(Lija Basu) Good morning, everyone,
and a warm welcome to all joining us for today's webinar.
I'm Lija Basu, and I will be your moderator for today's presentation.
Before we get started, let's go over a few items,
so you know how to participate in today's event.
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following the webinar.
So let's get started.
And with that, I would like to hand it over to Colette,
our presenter for today.
Colette, the floor is yours.
(Colette) Thank you, Lija.
And thank you, everyone, for joining us today.
It is my pleasure to have the opportunity to present to you
on Behavioral Healthcare and Human Services accreditation
with The Joint Commission.
As Lija said, my name is Colette Bukowski,
and I am the Associate Director of Behavioral Health Care
and Human Services at The Joint Commission.
I'm a licensed professional clinical counselor
of the supervisory endorsement in the state of Ohio,
and I'm coming to you today from sunny Cleveland,
where I think we're going to get a few more nice days
before the weather turns.
I've been in the Behavioral Healthcare field for over 25 years,
and worked in a variety of settings and organizations
as both a clinician and a leader.
I surveyed in the Behavioral Healthcare program
for The Joint Commission for over two years
before assuming this role,
and I'm excited to spend some time with you today.
Next.
Today's agenda is pretty straightforward.
We want to give you a little information about The Joint Commission,
talk about what makes Joint Commission different
and how we stand out,
show you a little bit about our accreditation requirements,
and review the accreditation process for you.
And as Lija said, we'll have some time for some questions.
Next.
The Joint Commission is the oldest and most trusted standard-setting body.
We are an independent and nonprofit organization
that was founded back in 1951.
The Joint Commission has been accrediting Behavioral Healthcare
and Human Services organizations for over 50 years,
and accredits across the continuum
of Behavioral Healthcare and Human Services,
including mental health services,
addiction services, human service organizations,
intellectual and developmental disability services,
opioid treatment programs, and CCBHCs.
Achieving the Gold Seal represents your organization's commitment
to meet the highest national standards around safety and quality,
and is increasingly becoming a qualifying factor
for network and payer partnerships.
The Joint Commission, as a whole, accredits over 23,000 organizations.
Of those, around 4,100 are Behavioral Healthcare
and Human Services organizations.
Next.
As I mentioned, we do accredit across the full continuum
of Behavioral Healthcare and Human Services,
and this is just a summary
of all of those for you to see.
Next.
Joint Commission accreditation provides an organization with a solid foundation
for high-quality care and safety.
By learning about The Joint Commission standards
and incorporating these into your policies and procedures,
you are able to impact quality systemically across your organization.
Joint Commission accreditation requirements are national guidelines
that provide an organizational framework to support improvements in care.
They can help organizations improve outcomes
of the individuals they serve as well.
Next.
Accreditation has an internal value to an organization.
The framework results in an increased standardization of practices,
reduced variation across programs, sites, and services.
This decreases risk to those you serve as well as to your staff and visitors,
all resulting in improved safety and quality,
and excellence in care.
Next.
Joint Commission accreditation certainly has external value as well.
Enhancing your brand and reputation,
accreditation with The Joint Commission sets you apart from your competition.
Joint Commission is a recognized leader in patient safety
as a result of our comprehensive approach to safety,
collaborative accreditation experience
that is paired with unmatched expertise and resources.
Our framework and approach fosters better outcomes,
improved safety, and success with business relationships.
Next.
These are the top five reasons why organizations choose
to come to The Joint Commission for their accreditation needs.
Let's talk about some of these a little more in depth.
Next.
Name recognition.
The Joint Commission's name is recognized and respected
throughout the Behavioral Healthcare and Human Services field,
as well as across the health care continuum.
It's a name preferred by payers, contracting agencies,
and referral sources.
Joint Commission accreditation demonstrates your commitment
to quality and safety.
Next.
Our standards represent the highest standards in the field.
They are developed with input
from Behavioral Healthcare and Human Service professionals,
providers such as yourself, subject-matter experts, and consumers.
They are informed by scientific literature and expert consensus.
They provide guidance for best practices in the area of quality and safety,
and assist organizations in becoming data-driven,
again, demonstrating your commitment to quality.
Next.
Our Behavioral Health and Human Services team are experts
in the Behavioral Healthcare and Human Services field.
