Hello, everyone. This is Madeline Ashley with Becker's
Healthcare podcast series. Thank you so much for
tuning in. Today, I'm thrilled to be joined
by Wade Parker, field director for the Joint
Commission's Ambulatory Healthcare Accreditation
Program.
Wade, welcome to the podcast, and thanks so
much for joining us. So I would love
to just kick things off right now to
let you introduce yourself and and share a
little bit about your background in health care.
You bet. I am a registered nurse here
in the state of Texas, currently licensed. I've
been with the Joint Commission 16 years.
The majority of that, I served as a
full time field surveyor for ambulatory.
And before that,
let's see, after getting my nursing degree, my
BSN,
before getting my master's,
I worked on the floor. I've
worked in quality and risk at an ambulatory
surgery center.
Ran that ambulatory surgery center on the campus
of Presbyterian Hospital of Dallas. That's where I
hail from.
And
cancer
director at the cancer center at UT Southwestern,
Baylor
Richardson,
director of outpatient services where I was over
ambulatory and GI and a couple other departments.
And then before coming on with the Joint
Commission, served as director of quality and risk
management in the hospital. So I've been on
the other side of the table. I know
the challenges of being surveyed. I've been the
point person at both the ambulatory surgery center
and the hospital. So it's just a tremendous
privilege to be on this side of the
table and support the hard work that goes
on every day
and the ambulatory setting.
Awesome. Thank you so much for sharing that
background.
So I just wanna kick things off by
asking, you know, many organizations look at accreditation
as as sort of a checklist procedure.
So I was just kinda curious, you know,
can you elaborate on why it's important to
to turn the survey process into meaningful and
constructive engagement
and what your process at the Joint Commission
might look like?
Absolutely. Thanks for that question. It's an awesome
question. And,
you know,
some of the titles that Becker's have had,
the speakers, they've alluded to the biggest challenge
these days, one of the biggest,
especially post COVID, during COVID, was staffing.
So as organizations and having run an ambulatory
surgery center, we had, managing general partners, limited
partners with shareholders,
busy surgeons,
cost analysis
and cross training and staffing issues.
Accreditation,
is one of the line items on these
organizations'
budgets. And
every year,
senior leadership at the Joint Commission
work harder and harder to make the survey
experience more meaningful.
Checklists are important.
Understanding what's inside the guardrails of the standards,
many of them driven from actual adverse events,
clearly the National Patient Safety Goals. Right?
But secondarily,
we need to understand the organization's
goals.
And Doctor. John Perlin,
the CEO and president of the Joint Commission
puts it like this. He says, the juice
has to be worth the squeeze.
Is the juice worth the squeeze? In other
words, when organizations
look back at their accreditation
experience,
the report,
the engagement
between the surveyors and the staff,
was it value added? And Ken Grubbs, Doctor.
Ken Grubbs says the same thing. Make sure
the survey is meaningful and value added.
So we start off right at the beginning,
right in the opening conference, listening, listening to
the organization's
goals, listening to what would make it a
meaningful experience. How did the last survey go?
And what
would we need to do to modify the
agenda to make it value added and meaningful?
Oh, thank you so much for breaking that
down. And I love that saying, the juice
is worth the squeeze.
I guess.
Yeah. That's good.
So also hoping you might be able to
provide, you know, some insights into the background
and and qualifications
of your ambulatory survey team
and, you know, maybe some more on what
expertise they they bring to the process and
and why is their viewpoint
so important.
You know, I remember years ago, I was
a preceptor, and I came out with a
brand new preceptee out of the dressing room
into the, the break room at a busy
ambulatory surgery center. A number of staff were
on break,
and we had just put on our scrubs.
And the surveyor came out with surgeon's skull
caps tied around their shoes,
thinking those were
shoe covers.
I never saw that surveyor again, actually. I
think they washed out and you have to
have strong ASC, ambulatory surgery center background. You
have to provide
that credibility.
When we have advanced diagnostic imaging centers, for
example, that we accredit an ambulatory,
we make sure we have a radiologist. In
fact,
our most recent addition
has
interventional
cardiology
background as a radiologist. So we utilize
that expertise
for cath labs, freestanding cath labs. So we're
talking masters prepared nurses, CRNAs,
nurse practitioners,
medical doctors,
many medical doctors.
These candidates
for ambulatory surgery center roles as field surveyors,
they must
have the background. They must understand the challenges.
Some I mentioned earlier with the surgeons and
the staffing, they must understand the challenges that
these organizations are going through every day. Yeah.
And I want to look to the future
a little bit too. So, you know, you
recently updated the guidelines for emergency management standards
at nursing care centers and this space is
ever evolving. So, you know, looking ahead, are
there any innovative approaches or new initiatives the
joint commission is exploring to, you know, enhance
the accreditation process? And
and how can they really impact quality of
care?
Every year every year, we look at the
voice of the colleague, we call it feedback
from end users, feedback from our accredited organizations.
We have an advisory council,
multiple advisory councils. Actually, Ambulatory has 1,
hospital has 1 where we get feedback from
end users.
And some of the things that we look
at as we are going into the future,
one
falls into the form of an acronym,
HELP, health equity for the H,
environmental sustainability for the E,
learning for L, and P, performance integration and
improvement. Health equity, of course, social responsibility,
patient safety. You know,
patient safety,
it's all about patient safety. Nothing more, nothing
less. It has to the patient comes first.
Patient goes away, we all go away. So
patient safety comes first.
Environmental sustainability, we have to look at,
being equitable. And so we're
trying not to ask organizations to print anything.
If we can look at the computer, let's
look at the computer.
We're offering a sustainable healthcare certification.
And in learning,
let's leverage
AI, leverage
algorithms. How can we look at responsible use
of health data?
And we have
responsible use health data certification.
And then lastly, and this I think is
probably the most important
because some of the feedback we receive
is how can we improve consistency
internally
in the survey process?
So we're looking at performance improvement,
performance integration,
looking at how we can minimize variations between
surveys.
Doctor. John Perlin directed not long after he
started that we look at all the standards.
Is there duplication?
Is there redundancy?
Are there standards that never really have any
findings year after year? Let's take those out.
And lastly, and probably most importantly of those
3
clinical practice guidelines,
is there as a support,
as a core,
evidence based practice? If not,
let's take that out as well. It has
we cannot ask an organization
to do something that does not have strong
evidence based practice,
CMS guideline background, for example, as well.
We have to have some background for that
requirement.
Thank you. Yeah. No, thank you for sure.
And I like how, you know, at the
beginning, you mentioned that, you know, past, present,
or future at the end of the day,
it's all revolving around patient safety.
So Nothing more, nothing less. Yeah. Nothing more,
nothing less.
So,
wanted to just see if there was anything
else that you would like to to touch
on, you know, might that we might not
have discussed.
Just one thing briefly, Maddie, and thanks for
asking. When we're training these new surveyors, it's
so important for us to get into their
DNA that,
number 1, it's a privilege. It is a
privilege for us as their accredited
organization to be invited in to their organization.
It's a privilege, number 2, to be allowed
to see
their patient care processes. And 3rd, it's a
privilege to be invited to have a conversation
about where there may be some risks.
Thank you.
Well, thank you so much for that, addition
there. And again, Wade, we really appreciate your
time and a great discussion today. We also
want to thank our podcast sponsor for this
episode, the Joint Commission. You can tune into
more podcasts for Becker
Health Care by visiting our podcast page at
beckershospitalreview.com.