Access to care and continuity of care

Access to Care and
Continuity of Care (ACC)

© Copyright, Joint Commission International

WHAT IS MEANT BY BOTH TERMS?

ACCESS TO CARE CONTINUITY OF CARE
 All insurance are accepted.  maintenance of comprehensive
 Changes in insurance are central record that contains all
actively accommodated. pertinent information
 Practice is accessible by public  Facility provides continuous care
transportation, where available. for transfer and after discharge
 Families are able to reach directly from the facility
to the facility when needed (24

hours/d, 7 days/wk, 52 wks/yr)
 The practice is physically
accessible and meets public
requirements.

Why are we here?

1 2 3
• To know a little • To conduct a • To fulfil criteria
information better practice of JCIA
about the ACC for health care reaccreditation
chapter provision.


Overview
A health care organization should consider the care
it provides as part of an integrated system of
services.
The goal of this system is to:
– match the patient’s health care needs with the
services available.

– coordinate the services provided to the patient.
– plan for discharge and follow-up.

So. what is the result?
The result is improved:
– Patient care.
– Patient outcomes.
– More efficient use of available resources.


ACCESS TO CARE
(ADMISSION TO ORGANIZATION)


ELEMENTS OF THE CHAPTER
–Admission to the Organization

–Continuity of Care.

–Discharge, Referral, and Follow-Up

–Transfer of Patients

–Transportation

So, to be easy to understand the contents of
this chapter we will listen to this story:
Few days in Zahra life in our facility Related standards:
 Madam Zahra brought by family to ask  Access to care
for medical advice through ER
 Been aramco listed.  Access to care
 Admission decided according to her  Admission to organization
needs confirming the priority items and
the facility mission.
 ACC 1
 Admitted to regular ward.
 ACC 1.2

 Care plan and proposed outcome
explained to family
 All barriers detected are bypassed  ACC 1.3

So, to be easy to understand the contents of this
chapter we will listen to this story:

Few days in Zahra life in our facility Related standards:
 One day later, patient suffered from medical  ACC 1.4
condition that need to be shifted to other  ACC 2
intra-organization areas.
 Treating physician still in command care  ACC 2.1
 The case endorsed well by well documented  ACC 2.1
file workup
 The patient and her family asked for referral
 ACC 3
to other facility

 Family counselled for the proposed care plan
after referral and they are thinking to go  ACC 1.2
DAMA  ACC 3.3
 ACC 3.5

So, to be easy to understand the contents of this
chapter we will listen to this story:
 Report prepared based upon clinical assessment  ACC 3.2
and include all significant history of our patient
 Patient will be transferred to this facility based  ACC 4
upon her needs and their mission  ACC 4.1
 Sending the report to receiving facility and care  ACC 4.2
plan approved and accepted
 Discharge summary wrote and kept in our patient
file  ACC 3.2
 Transfer summary wrote and sent to receiving  ACC 3.2
facility.
 Qualified team matching the patient needs will  ACC 4.3
transfer the patient  ACC 4.4

 With full medical records with transfer summary
 Patient been transported to the receiving facility  ACC 5
by our facility according the patient needs

Organization
1. Admission to the


1. Admission to the Organization

–ACC.1
 Patients are admitted to receive inpatient care
or
 registered for outpatient services

based on their identified health care needs
and the organization’s mission and
resources.

–ACC.1.1 The
–ACC.1.1.1 Patients with emergent, urgent,
organization has a or immediate needs are given priority for
process for: assessment and treatment.

–ACC.1.1.2 Patient needs for preventive,
–Admitting inpatients palliative, curative and rehabilitative
services are prioritized based on the patient’s
and condition at the time of admission as an
inpatient to the organization.

–For registering –ACC.1.1.3 The organization considers the

clinical needs of patients when there are
outpatients. waiting periods or delays for diagnostic
and/or treatment services


 ACC.1.2
– At admission as an inpatient, patients and families receive
information on:
 the proposed care,
 the expected outcomes of that care, and
 any expected cost to the patient for the care.
 ACC.1.3
– The organization seeks to reduce physical, language, cultural,

and other barriers to access and delivery of services.
 ACC.1.4
– Admission or transfer to or from units providing intensive or
specialized services is determined by established criteria.

CARE
2.CONTINUITY OF


2.CONTINUITY OF CARE:
– ACC.2
The organization designs and carries out its own
processes
– why? 
 provide continuity of patient care services in the organization .
 and coordination among health care providers.
– ACC.2.1

During all phases of inpatient care  there is a qualified
individual identified as responsible for the patient’s care.

Follow-Up
3.Discharge,
Referral, and


3.Discharge, Referral, and Follow-Up

– ACC.3.1 The appropriate referrals (written
– ACC.3 acceptance form?).
There is a policy
– ACC.3.2 the clinical records and the
guiding discharge summary.
 the referral or
– ACC.3.2.1 The discharge summary of
 discharge of inpatients is complete.
patients.
– ACC.3.3 the clinical records

– ACC.3.4 (Discharge prescription)
–
– ACC.3.5 The patients who leave against
medical advice.(OVR and DAMA FORMAT)

Client name/ Presentation Name/ 12pt -

3.Discharge, Referral, and Follow-Up
– ACC.3.1 The organization cooperates with health care practitioners and outside agencies to
ensure timely and appropriate referrals.
–
– ACC.3.2 the clinical records of inpatients contain a copy of the discharge summary.
–
 ACC.3.2.1 The discharge summary of inpatients is complete.
–
– ACC.3.3 the clinical records of outpatients receiving continuing care contain a summary
of
 All known significant diagnoses,
 Drug allergies,
 Current medications, and
 Any past surgical procedures and hospitalizations (transfer summary).

–
– ACC.3.4 Patients and their families are given understandable follow-up
instructions.
–
– ACC.3.5 The organization has a process for the management and follow-up of patients who
leave against medical advice.

Patients
4.Transfer of


4.Transfer of Patients:
ACC.4
Patients are transferred to other
organizations based on:
Status of the patient
Need to meet their continuing care
needs.


4.Transfer of Patients:
 ACC.4.1
– The referring organization determines that the receiving organization can meet the
patient’s continuing care needs.
(COMMUNICATION)
 ACC.4.2
– The receiving organization is given a written summary of the patient’s clinical condition
and the interventions provided by the referring organization.
(Transfer summary)
 ACC.4.3
– During direct transfer, a qualified staff member monitors the patient’s condition.

 ACC.4.4

– The transfer process is documented in the patient’s record.

of the patients
5.Transportation


5.Transportation of the patients
ACC.5
The process for :
 Referring,
 Transferring, or
 Discharging patients,
Both  inpatients and outpatients,
includes  planning needs to meet the

patient’s transportation.
What does this mean?

Access to care and continuity of care

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