Our small cadre of licensed professional services
all have direct experience in the field that they are surveying.
They survey an average of 25 times a year
and have an in-depth understanding of the standards
and how they are implemented.
Because they survey so frequently,
they're able to gather best practices from the field,
and be able to bring these during your--
Share these with you during your survey,
providing some additive value when they're on site with you.
Next.
The Joint Commission has the broadest range of resources
to help you excel before, during, and after your accreditation,
with a multitude of live or online resources.
Our standards, surveyors, and resources help organizations become data-driven
and performance improvement-focused.
They guide organizations in areas like suicide reduction
and measurement-based care to improve outcomes.
Some examples.
The Joint Commission Connect, which is on your top left,
it really becomes your portal
once you are an applicant or an accredited organization,
where you access all things related to Joint Commission accreditation.
The Perspectives.
Our Perspectives is a regular publication that communicates updates
and changes to you.
We also have a readiness roadmap,
which is integrated into your Connect site and website
to help guide you with needed resources throughout your accreditation cycle.
We also publish heads-up reports.
These take some of the most commonly found findings on surveys
and essentially tell you how to be compliant,
and give you steps on how you can bring yourself into compliance
and maintain compliance.
There are additional resources available for purchase
through Joint Commission resources,
for anyone who is interested.
Next.
Something that makes us different
is that we provide a high level of direct support
throughout the process--
from your business development professional, which is me,
who can assist you in gathering information and starting the process,
to your dedicated account executive
who works with you throughout your tenure
as an accredited organization.
Organizations also have access to our standards experts
for one-on-one support in interpreting the standards,
as well as the various resources they produce for organizations,
such as on topics of suicide prevention,
health and healthcare equity, to name a few.
Next.
As mentioned previously,
the standards really do provide an organization with a framework
to become data-driven.
One of those areas that the standards focus on
is measurement-based care.
Measurement-based care refers to the use of a standardized instrument
to track the impact of care, treatment, or services
throughout the course of those services.
Results are used to monitor progress, inform goals and objectives,
and inform decisions related to changes
in individual plans for care, treatment, or services.
Organizations are also required to use this data to evaluate program outcomes.
Since the standard was released,
organizations have really begun to see the benefits of measurement-based care.
Some of these benefits that our organizations have identified
include being able to identify treatment issues sooner
and adjust course,
as well as improving treatment team collaboration.
We are the only accreditor that requires
that measurement-based care be used.
Next.
Just a few more things that make us unique.
The Joint Commission believes that safety and quality
are an organizational foundation.
Therefore, our accreditation is organizational-wide,
and we would accredit all eligible programs and services
that an organization provides.
Our framework and standards help organizations standardize those processes
across functions and location.
Our standards are non-prescriptive.
While they're specific to Behavioral Healthcare
and Human Services settings and populations,
they allow organizations the freedom
to implement what works for their particular program
and/or population.
The Joint Commission is also always a three-year accreditation award.
Our timing is very flexible.
It is really guided by and driven by the organization's level of readiness
and by your timeline.
Next.
Also unique to Joint Commission is the SAFER Matrix.
I always say that this is sort of a "So what?" to your survey data.
We show you where you need to focus
based on data.
There can be all of your--
Any findings from a survey get placed on here.
And they really help you understand
what is the impact of not being in compliance
or what is the risk to us, to those that we serve.
It also provides a nice roadmap post-survey
on how to and where to focus moving forward.
Next.
More recently, we released the SAFER Dashboard,
which is really a data intelligence tool
that puts your survey results in your hands.
It allows you to track them over a accreditation cycle,
compare them to other organizations
who are providing similar services,
and manipulate that data.
So your survey data doesn't just become a report,
it becomes something that you're allowed to continue
to use to continue to improve,
as you monitor how you're doing
in terms of compliance with the standard in various risk areas.
Next.
I'd like to take a little time to talk just about our accreditation requirements
and show you a little bit about what those look like.
Next.
Our requirements are available electronically or in print.
We provide a free access to an organization
for 90 days prior to applying.
Post-application organizations always have access to our standards.
You can use this link if you'd like to take a view of them
or contact me directly, and I can certainly get you access.
You can also purchase the manual in print,
again, at Joint Commission Resources.
Next.
As mentioned, our standards are specific to Behavioral Healthcare
and Human Services settings and populations.
