First Integrated Care Certified Organization Shares Tips for Streamlining Processes | Joint Commission

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First Integrated Care Certified Organization Shares Tips for Streamlining Processes

Oct 18, 2017 | 5948 Views

By Michael Kulczycki
Executive Director, Ambulatory Health Care Program

The term “integrated care” is thrown around a lot in health care, but the recent emphasis on population health has made integration absolutely essential in providing safe care.

Last year, Parrish Medical Center of Titusville, Fla., received well-deserved attention for becoming the first hospital in the U.S. to earn integrated care certification (ICC) from The Joint Commission. For an organization or system that provides and coordinates care across different health care settings, this certification highlights:

  • information sharing

  • handoffs

  • IT integration 

  • risk sharing

  • patient-centered care


Parrish Medical Center is a 210-bed, not-for-profit public medical center in North Brevard County, Florida.  In late 2016, Parrish was reviewed initially for ICC certification for hospital and ambulatory care. In August, The Joint Commission conducted an extension survey for Parrish adding home health and skilled nursing to its ICC. Now four certified components partner together in delivering integrated care for Parrish: acute care, ambulatory care, home health, and skilled nursing.

A year into its 36-month integrated care certification, Parrish’s Edwin Loftin, Vice President Acute Care Services/CNO, notes that the organization had already been doing much of what is required for certification. Completing the certification evaluation last year merely documented their existing best practices.

Loftin explains, “As we all know, such an effort requires buy-in from the whole team. Unless ambulatory providers are truly integrated – not just affiliated – with their partner organization, it’s impossible to achieve the kind of care our patients deserve.”

Perfecting Transitions

Since Parrish Medical Center was already Joint Commission accredited, the first part of the ICC process was complete. The Joint Commission requires that an organization have only one component or program (the hospital, critical access hospital or psychiatric hospital, ambulatory setting, physician network, nursing care center, or home care) already accredited to apply for integrated care certification. 

Regardless of whether every part of the system is accredited or just one, it’s essential that every entity is communicating well. It’s been proven time and again that poor communication, especially during patient care transitions, results in adverse events. The certification process helped Parrish standardize:

  • hospital to ambulatory admission and vice versa

  • timelines for sending information between settings of care 

This really comes into play when process improvement efforts must span both the ambulatory and hospital settings, addressing areas like:

  • osteoporosis-associated fractures 

  • referral for tobacco cessation services 

  • radiation therapy and adjuvant chemotherapy after lumpectomy for breast cancer

Thriving During the ICC Survey

When The Joint Commission’s certification reviewers visit, they’ll want to “trace” the patient’s experience between sites and settings of care.

Reviewers will want to ensure high engagement between ambulatory providers, referring physicians and the hospital, often referred to as the “medical neighborhood”. One way of promoting strong engagement is by auditing pertinent data sets. These aren’t typically included in the general referral request, but speak volumes about the level of care coordination.

Pertinent data sets address:

  • the name of the clinical condition or diagnosis

  • description of how pertinent data set conclusions were achieved, including any supporting references

  • additional relevant patient information that’s included in the patient record

Certification Standards Specifics 

Parrish Medical Center actually found the process to be pretty seamless and the specific certification standards aligned with the processes already in place. 

Integrated care standards simply covered:

  • program organization

  • defined leadership

  • clear mission, vision and goals

  • identified scope of service

  • communication processes ensuring quality care throughout the hospital and ambulatory journey

  • support of population-based care

  • sufficient providers to meet patient needs

Parrish is no longer the only organization certified for integrated care by The Joint Commission, but its experience seems universal to many healthcare organizations focused on providing integrated care to select patient populations. If your organization could benefit from ICC certification, like Parrish, please email us for more information. If you’d like to learn about Parrish’s ICC journey, I encourage you to request this ICC white paper.

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