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AAAHC Update: The Myth of the Perfect Score

By Angela FitzSimmons


AAAHC strives to educate ambulatory health care facilities about the value of measuring and improving the quality of their services. We are already very serious about providing the best quality service that we possibly can – hence our getting a perfect score twice on the accreditation test.

I like everything about this message. Except the last seven words. Accreditation is not a test and organizations do not end up with a score. I know what was meant (and so do you): based on the survey report that came with the decision letter, there were no Standards (or elements of Standards) rated partially- or non-compliant. In other words, the survey team found no evidence of significant deficiencies and all applicable Standards were rated “substantially compliant.”

Marketing your successful accreditation

Part of my job as marketing and communications director is to monitor mentions of AAAHC that appear online and in print. As a leading accrediting organization, AAAHC provides articles (like this one), as well as expert opinion in response to many health care issues that affect ambulatory settings. When a mention is the result of direct outreach – ours or that of a reporter – we are usually aware of when and where it will run. Occasionally, I will be surprised by a non-accredited organization making a false claim of accreditation and those discoveries are shared with our legal department. More frequent, however, are announcements made by organizations that have received a positive decision following a successful accreditation or reaccreditation survey. They share the good news as a means of celebrating the hard work of their staff and providers, and to showcase to a broader audience the quality of the health care services they provide.

Marketing your accreditation is a good idea – we help by providing “accredited by AAAHC” logos for print and digital uses, a template for a basic press release, and a list of other activities to consider. Many of these options build messages that also can translate to images for social channels. Figuring out how to promote your accreditation can continue the team building that has gone into preparing for a survey.

Getting creative

Some organizations have gone above and beyond in creativity. I know of one ASC that has replaced “hold music” in their phone system with an explanation of what accreditation means for patients. I’ve seen videos posted to websites touting the contributions of each department of an ASC. The clearly celebratory tone and the many Facebook posts with smiling staff showing off a newly received certificate of accreditation do a lot to communicate the sense of achievement.

But sometimes, an organization will strike a discordant note (at least to my ears) with something that sounds like: XYZ Clinics received an exceptional score of 100 percent in a reaccreditation survey…

Michael Huey, M.D., Executive Director, Student Health and Counseling Services, Emory University and a AAAHC surveyor for over a decade says, “the only thing worse than a failing survey is a ‘perfect survey,’ because a perfect survey doesn’t give you any place to go to improve.”

A “test” that receives an “A” will never be looked at again. It’s the opportunities for correction that get attention.

Changes to ratings for 2018

The next edition of the “Accreditation Handbook for Ambulatory Health Care” is scheduled to be released in September. The biggest change that AAAHC-accredited organizations will notice is the introduction of “elements of compliance.” The Standards continue to be written as broad-based statements. The elements of compliance will be the indicators that a surveyor will look for to demonstrate compliance and each will be assessed as yes/no. Then, the number of yes responses will be counted and applied to a rating chart for each Standard that will range from “fully-“ to “non-compliant.”

For those who look for that “perfect score,” the new rating methodology could, in fact, result in a survey that reflected full compliance with AAAHC Standards. Still, rather than marketing the message, “we got an A,” I’d prefer to see a story that says, “we’re an organization interested in continuous improvement. That is why we invite an independent third-party to review our policies and procedures against nationally recognized standards. With each triennial survey, we strive to improve our organizational and clinical operations. Our ongoing accreditation tells us we’re serving our patients well. Come see for yourself.”

Ms. FitzSimmons is responsible for AAAHC publications. Her team focuses on bringing best practices to life by sharing concepts addressed via AAAHC Standards and by highlighting excellence as exemplified by AAAHC-accredited organizations, surveyors and staff.



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