QUAD A is introducing Observation of Care for all non-Medicare programs.
This requirement is already part of the Medicare program survey process. The purpose of observation of care is to allow for real-time evaluation of compliance with QUAD A standards by directly witnessing patient care, treatment, practices, and processes. Essentially, your facility’s policies and procedures in action. We understand that this change may raise questions, and this newsletter is intended to address those questions and any potential concerns.
During a survey, surveyors will observe care that is provided to a scheduled patient for the day. The observation may include being present for an entire surgery/procedure or for portions of it. It’s important to note that QUAD A is not to critique the physicians’ technical skills, but rather to observe the OR team’s adherence to the standards and their delivery of patient care. Direct observation offers the most accurate and insightful perspective on how policies and procedures are implemented in real-time clinical settings.
Key Steps for a Smooth Survey Process
- Provide up-to-date calendars to your facility-assigned accreditation specialist
- Obtain patient consent
- Have policies and procedures ready for review
- Have personnel files completed and ready for review
- Be flexible
Scope of Observation
Surveyors will focus on compliance with QUAD A standards in critical areas
- Patient identification
- Time-out
- Handoff communications in PACU
- Infection control practices, i.e., hygiene and medication handling
- Room turnover procedures
- Sterilization practices, i.e., pre-cleaning and transport of instruments
- PACU care
- Patient discharge process
What to Expect the Day of the Survey
- Good communication and collaboration between the surveyor and your facility staff to plan the day so that all survey agenda items are conducted.
- The surveyor will request a list of surgical/procedural cases scheduled for the day.
- The surveyor will choose a scheduled case to observe elements of patient care.
- The surveyor may request surgical attire.
- With the facility’s assistance, surveyors will introduce themselves to the patient identified for the observation of care, explain their role, and obtain consent to observe staff providing their care directly.
- The surveyor may be present for the entire case or may only be present for portions of the case.
- Patient care observations will not be limited to the operating room; they will also take place outside of the operating room.
- If more than one case is scheduled and depending on the flow of the survey and availability of facility resources, the surveyor may observe the different aspects of patient care on more than one patient.
- Facility staff should be ready to respond to questions about processes, policies, and procedures related to the care being delivered.
- Surveyors may be on site for 6-8 hours
The observation may not include every bullet above based on timing and variability of the process.
Why Observation of Care Matters
QUAD A’s Board of Directors, composed of experienced physicians and accreditation experts, supports this approach because by understanding and preparing for Observation of Care, facilities can demonstrate compliance, efficiency, and optimal patient outcomes.
It enhances accountability, standardization, and patient safety across accredited facilities and keeps Patients First. Always.
Since 1980, QUAD A (a non-profit, physician-founded and led global accreditation organization) has worked with thousands of healthcare facilities to standardize and improve the quality of healthcare they provide – believing that patient safety should always come first.