Again, they all go through a very specific process
before being put in place, including field review,
public comments.
And they're all piloted, again, non-prescriptive.
A lot of organizations-- they pride themselves on being unique.
They pride themselves
on what makes them different from everyone else
and how they approach providing care.
And the non-prescriptive nature really allows for that organization
to maintain that individuality and that uniqueness,
while bringing themselves into compliance and providing quality care.
Next.
If you have never been in one of our manuals,
this is, again, an online manual.
This is what the home screen looks like
in terms of when you would first log on.
Next.
The manual is set up really to be just one big manual.
And you filter and customize the standards,
so you are able to see those standards that apply to your specific organization
based on the types of services you're providing
and where you're providing them.
So you're able to customize and look at all this from the beginning.
Once an organization does submit an application,
their view of the standards is tailored for them automatically.
But this helps you, again,
be able to have a clear view
of what do we need to look at, what do we need to be in compliance,
and what are the standards that apply to us.
Next.
All of our accreditation chapters.
These are the different chapters
within the manual on the left-hand side,
and they're all set up the same.
So, there is a standard,
which really is the performance expectation.
What does an organization need to do?
They contain a rationale. So, why do it? Why is it important?
Underneath each standard lives what we call "Elements of Performance."
These are really your objectives,
step-by-step, to implementing what you need to be doing.
I sometimes like to think of this manual
as an organization's treatment plan,
in terms of setting some expectations
and giving you the steps that you're going to take to achieve it.
Next.
Here's just an example of what a standard would look like.
As you can see, they are all labeled by an abbreviation of the chapter
in a six-digit numerical code.
Remember, that is your performance expectation,
a rationale, again,
why is it important to do it, or why do it?
And then your elements of performance,
your steps, your guidance
in order to guide you to meeting that standard
and bringing yourself into compliance.
Next.
Here's another example.
In the manual, there are some keys
that help you understand more in depth what is required.
For elements of performance that contain that D with a circle around them,
that means a document is required at the time of the survey
to be in compliance with that particular element of performance.
If you see an ESP-1 on the right-hand side,
that means that that is part of the Early Survey process
for those organizations needing limited temporary accreditation.
We'll talk a little more about that in subsequent slides.
I put at the bottom that Filters.
That is actually where you would select your view
if you wanted to just simply see those that require a document,
or if you wanted to see those contained during the Early Survey process.
So just an FYI, if you are going to be requesting access,
it helps give you a little more information
about what you're looking at.
Next.
All right, let's get into the accreditation process
a little bit.
As I mentioned, the process is really guided by you as an organization.
It's flexible to meet your timeline and deadlines.
We also don't have a look-back period.
So we survey compliance from the day the survey starts.
We do not require that a formal self-assessment
or submission of any supportive documentation
be provided to us prior to your survey.
You tell us when you would be ready for your survey,
And we are able to schedule that within 60 days of the date,
more often sooner.
I think right now we're at about 30 days,
if not sooner.
So, we are able to get to you, again,
to help you meet your timeline and your needs.
Next.
So, this is just a reminder.
Many of you probably already know this, and that's why we're having this webinar,
but OMHAS's new national accreditation requirement,
if you are a currently certified provider,
you will need to hold national accreditation
at your first renewal
on or after October 1st, 2025.
If you are a new provider that is not certified with Ohio yet,
you will need to achieve accreditation
prior to submitting an application to OhioMHAS.
And that, again, would be going through our Early Survey,
which results in a limited, temporary accreditation.
Next.
The first step you would want to do
is, again, you want to take a look at the standards.
So, get access to the standards.
Again, we provide this for free.
I am available to not only get you access to that manual
but give you a tour, a guide,
make sure that your service profile is set up correctly,
and provide any other assistance navigating that.
But that's your first step when wanting to go through this process.
Next.
The next step is, you always want to understand what your pricing is.
Our accreditation costs are based on the types of services and the volumes,
as well as your number of locations.
Our fees are all-inclusive
and broken up over an organization's three-year accreditation cycle.
We have two main types of fees:
annual fees and survey fees.
Annual fees are billed every January.
Survey fees are billed after an organization undergoes a survey
and essentially covers all survey costs
in terms of surveyor time, travel, lodging, etc.
There is also a $1,700 pre-payment of the annual fee
that is due at the time of your application submission.
