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presentation in JCIA awareness week
1.
Access to Care
and Continuity of Care (ACC) © Copyright, Joint Commission International 1
2.
Overview A health care
organization should consider the care it provides as part of an integrated system of services. The goal of this system is to: – match the patient’s health care needs with the services available. © Copyright, Joint Commission International – coordinate the services provided to the patient. – plan for discharge and follow-up. 2
3.
So. what is
the result? The result is improved: – Patient care. – Patient outcomes. – More efficient use of available resources. © Copyright, Joint Commission International 3
4.
CARE
ACCESS TO 4 © Copyright, Joint Commission International
5.
ELEMENTS OF THE
CHAPTER –Admission to the Organization –Standards –Continuity of Care. –Discharge, Referral, and Follow-Up –Transfer of Patients © Copyright, Joint Commission International –Transportation 5
6.
Organization
1. Admission to the © Copyright, Joint Commission International
7.
1. Admission to
the Organization – ACC.1 – Patients are admitted to receive inpatient care or registered for outpatient services based on their identified health care needs and the © Copyright, Joint Commission International organization’s mission and resources. 7
8.
1. Admission to
the Organization –ACC.1.1 The –ACC.1.1.1 Patients with emergent, urgent, organization has a or immediate needs are given priority for process for: assessment and treatment. –ACC.1.1.2 Patient needs for preventive, –Admitting inpatients palliative, curative and rehabilitative services are prioritized based on the patient’s and condition at the time of admission as an inpatient to the organization. –For registering –ACC.1.1.3 The organization considers the clinical needs of patients when there are outpatients. © Copyright, Joint Commission International waiting periods or delays for diagnostic and/or treatment services 8
9.
1. Admission to
the Organization ACC.1.2 – At admission as an inpatient, patients and families receive information on: the proposed care, the expected outcomes of that care, and any expected cost to the patient for the care. ACC.1.3 – The organization seeks to reduce physical, language, cultural, © Copyright, Joint Commission International and other barriers to access and delivery of services. ACC.1.4 – Admission or transfer to or from units providing intensive or specialized services is determined by established criteria. 9
10.
Measurable elements of
ACC1 Patients are admitted to receive inpatient care or registered 1. Screening is initiated at the point of first contact within or for outpatient services based on their identified health care outside the organization. needs and the organization's mission and resources. 2. Based on the results of screening, it is determined if the needs of the patient match the organization’s 3. Patients are accepted only if the organization can provide the necessary services and the appropriate 4. There is a process to provide the results of diagnostic tests to those responsible for determining if the © Copyright, Joint Commission International 5. Policies identify which screening and diagnostic tests are standard before admission. 6. Patients are not admitted, transferred, or referred before the test results required for these decisions are available. 10
11.
Measurable Elements of
ACC.1 The organization has a process for admitting 1. The outpatient registration process is standardized. inpatients and for registering outpatients. 2. The inpatient admitting process is standardized. 3. There is a process for admitting emergency patients to inpatient units. 4. There is a process for holding patients for observation. 5. There is a process for managing patients when bed space © Copyright, Joint Commission International is not available on the desired service or unit or elsewhere in the facility. 6. Written policies and procedures support the processes for admitting inpatients and registering outpatient. 7. Staff are familiar with the policies and procedures and follow them. 11
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OF CARE
2.CONTINUITY 12 © Copyright, Joint Commission International
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2.CONTINUITY OF CARE: –
ACC.2 The organization designs and carries out its own processes – why? provide continuity of patient care services in © Copyright, Joint Commission International the organization and coordination among health care providers. 14
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2.CONTINUITY OF CARE: –
ACC.2.1 During all phases of inpatient care; there is a qualified individual identified as responsible for the patient’s care. © Copyright, Joint Commission International 15
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Follow-Up
3.Discharge, Referral, and 16 © Copyright, Joint Commission International
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3.Discharge, Referral, and
Follow-Up – ACC.3.1 The appropriate referrals – ACC.3 (acceptance form?). There is a policy – ACC.3.2 the clinical records and the guiding discharge summary. the referral or – ACC.3.2.1 The discharge summary of discharge of inpatients is complete. patients. – ACC.3.3 the clinical records © Copyright, Joint Commission International – ACC.3.4 (Discharge prescription) – – ACC.3.5 The patients who leave against medical advice.(OVR and DAMA FORMAT) Client name/ Presentation Name/ 12pt - 17
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3.Discharge, Referral, and
Follow-Up – ACC.3.1 The organization cooperates with health care practitioners and outside agencies to ensure timely and appropriate referrals. – – ACC.3.2 the clinical records of inpatients contain a copy of the discharge summary. – ACC.3.2.1 The discharge summary of inpatients is complete. – – ACC.3.3 the clinical records of outpatients receiving continuing care contain a summary t of All known significant diagnoses, Drug allergies, Current medications, and Any past surgical procedures and hospitalizations (transfer summary). © Copyright, Joint Commission International – – ACC.3.4 Patients and their families are given understandable follow-up instructions. – – ACC.3.5 The organization has a process for the management and follow-up of patients who leave against medical advice. 18
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Patients
4.Transfer of 19 © Copyright, Joint Commission International
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4.Transfer of Patients: ACC.4 Patients
are transferred to other organizations based on: Status of the patient Need to meet their continuing care needs. © Copyright, Joint Commission International 20
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4.Transfer of Patients:
ACC.4.1 – The referring organization determines that the receiving organization can meet the patient’s continuing care needs. (COMMUNICATION) ACC.4.2 – The receiving organization is given a written summary of the patient’s clinical condition and the interventions provided by the referring organization. (Transfer summary) ACC.4.3 © Copyright, Joint Commission International – During direct transfer, a qualified staff member monitors the patient’s condition. ACC.4.4 – The transfer process is documented in the patient’s record. 21
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of the patients
5.Transportation 22 © Copyright, Joint Commission International
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5.Transportation of the
patients ACC.5 The process for : Referring, Transferring, or Discharging patients, Both inpatients and outpatients, includes planning needs to meet the © Copyright, Joint Commission International patient’s transportation. What does this mean? 23
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