They Are Watching

How many of us shook our heads in disbelief when we heard that during a transplant operation it was discovered that the blood type of the organ was not a match for the patient. We thought this certainly must have happened in a third-world country. Not so! This occurred at the highly regarded Duke Medical Center in Durham, N.C. A simple series of procedures confirming blood type from the organ bank to the operating table could have prevented the mistake.

The problem was not the medical team or the many caring health care professionals serving the patient, but a simple process disconnect. Unfortunately, medical errors have increased significantly over the past several years, and consumers are becoming much more aware of the problem. The Commonwealth Fund reports that eight million households have experienced medical errors that caused serious health problems.

While the majority of these problems occur in hospitals, consumers know that sick patients are being sent home earlier than in the past. The responsibility for care then shifts to the home care professional. Consumers not only expect to see vast improvements in the delivery of health services in our country’s hospitals, but they also expect to see leaders in home care accept the same challenges of patient safety and quality of care.

I believe home care is part of the solution to our nation’s health care crisis. Our industry can care for an aging population much more effectively at home. In addition, I believe the vast majority of home care providers are committed to operating their businesses ethically and to providing quality products and services. Thus, being measured by quality standards should be something that providers support.

A desire to meet expectations and improve quality should emanate from a passion for our patients. Regardless of whether managed care, government or other third-party stakeholders require or do not require external peer review, the industry itself should embrace the challenge of a fail-safe patient care system that reduces human error and provides best clinical practices. Home care providers’ goals must be to direct their businesses — clinically and managerially — as professionally and efficiently as possible.

Accreditation does help companies reach these goals. At a recent conference, an attendee told me that it was time-consuming to prepare for accreditation. However, he acknowledged that the process helped improve his business plan and policies for delivering services to his patients. I told him it is our goal as an accrediting agency to help our customers improve.

While accreditation does have a positive impact upon those companies that it services, all of the nation’s accrediting bodies must join with providers to seek ways of improving standards and procedures to better help companies achieve quality objectives.

There are inherent weaknesses in the traditional model of accreditation used today in the United States that need improvement. Otherwise, we would not be reading about problems in accredited health care organizations. Since there are numerous interrelated and interacting processes that take place in health care organizations, accreditation standards need a design that will direct providers into a systematic identification and management between processes and procedures throughout the organization. This should apply to both the clinical services and the business operations.

Harvard’s Regina Herzinger points out in her book Market-Driven Health Care that informed and assertive consumers historically have caused revolutions in American industry. She concludes that the same is about to take place in health care. Therefore, we must all work together to foster a transformation that meets the expectations of consumers.

Consumers, or patients, are what home care is all about. One day, you and I may be seniors at home using home care products and receiving care. Then we will also be watching.

Tom Cesar is president and chief executive officer of the Accreditation Commission for Health Care Inc., a private, not-for-profit corporation that develops accreditation standards for home care providers and alternate-site markets. For more information, you may contact ACHC by telephone at 919/785-1214 or visit www.achc.org.