That prepayment gets applied to your annual fee.
I'm happy to provide anyone for an estimate.
Next.
I used a range here just to give you an idea
of accreditation costs over the three-year cycle.
Year one, you have an annual fee and a survey fee.
If you need to go through the Early Survey fee
or the Early Survey policy,
you would actually incur two surveys
as you would need to go through an Early Survey,
and then a Full Survey.
The Early Survey fee is around $1,485, although not on this slide.
So this gives you a range.
But really, for an organization,
if you really want to know pricing,
the best thing to do, shoot me an email, give me a call.
Let's talk about your program and let me provide you with an estimate.
Next.
Once you have your manual access,
you really want to conduct a gap analysis.
This is you going through the standards
and seeing what you currently have in place.
So those things, you would be mining for gold.
We are already in compliance.
Then, where are some places we might need to tweak or add something
to bring yourself into compliance,
or where you may not have something in place
and need to put something in place to be in compliance.
From that process, you want to look at a timeline.
I'm available for guidance, support,
to help you flush out that timeline
or provide additional guidance around this.
If you aren't sure what compliance looks like,
we can get in contact with the Standards Interpretation Group,
again, so that you have an answer and feel comfortable.
Next.
Available for your use is our readiness assessment tool.
It allows you to take a look
at each of the standards that would apply to you,
identify if you're in full compliance, partial compliance, or not in compliance,
and make some notes.
This is available through me.
Again, it's meant to help--
just help support you in that gap analysis
as you're looking at completing it to really know what is the lift here
of how long is it going to take us to get ready and develop that timeline.
Next.
Next, we would apply for accreditation,
and this is the start of the survey process.
In the application, you're going to select either the Early Survey option
or the Full Initial Survey, option and put a ready date in that.
We use the term "ready date"
which represents the earliest you would want to undergo your survey.
This date can be up to one year from the date,
once you submit your application.
As I said, you will select in this application
either the Early Survey or a Full Survey.
If you are not yet certified by the state of Ohio,
you will need to undergo the Early Survey option.
The basis of the application is really basic information.
It is who are you,
where are you, and what services do you provide.
It really helps us know what your survey should look like.
I support organizations in completing this all the time
and just helping them make sure it's completed accurately,
and answering questions they may have.
As mentioned previously, when you submit this application,
there is a pre-payment of $1,700
that goes towards your first year's annual fee.
Next.
So I want to pause for one minute
because there's a slide in here that somehow went missing.
I just want, before we keep going, to tell you the differences
between the Early Survey and the Full Survey.
There was a slide in here, and I'm not certain what happened to it,
but, again, just to help frame.
Well, Lija, I don't know, it just wasn't in here.
It was a snapshot to accreditation.
(Lija) Got it. Okay, keep going.
(Colette) But so, for organizations needing the Early Survey,
the Early Survey itself is a shortened one-day survey.
It looks at a subset of the manual,
which is really core policies, procedures,
your environment of care.
It occurs before you begin providing any services.
That survey is typically being conducted virtually at this time.
When you select that Early Survey,
you would have that one-day survey.
Again, this would be organizations who are not currently certified.
After that survey, and we're going to look at this more--
After that survey, you would have
some time to complete...
...any plan of correction,
which we call "evidence of standards compliance,"
and then you would be able to submit your application for certification
to the state of Ohio.
A couple of my other slides go into this later,
but I did want to pause
just because I'm not really sure what happened to that slide.
So I'm sorry if anyone was confused, or perhaps I am confused today.
That's how you plan which path you need to do.
And if you're not sure, again, let's talk about it.
But once you submit that application,
you're going to continue to prepare for survey.
Remember, you can prepare up until your survey is scheduled.
And you want to use a team,
if possible, throughout your organization
to help really communicate the value and benefits of accreditation,
establish some excitement if you can.
It is an achievement to achieve accreditation,
and when everyone works on it,
it brings your team together,
helps develop a culture of excellence.
But you're going to work to close any gaps
that you identified in that initial gap analysis,
as you move towards your survey.
You're able to continue to participate in free webinars,
view any webinar replays,
utilize the resources that will be on your Connect page.
You'll see up there,
there's an all-accreditation survey activity guide,
which gives you a lot of details about what will happen in the survey.
