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The Value of CAAS Accreditation
This is the sixth in a series of articles from MONOC Mobile Health Services. MONOC is New Jersey's largest provider of EMS and medical transportation and first CAAS-accredited agency. The goal of this series is to provide insight and solutions for the different managerial and operational challenges facing the EMS leaders of tomorrow. For more, see www.monoc.org.
Prior to 1990, there were no national standards in place for the medical transportation industry. Agencies would claim they were delivering a quality service, but without industry-wide standards, could they really prove it?
This sentiment seemed to be shared by many. In 1982, the American Ambulance Association (AAA) conducted a needs assessment workshop on the state of EMS in the United States. The need for high-quality industry standards emerged at the top of the list of pressing issues. As a result, in May 1984, the AAA Board of Directors authorized the formation of its Ad Hoc Committee on Accreditation and Standards. With input from EMS industry professionals, a list of comprehensive standards was identified and in 1990 the independent Commission on Accreditation of Ambulance Services (CAAS) was formed.
So what did this mean for the EMS industry? It meant that finally there was a benchmark for excellence. The standards covered all aspects of an organization including structure, interagency relations, management, finance, community relations and public affairs, human resources, clinical standards, safety and risk management, equipment and facilities and communication centers. These standards were designed to help increase operational efficiency and decrease risk and liability across the entire organization.
With all that said, is CAAS accreditation worth the effort? My employer, MONOC Mobile Health Services, thought it was. In late 2003, our president and CEO made the commitment to move forward and become CAAS accredited.
Our first step was to obtain a set of the current CAAS standards so we could perform a company-wide self assessment. We evaluated our entire organization, characteristic by characteristic. Some standards we complied with fully. In order to meet others, we needed to make internal changes such as revisions to policies, SOPs and processes. Some changes were small, but others involved company-wide education and buy in.
Once our operation met all CAAS standards, we completed the formal application. This involved collating reams of documentation including reports, policies and confirmation letters. In the end, the count totaled five binders, each six inches wide, containing just shy of 3,000 pages of documentation. This entire process of self assessment, including the time it took to incorporate all necessary changes and complete the formal application, took just over a year to complete.
The CAAS office thoroughly evaluated the application and documentation.. They contacted our CAAS coordinator with any questions or deficiencies, then followed up with an on-site review.. with a team of three experienced industry professionals, including one physician. They were on site for two full days, conducting interviews with managers and staff, visiting our communication center and remote stations, inspecting ambulances, reviewing patient care reports and human resource records, and in general, making certain that the policies and procedures we had in place were truly being practiced.
Once the review team completed its inspection, the report was turned over to the CAAS Panel of Commissioners which reviewed the application, as well as the on-site reports to determine whether we met all CAAS standards. A couple of months later we received notice we met all the standards and we received unconditional CAAS accreditation for three years.
So was all of that worth it? Without a doubt, yes! CAAS accreditation has added value to MONOC in many ways.
First and foremost, completing a company-wide self assessment proved priceless. It forced us to look closely at processes in every department, from the communication center to billing to operations to our warehouse. Simply put, it allowed us to do what we always wanted to do, but were too busy to do. In the end, we were able to update processes to increase our productivity and accountability. Adding new policies and procedures to meet various CAAS standards also showed us the importance of documentation and how it can reduce risk and liability. Many CAAS standards also helped us strengthen our continuity and succession plans.
CAAS accreditation also strengthened our clinical department by moving it from a Quality Assurance (QA) to a Quality Improvement (QI) operation. QA is important, but what you do with the information you gather, and how you use it to improve your organization and patient care, is most important. CAAS standards enhanced our ability to trend and analyze information, then improve what we do by initiating ongoing educational programs for staff. Additionally, while we perform QI on each patient care report we generate, having the CAAS physician review our charts and processes is invaluable. Getting that second opinion from an outsider allows for a fresh unbiased opinion of our performance.
Some less tangible benefits of CAAS accreditation include the ability to market your accreditation to the community and to better relate to hospitals that depend on accreditation every day, giving your organization a competitive advantage when bidding on contractsYou are also able to prove to your stakeholders that your organization meets the highest national standards in the industry.
Beyond ensuring that all CAAS standards and characteristics were met, the on-site review team also shared best practices that might be applicable for our type of agency. As experts in our industry, they've seen a lot and were more than happy to share their experiences and ideas on how we can improve as an organization.
Today CAAS is international, with just over 130 accredited agencies throughout the United States, Canada and the West Indies. Many states have even enacted EMS legislation that recognizes CAAS accredited agencies exceed state requirements. This allows accredited agencies to bypass some or all components of the state licensing or inspection process. The bottom line is that becoming CAAS accredited demonstrates your commitment to excellence to your employees, patients and the community you serve.
Scott A. Matin, MBA, NREMT-P, is the Vice President of Clinical & Business Services for MONOC Mobile Health Services in Wall Township, New Jersey. His responsibilities include oversight of MONOC's clinical, education, Q/I, research, public relations, marketing, government affairs and business development services. In addition to his present position at MONOC, Scott is adjunct faculty for the School of Administrative Science at Fairleigh Dickinson University and an on-site team leader for the Commission on Accreditation of Ambulance Services (CAAS). Scott has been involved in Emergency Medical Services for over 25 years and is an established manager, educator and Nationally Registered Paramedic. Scott is also the author of numerous articles and research studies, a member of several editorial review boards and a frequent presenter at professional conferences throughout the country.
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