Anne Beekman, BSN, RN, Manager Kresge Cardiac Cath Labs, Frederik Meijer Heart & Vascular Institute, Spectrum Health, Grand Rapids, Michigan
Can your cath lab certify that it is ahead of the curve in meeting appropriate care standards? Have you or anyone on your cath lab team considered getting third party validation to prove medical necessity in all cases? And, as with any strategic plan, how do you provide data to all hospital stakeholders that your lab is meeting national standards? How do you engage your physicians to create documentation that paints a true picture of the care being provided?
With accountable care on the horizon, how do we prove our processes under the scrutiny of Recovery Audit Contractors (RACs) and other regulatory bodies? How do we demonstrate to communities we serve that patients are receiving the highest quality care? These are issues all cath labs grapple with today. At Spectrum Health, we expected the Accreditation for Cardiovacular Excellence (ACE) accreditation process would provide the following three benefits: a process to improve case review, a comprehensive evaluation without insider bias, and a focus on issues at the top of physicians’ minds.
As a cath lab manager at Spectrum Health, I was immersed in the ACE accreditation process. The front-end work was significant and required help from our CNS, medical director and quality department to complete all the submission requirements. However, the work done at the beginning added value to the on-site visit and greater meaning to the action plan provided by ACE.
What did we find? We were surprised to uncover gaps between physician documentation of clinical care and quality abstraction; this disconnect was revealed and quantified during our ACE review. The reality of value-based purchasing is here and the ACE review process can help mitigate that risk and cost to your organization. We found the cost of ACE accreditation was warranted by reducing our exposure to paybacks or penalties.
Below, we share our experiences, reasons and benefits that we believe demonstrate the importance and value of ACE’s thorough accreditation procedure.