And your account executive will also be there
to support you and provide any assistance,
as well as our standards interpretation.
Next.
Each survey is different and customized to your organization.
You will get a 30-day notice of your on-site survey,
and this is for both an Early Survey or an Initial Survey.
You will receive seven business days for resurveys.
As I mentioned, Early Surveys are one-day-long
and typically conducted virtually.
Our shortest Full Initial Survey is one surveyor for two days,
but depending upon the size of your organization
and the types of services,
you could have multiple surveyors for multiple days.
You are provided with an agenda.
The agenda is meant to be in sync with your normal operational day,
but it's always nice to know that it's flexible.
So say you get the agenda,
and there's some session plan at a time where you happen to have a board meeting,
and it happens, right?
Simply talk to your surveyor,
and they will make adjustments
to ensure that everything that needs to get in during your survey
can get completed.
Here is a sample of the Early Survey agenda.
Next.
There's an opening, there's some review of your documents,
environment of care session, system tracers with data management.
We'll talk a little bit about that
in a couple slides down the road.
But this is what an example would look like.
And here's an example
for what day one of a Full Initial Survey might look like.
Next.
So what happens during surveys?
We use tracer methodology to assess compliance during the survey.
We have two types of tracers.
System tracers, which focus on just that:
systems such as environment of care;
emergency management;
infection control;
medication management;
data;
competency, which is human resources;
and leadership.
There are also individual tracers.
These focus on the experiences
of the individuals you provide care, treatment, or services to,
and make up approximately 60% of the survey.
Individual tracers involve staff working with the individual
to follow or trace the individual's experience.
This is done through interviews and direct observation.
The individual's service may also be involved as appropriate, of course,
with their consent.
Individuals for these tracers will be chosen to represent
all programs, services, and sites operated by the organization.
Next.
Your exit conference happens on the last day of your survey.
You will have daily communication of survey findings and transparency.
So nothing should be a surprise to you
if it shows up on an accreditation report.
The exit conference is where all observations will be reported out,
and a preliminary accreditation report with the SAFER matrix will be provided.
This is for both the Full Initial or an Early Survey.
All of the accreditation reports are reviewed by central office
before they are finalized,
which typically occurs between seven and ten days
after your survey has been completed.
When your final accreditation report is posted to your Connect site,
you will then have 60 days to submit your evidence of standards compliance.
So your evidence of standards compliance is,
for each observation noted on the report,
you will tell us what you did to bring it into compliance
and how you intend to keep it in compliance.
This is an online submission done directly in your Connect site.
Your account executive will support you in this process,
and the Standards Interpretation Group is also available for support.
Once those are submitted and accepted,
you would receive your accreditation decision.
The accreditation effective date becomes the date
that your last evidence of standards compliance was accepted.
So if you completed the Initial Survey,
at this point, you would have received your accreditation decision.
If you completed the Early Survey, we're going to go to the next step.
Again, if you are not yet certified by OMHAS,
and you need to go through the Early Survey,
the accreditation outcome of this Early Survey
would be "limited temporary accreditation."
Once you receive limited temporary accreditation
upon completion of those evidence of standards compliance submissions,
you can then submit your application for
and receive your certification from OhioMHAS.
You would then begin providing those services.
You want to continue to keep your account executive updated
about how things are going.
You would undergo a Full Initial Survey
within six months of your Early Survey.
In order to undergo that Full Initial Survey,
you need to have served at least three individuals,
and to have two active in the services that you're providing
in each of those services.
Again, after you would then have that Full Initial Survey,
you would have your exit conference,
you would have your preliminary accreditation report.
Once you have that accreditation report, you would have your 60-day window
to submit your evidence of standards compliance.
And then, once those are completed,
you would receive your accreditation decision,
and it would be effective the last date
that the last evidence of standards compliance is accepted.
Next.
Once you achieve accreditation,
I like to think of accreditation as it's not like a destination,
it's really a journey.
You want to maintain survey readiness.
We have many tools available to you on your Connect portal
to help you maintain compliance in between surveys.
We do update standards
at a minimum of at least two times a year.
So you'll want to remain aware of those updates.
Notification does go out pretty regularly about those.
Then, again, always know that the Standards Interpretation Group
is there to help and support you
if anything comes up and to get clarification from.
