00:07:31,110 --> 00:07:32,409 in the survey process? 207 00:07:33,029 --> 00:07:35,689 So we're looking at performance improvement, 208 00:07:36,470 --> 00:07:37,529 performance integration, 209 00:07:38,229 --> 00:07:41,689 looking at how we can minimize variations between 210 00:07:42,404 --> 00:07:42,904 surveys. 211 00:07:44,164 --> 00:07:46,564 Doctor. John Perlin directed not long after he 212 00:07:46,564 --> 00:07:48,745 started that we look at all the standards. 213 00:07:49,444 --> 00:07:50,345 Is there duplication? 214 00:07:51,365 --> 00:07:52,345 Is there redundancy? 215 00:07:52,884 --> 00:07:55,290 Are there standards that never really have any 216 00:07:55,290 --> 00:07:58,250 findings year after year? Let's take those out. 217 00:07:58,250 --> 00:08:00,970 And lastly, and probably most importantly of those 218 00:08:00,970 --> 00:08:01,470 3 219 00:08:01,850 --> 00:08:03,389 clinical practice guidelines, 220 00:08:04,329 --> 00:08:06,110 is there as a support, 221 00:08:06,649 --> 00:08:07,470 as a core, 222 00:08:08,435 --> 00:08:10,454 evidence based practice? If not, 223 00:08:10,754 --> 00:08:12,595 let's take that out as well. It has 224 00:08:12,675 --> 00:08:14,134 we cannot ask an organization 225 00:08:14,595 --> 00:08:16,675 to do something that does not have strong 226 00:08:16,675 --> 00:08:17,894 evidence based practice, 227 00:08:18,274 --> 00:08:21,120 CMS guideline background, for example, as well. 228 00:08:22,079 --> 00:08:24,479 We have to have some background for that 229 00:08:24,479 --> 00:08:24,979 requirement. 230 00:08:26,000 --> 00:08:28,639 Thank you. Yeah. No, thank you for sure. 231 00:08:28,639 --> 00:08:30,079 And I like how, you know, at the 232 00:08:30,079 --> 00:08:32,720 beginning, you mentioned that, you know, past, present, 233 00:08:32,720 --> 00:08:34,000 or future at the end of the day, 234 00:08:34,000 --> 00:08:36,019 it's all revolving around patient safety. 235 00:08:36,455 --> 00:08:39,654 So Nothing more, nothing less. Yeah. Nothing more, 236 00:08:39,654 --> 00:08:40,475 nothing less. 237 00:08:40,774 --> 00:08:41,095 So, 238 00:08:41,654 --> 00:08:43,174 wanted to just see if there was anything 239 00:08:43,174 --> 00:08:44,934 else that you would like to to touch 240 00:08:44,934 --> 00:08:46,215 on, you know, might that we might not 241 00:08:46,215 --> 00:08:46,955 have discussed. 242 00:08:48,054 --> 00:08:50,220 Just one thing briefly, Maddie, and thanks for 243 00:08:50,299 --> 00:08:53,179 asking. When we're training these new surveyors, it's 244 00:08:53,179 --> 00:08:56,059 so important for us to get into their 245 00:08:56,059 --> 00:08:57,120 DNA that, 246 00:08:57,500 --> 00:08:59,419 number 1, it's a privilege. It is a 247 00:08:59,419 --> 00:09:01,120 privilege for us as their accredited 248 00:09:01,500 --> 00:09:04,514 organization to be invited in to their organization. 249 00:09:04,575 --> 00:09:07,154 It's a privilege, number 2, to be allowed 250 00:09:07,615 --> 00:09:08,274 to see 251 00:09:08,575 --> 00:09:11,534 their patient care processes. And 3rd, it's a 252 00:09:11,534 --> 00:09:14,434 privilege to be invited to have a conversation 253 00:09:14,654 --> 00:09:16,355 about where there may be some risks. 254 00:09:17,149 --> 00:09:17,809 Thank you. 255 00:09:18,190 --> 00:09:20,509 Well, thank you so much for that, addition 256 00:09:20,509 --> 00:09:22,830 there. And again, Wade, we really appreciate your 257 00:09:22,830 --> 00:09:25,470 time and a great discussion today. We also 258 00:09:25,470 --> 00:09:27,389 want to thank our podcast sponsor for this 259 00:09:27,389 --> 00:09:29,870 episode, the Joint Commission. You can tune into 260 00:09:29,870 --> 00:09:31,169 more podcasts for Becker 261 00:09:31,878 --> 00:09:34,118 Health Care by visiting our podcast page at 262 00:09:34,118 --> 00:09:34,618 beckershospitalreview.com.