Margaret Spear, MD, has recently been elected Chair of the Board for the Accreditation Association for Ambulatory Health Care. Dr. Spear is an American College Health Association Fellow and currently serves as the senior director of university health services at Pennsylvania State University in University Park. Here she discusses her new position and what lies ahead for accreditation and AAAHC.
Q: What do you hope to achieve as the new Chair of the Board?
Dr. Margaret Spear: I honestly see my role as one of service. I am honored to have been nominated and elected Chair of the Board. My intention is to serve the board and member organizations to advance the AAAHC core mission. Our mission is to promote quality, safety and excellence in ambulatory healthcare. AAAHC accomplishes these goals by supporting and educating our accredited organizations. Through education, we hope to facilitate the growth of our accredited organizations.
Today, our focus is on ambulatory healthcare organizations. The majority of our accreditations go to ambulatory surgery centers, but we also work with office based surgery operations. As a primary care internist, I concentrate my survey work on primary care, which in the recent years has shown growth in the area of accreditation. I expect to be involved with the full range of ambulatory care organizations during my year as Chair of the Board.
Q: How have your previous roles at AAAHC prepared you for new position?
MS: I have been an AAAHC surveyor since 1994. As a surveyor, I have seen many different organizations and this experience has affected everything else I have done with AAAHC.
In addition to being a surveyor, I have served 15 years on the AAAHC accreditation committee, which has the final say on whether or not an organization receives accreditation. As a surveyor, I visited up to a half-dozen organizations a year. On the other hand, on the accreditation committee I reviewed reports from hundreds of organizations each year. This gave me an understanding of the scope of the challenges accredited agencies face. I know how much is involved in each decision made during the accreditation process.
I have also served on the executive committee board for four years. I had the opportunity to work closely with three previous Chairs and gain an understanding of that level of governance. This has been instrumental in preparing me for my current role.
Q: How would you describe the typical AAAHC accreditation process you participate in as a surveyor?
MS: When any organization seeks AAAHC accreditation, the process begins with the initial application, which involves reviewing documents relating to governance, credentialing and quality improvement. Before a surveyor even steps into the building, we begin to form a picture of the organization and how it operates.
The length of the accreditation process varies based on the size and complexity of the organization. Survey teams tend to have more than one person. The entire process can take anywhere from one day to several.
Once the survey team enters the facility, we review records, policy and procedures. We talk to as many staff members as possible and observe safety and infection control protocols.
If we are in a surgery center, we will observe a procedure from the perspective of a patient. We are ultimately trying to evaluate the patient experience. Accreditation is about gaining a sense of the quality of care, not just reviewing policy.
Q: What suggestions would you offer organizations seeking accreditation?
MS: We refer to our survey process as an open book test. Each accreditation agency has standards and the survey is about meeting those standards. There are no surprises. Any organization seeking accreditation should buy a set of our Standards and perform a self-assessment. Ask yourself, do we do this? If so, how do we demonstrate that we do this to a surveyor?
Four times a year, AAAHC holds an Achieving Accreditation conference. Any organization interested in pursuing accreditation should attend a conference. The sessions held there are invaluable. In addition to being an education on AAAHC expectations, organizations have the opportunity to network with one another. Find a center similar to yours and help one another work towards accreditation.
Q: What trends do you see driving the future of AAAHC and accreditation?
MS: AAAHC largely accredits organizations such as freestanding ASCs and primary care practices, but we also have programs for health plan accreditation. This is an area we expect will grow. Though we are unsure of the emerging world of accountable care organizations, we see a possibility in creating an accreditation program for ACOs.
Three years ago, AAAHC developed a separate focus on medical home accreditation. The number of these organizations seeking accreditation is on the rise.
We also have seen a growing interest in accreditation from retail-based clinics. We have conducted a pilot accreditation program with a number of Walgreens Take Care Clinics. AAAHC is beginning to move towards a national accreditation program for the Walgreens clinics.
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