You'll also want to remember to notify Joint Commission
of any changes of service, location, ownership.
Your account executive is there.
They're there to help with questions.
I think a lot of times they deal with questions--
"We're adding a new service" or "We're getting a new location,"
and they're there to help with that
and support you throughout your tenure with The Joint Commission.
Next.
These are my quick lowdown tips on how to get the most out of your survey.
You really want to educate your staff about the survey process.
If you want to do mock surveys or mock tracers,
to get them used to it--
a lot of organizations use those--
you want to encourage staff to be open
and learn, and share, and seek to understand.
As a former surveyor, there's so much to learn,
particularly during an Initial Survey,
that you want to ask questions, you want to seek clarification,
so that you are gaining the knowledge that you need
to not only bring yourself into compliance, if you're not,
but really gain a better understanding of,
What does compliance look like?
How are other organizations achieving this?
I always say, "Be eager."
"Expect to grow and improve."
That's really what we strive
to help organizations do as we are an accreditor,
but I think we often view ourselves as a performance improvement organization,
really wanting to support your organization's mission and vision
as it aligns with ours.
Then ask your staff, ask yourself,
"What do we want to get out of this survey?"
Obviously, you want to get accreditation,
but what else?
What else would you like to get out of this survey?
Your surveyor will ask you this on day one.
Another good question to just keep in mind,
is, "How will we measure success of the survey?"
To me, these are things that I think just help you
put yourself in perspective as you begin going through this process
and keep that in the back of your mind.
Next.
That concludes my presentation, minus slide 30,
but let's see if there's any questions.
(Lija) Thank you, Colette.
That was quite a bit of information we have here,
so I'll let our audience digest it,
and we can open it up for questions at this point.
So let me see the most amount of questions,
and I'll undock and read out some of the questions.
Mary, thank you for putting it in the chat.
I think she's answered some of the questions
that we're having most frequent here.
Another question I see most frequent
is if there will be a copy of the presentation sent out.
Yes, everybody on this call will have a copy of the deck,
as well as the recorded presentation
sent to you.
As I let you, Colette, take a breath, I will look through some of the questions.
Some of them are customized,
so I will have Colette reach out to answer those for you.
There was a bit of questions on the Early Survey
that I'm going through,
so I think we have answered that in detail.
But if there are follow-up questions, please feel free to chime in again.
I'm still looking through the roster of questions.
There is a question that came in:
"Where can I find the readiness Excel,
and where can I find the mock survey tools?"
(Colette) So you can connect with me for the readiness tool.
The mock survey tools, I know one of them is in--
There's some in the Perspectives,
so we need to dig around and find that.
I've seen them a couple of times come out in Perspectives
to support organizations.
So connect with me, and let's see where those live
and if we can get you some.
(Lija) Awesome. And then I have one more question that says,
"How much time should we allocate for preparation?"
"How do we know we are ready for survey?"
(Colette) Great question.
So, you've heard me say,
the timeline is really driven by the organization.
On average, organizations take about four to six months to prepare,
but it can vary from organization to organization.
In terms of knowing your readiness,
I think it's really like, "Have we done our due diligence
to conduct a thorough gap analysis,
and try to put things in place
that we believe are in compliance with the standards?"
Sometimes, you'll hear, as a surveyor,
"Oh, we want to have a perfect survey."
"We want to have a perfect survey."
The perfect survey doesn't exist, and it really shouldn't in terms of--
Part of the process of having someone come in as a third eye
outside of your organization
is to maybe be able to see things
that you, in your day-to-day--
Just become a part of your day-to-day,
so you don't see that the exit sign isn't lit,
or the exit sign was hung backwards when somebody painted the wall.
Those are just some examples.
In terms of readiness and knowing that,
I think it's like, "Have we done what we can do?"
"Do we feel good about moving forward?"
Because you want to have a successful survey,
but there are always going to be some findings
because you can always improve and do things better.
And that is essential to the survey process,
and really one of the best benefits of it, if you ask me.
(Lija) Awesome, thank you, Colette.
That is a great answer and probably sums it up for us.
I'm looking through the questions.
I do not have any other ones at this point.
There are some custom questions
that we could probably follow up with Colette.
Also, you have Colette's information on the slide.
You may reach out to her at any time for any other things that come to mind.
So, at this point, I think we are good.
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