3.  ADAPTING THE CHART AUDIT TO MEET JCAHO/AAAHC REQUIREMENTS

The health care environment continues to evolve, both within and outside of IHS.  In keeping with recent changes, both Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and Accreditation Association for Ambulatory Health Care (AAAHC) emphasize patient centered, performance-based evaluations. Health centers are asked to demonstrate the efficacy and appropriateness of the care they provide.  JCAHO and AAAHC both seek to determine whether a health facility is actually carrying out those functions that reasonably can be expected to improve the health of the patients they serve. 

If JCAHO or AAAHC accreditation is important to your facility, you will be pleased to find that the diabetes audit process described here can serve as an excellent example of the type of performance oriented clinical self-assessment and improvement activity that both of these organization require.  The diabetes audit is based on consensus-derived standards of care.  These standards are reviewed regularly and then widely disseminated.   The audit looks at your facility's actual performance on a number of key processes that are known to (or considered likely to) improve the health of people with diabetes.  Outcome measures, such as blood pressure control and glycemic control, are also monitored.  Because the diabetes audit is designed to be performed on a regular basis, it can be extremely useful in documenting performance trends that JCAHO or AAAHC find of interest.  Additionally, when the diabetes audit results are routinely incorporated into multidisciplinary diabetes care planning activities, they provide a clear illustration of interdepartmental coordination to improve patient care.