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AAAHC Updates Allergy Documentation Resource

Revised toolkit and new benchmarking study offer tips for latex and penicillin allergies

(Skokie, Ill.) November 25, 2019 – The Accreditation Association for Ambulatory Health Care (AAAHC) has updated its Allergy Documentation Toolkit. The revised version includes an overview of challenges and improvement strategies, as well as more specific information on latex and penicillin/beta-lactam allergies, to help ambulatory health care organizations avoid patient complications.

More than 50 million Americans suffer from allergies each year, costing the health care system an estimated $18 billion.[i] Penicillin allergies are the most common drug allergy in the US, with a reported prevalence of 10%,[ii] while latex allergies affect 1–7% of the US population.[iii] [iv] For surgical procedures, specifically, hypersensitivity reactions may affect 1 in every 358 patients.[v] The updated toolkit covers a wide range of allergic reactions – from severe and life-threatening, to sensitivities, intolerances, idiosyncratic reactions, and side effects.

“While documentation cannot always prevent adverse reactions, how health care providers approach documentation can help to reduce risk,” said Naomi Kuznets, PhD, vice president and senior director of the AAAHC Institute for Quality Improvement. “Ambulatory organizations can use this resource to develop an action plan to improve allergy education and create a standard, consistent process to follow when documenting allergies.”

Documentation Challenges

While the Centers for Medicare and Medicaid Services (CMS) require documentation of allergies to medications in the pre-surgical assessment, allergy information on patient charts is often incomplete or inconsistent.[vi] [vii] [viii]

As shown in the 2019 AAAHC Quality Roadmap, accreditation survey data from 2018 surveys revealed two of the most common issues in allergy documentation are allergies not being updated during each visit and an overreliance on “No Known Drug Allergies” (NKDA).

“It is best practice for providers to note any severe reactions a patient has to any type of treatment and not just to drugs,” said Kuznets. “Thorough documentation enables health care providers to take immediate action when a reaction occurs in the future.”

Updated Educational Resource

To improve allergy documentation practices, AAAHC encourages ambulatory organizations to develop an action plan centered on education, consistency, and standardization. The updated toolkit provides organizations with current research and an action plan to educate staff, achieve consistent documentation, and standardize processes, prompts, and care transitions. Complementing the revised toolkit is an allergy documentation benchmarking study set to begin in January 2020.

“Our allergy documentation resources are dynamic, educational opportunities designed to help organizations develop best practices, reduce risk and improve patient outcomes,” said Noel Adachi, MBA, president and CEO of AAAHC. “The updated toolkit and the new benchmarking study underscore the many ways AAAHC works with accredited organizations to help them stay 1095 Strong, quality every day, for the 1,095 days of the accreditation term.”

To order the updated Allergy Documentation Toolkit, please visit: https://www.aaahc.org/quality/patient-safety-toolkits/

To learn more about the Allergy Documentation benchmarking study and/or to register, visit: https://www.aaahc.org/quality/benchmarking-studies/

About AAAHC

Founded in 1979, AAAHC is the leader in ambulatory health care accreditation, with more than 6,100 organizations accredited. We accredit a wide range of outpatient settings, including ambulatory surgery centers, office-based surgery facilities, endoscopy centers, student health centers, medical and dental group practices, community health centers, employer-based health clinics, retail clinics, and Indian/Tribal health centers, among others.

AAAHC advocates for the provision of high-quality health care through the development and adoption of nationally recognized standards. We provide a valuable survey experience founded on a peer-based, educational approach to on-site review. The AAAHC Certificate of Accreditation demonstrates an organization’s commitment to providing safe, high-quality services to its patients—every day of the 1,095-day accreditation cycle. It is recognized by third-party payers, medical professional associations, liability insurance companies, state and federal agencies, and the public. For more information on AAAHC, please visit www.aaahc.org.


[i] WebMD. Allergy Statistics and Facts. Dec. 2018. http://www.webmd.com/allergies/allergy-statistics. Accessed May 2019.

[ii] Joint Task Force on Practice Parameters; American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. Drug allergy: an updated practice parameter. Ann Allergy Asthma Immunol. 2010.105(4):259-273. https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/drug-allergy-updated-practice-param.pdf. Accessed May 2019.

[iii] Association of Surgical Technologists. Guidelines for Best Practices for the Natural Rubber Latex Allergic Patient. Apr 2018. http://www.ast.org/uploadedFiles/Main_Site/Content/About_Us/Guideline_Latex_Allergy.pdf. Accessed May 2019.

[iv] American Association of Nurse Anesthetists. Latex Allergy Management Guidelines. Reaffirmed Sep 2018. https://www.aana.com/docs/default-source/practice-aana-com-web-documents-(all)/latex-allergy-management.pdf?sfvrsn=9c0049b1_8. Accessed May 2018.

[v] Garro LS et al. Specific questionnaire detects a high incidence of intra-operative hypersensitivity reactions. Clinics (Sao Paulo). 2018 May 17;73:e287. doi: 10.6061/clinics/2018/e287. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938488/. Accessed May 2019.

[vi] Centers for Medicare and Medicaid Services. State Operations Manual: Appendix L – Guidance for Surveyors: Ambulatory Surgery Centers. 42CFR416.52(a)(1). Apr 2015. https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf. Accessed May 2019.

[vii] Shah NS, Ridgway JP, Pettit N, Fahrenbach J, Robicsek A. Documenting Penicillin Allergy: The Impact of Inconsistency. PLoS One. 2016 Mar 16;11(3):e0150514. doi: 10.1371/journal.pone.0150514. eCollection 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794183/. Accessed May 2019.

[viii] Kiechie ES et al. Medication Allergy and Adverse Drug Reaction Documentation Discrepancies in an Urban, Academic Emergency Department. J Med Toxicol. 2018 Dec;14(4):272-277. doi: 10.1007/s13181-018-0671-7. Epub 2018 Jul 2.

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