One of the most effective ways for a healthcare organization to keep their patients safe is through ongoing periodic practice evaluation (OPPE) or periodic practice evaluation (PPE). PPE programs and processes are how healthcare organizations meet the regulatory and accreditation requirements for peer review. VerityStream shares industry-leading best practices to evaluate performance that can be implemented within your healthcare systems to leverage the PPE program as a valuable and strategic contributor to both individual provider performance and organizational quality.
Regulatory and Accreditation Requirements for PPE
PPE programs enable healthcare organizations to accurately meet the regulatory and accreditation requirements for peer review. As is the case with most processes in the medical field, PPE requirements vary depending on the agency. Here’s a quick summary of the details:
|Centers for Medicare and Medicaid Services (CMS)||
CMS has requirements that all healthcare organizations need to meet unless they have more stringent state requirements/accreditation body requirements. Those would need to be met as well while ensuring that the highest regulations and standards are met.
|The Joint Commission (TJC)||
TJC accreditation applies to hospitals, ambulatory surgery centers, and Federally Qualified Health Centers (FQHCs). Regardless of which Joint Commission program you are accredited under, there are PPE standards that apply.
TJC will want to see both qualitative and quantitative criteria or data requirements which have been approved by the medical staff and designed into the OPPE process.
|Healthcare Facilities Accreditation Program (HFAP)||
The Healthcare Facilities Accreditation Program (HFAP) accreditation program applies to hospitals, ambulatory surgery centers, and physical rehab facilities.
|Det Norske Veritas, Inc. (DNV)||
DNV accreditation applies to hospitals.
|Accreditation Association for Ambulatory Healthcare (AAAHC)||
Accreditation applies to freestanding ambulatory centers such as surgery and pain management centers.
Going Beyond Meeting Regulatory Requirements
Many healthcare systems throughout the country have failed to recognize the full potential of having a PPE program and the impact it can have on providers, patients, and the overall quality of care throughout an organization. PPE has been primarily viewed as an administrative function belonging to the medical staff services department, but it’s much more than that. PPE can be one of the most effective programs we have within the medical staff services department to make a significant impact on quality.
A PPE program is evidence that the medical staff has made a commitment to providing safe, kindly, efficient, effective, equitable, and patient-centered care in today's complex healthcare environment. It is through physician-supported and led programs and initiatives that performance expectations are established, and it provides assurance that the organization will exceed established standards of care for all patients. It is also one of the few mechanisms that allow the medical staff to proactively, concurrently, and retrospectively identify their combined and individual strengths, weaknesses, opportunities, and threats. In order to realize its full potential, we must make concerted efforts to move our PPE programs forward through standardization and optimization.
|Standardization ensures the PPE processes and procedures follow established industry best-practice recommendations that support results that are relevant, reliable, comparable, and consistent.||Optimization ensures those processes and procedures function as efficiently and effectively as possible, and continuously evolve not only to maximize the value of the PPE program but contribute to the transformation of quality in healthcare.|
There are many i’s to dot and t’s to cross to ensure PPE is done effectively, but that doesn’t mean it’s impossible. With a solution like CredentialStream, you have everything you need to request, gather, and validate information about a provider. Learn all about it and request a demo today!
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