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Tanana Chiefs Conference A newsletter of the Accreditation Association for Ambulatory Health Care, Inc. Volume 4 | Issue 3 | Summer 2017 Exterior of TCC's primary facility, Chief Andrew Isaac Health Center, in Fairbanks, Alaska Spotlight on: Tanana Chiefs Conference For over 10,000 years, an indigenous, nomadic people have hunted, trapped, and fished the 45 million acres—roughly 31% of Alaska—that the Tanana Chiefs Conference (TCC) now serves. The story of these tribes attests to a spirit of self-determination, perseverance, and commitment to community in a richly resourced, but harsh and isolated environment. BEGINNINGS that, for the tribes, had been traditionally from the health center in Fairbanks, to recognized tribes. Today TCC employs In 1741, the Russian Empire conquered open and free. 24 sub-regional clinics serving 16,000 950 people with an average operating a small area of Alaska intending Alaska Natives and American Indians. budget of $155 million. FORMATION OF TCC to colonize it. More than a century TCC also serves 700 non-Native veterans In the latter half of the twentieth During the 2012 construction of the later those efforts were abandoned through an agreement with the U.S. century, Alaska became a state (1959), new CAIHC, cultural items and earth and Russia sold its territorial claim Veterans Administration. The governing and in 1962, at a meeting of 32 from the villages served by the facility to the United States. While no local body for the organization’s health surrounding villages in Tanana, Dena’ were brought and incorporated into Native tribes or chiefs were consulted services is the TCC Regional Health Nena’ Henash (dba Tanana Chiefs the building and its grounds. This during the negotiations, the 1867 sales Board. This group consists of eight tribal Conference) was incorporated. goes to the heart of the organization’s agreement included language requiring members from within the TCC region. inclusivity: everyone is welcome; the U.S. to settle land claims of the A decade later, TCC successfully bid to The larger organization, which provides everyone is invested; everyone “owns” indigenous people. receive grants from the state of Alaska many other social and community the facility. to provide health care, social services, Once the U.S. took ownership of the development services, is made up of and public safety services to all residents land, the area began to see an influx 42 members representing 37 federally continued on page 6 of metropolitan Fairbanks and smaller of non-Native settlers, in part, due to interior Alaska villages. In the mid- Interior of the Chief Andrew Isaac Health Center with cultural items from surrounding villages served by TCC a local gold strike. Tanana, meaning 1980s, TCC began clinical operations “the place where two rivers meet,” was by assuming management of the Alaska an important point of contact between Native Health Center in Fairbanks, Native tribes and settlers, a crossing of renaming it Chief Andrew Isaac Health cultures that also brought conflict. Land Center (CAIHC) after a traditional tribal disputes erupted between settlers and leader of the region. Natives over the deeding and ownership of hills, streambeds, and rivers, land Today TCC operates 25 facilities, ranging During the 2012 construction of the new CAIHC, cultural items and earth from the villages served by the facility were brought and incorporated into the building and its grounds. This goes to the heart of the organization’s inclusive approach to healthcare: everyone is welcome; everyone is invested; everyone “owns” the facility. In Memoriam: Dr. John E. Burke New look for 2018 Standards AAAHC is saddened to announce the passing of former AAAHC president and CEO, The next edition of the Accreditation For example, Chapter 1, Patient Dr. John E. Burke. Handbook for Ambulatory Health Care— Rights and Responsibilities, intends Dr. Burke retired in June 2015, after 18 years with AAAHC and, over the course the version of our handbook that is to emphasize patient-centeredness as of his career, more than 40 years’ experience in healthcare. On the eve of his used by all organizations except ASCs essential to an accreditable organization. that participate in the Medicare Deemed The current handbook reads: continued on page 2 Status program—will present the AAAHC 1.A Patients are treated with respect, Standards with a different look. While consideration, and dignity. there are only minimal changes to the The next four Standards, 1.B-E, address content of the Standards, they have all personal privacy, provider-patient Standard Bearer Surveyor spotlight been redrafted to reflect a big picture communication, patient engagement view followed by a set of descriptors Standard 5.I.C is the infamous “quality “Understanding the rigors that an and shared decision-making. For 2018, or “elements of compliance” that reflect improvement study Standard.” Its 10 accredited center has had to meet Standard 1.A has not changed, but specific, yes-no decision points. These elements are the components of an or exceed in order to achieve that Standards 1.B, C, D, and E will become elements of compliance should provide ongoing cycle of improvement. accreditation makes me feel more the “elements of compliance” that serve for a closer alignment between an comfortable as a health care consumer to describe what we intend by “respect, when seeking care for myself or others.” organization's self-assessment and that of an on-site surveyor. Page 2 Page 7 continued on page 3 IMPROVING HEALTH CARE QUALITY THROUGH ACCREDITATION SUMMER 2017 | TRIANGLE TIMES ›› 1 Standard Bearer: 5.I.C.10 Communication of QI results Standard 5.I.C is the infamous and build investment in change is one documentation. The chart below shows For data-driven results “quality improvement intent of 5.I.C.10. A second is to how the PDSA model can crosswalk Registration is open for July-December study Standard.” Its 10 build a culture of continuous with these elements. However, PDSA 2017 benchmarking studies. Review elements reflect the improvement by formalizing the starts with setting an objective or goal topics and register for currently available components of a process. Once a corrective action and AAAHC recommends that the search studies at www.aaahc.org/institute/ completed quality has been taken and proven for a meaningful QI study begin with a Benchmarking. improvement successful, its sustainability review of data that your organization is For developing a QI program/ cycle that depends on telling the already collecting and an evaluation of understanding the QI process demonstrate story of what happened, your performance against benchmarks— Illuminating Quality Improvement is to your AAAHC why it happened, and how the your own (internal) or those of like a workbook used at our Achieving surveyor that your new, improved state will be organizations (external). If you find that Accreditation seminars that is now organization has an active, maintained. you are not meeting the benchmark, then available as a self-study tool. It’s available ongoing, data-driven, MEETING THE STANDARD you have identified a study opportunity. for purchase at peer-based program of The ten elements of This is the point at which the PDSA cycle www.aaahc.org/publications. quality improvement. of activity begins. Standard 5.I.C create a For recognizing excellence While the elements are not steps to structure for quality improvement. ADDITIONAL QI RESOURCES Nominations are open for the Bernies! be completed in a particular order, Other models are equally valid and easily For benchmarking The Bernard A. Kershner Innovations in depending on how frequently (and by align with the AAAHC structure. For Each year, we release AAAHC Quality Quality Improvement Award is awarded what means) your organization reports example, many organizations like the Roadmap, an annual summary of for QI studies in surgical/procedural on quality activity, 5.I.C.10 may represent PDSA (Plan, Do, Study, Act) model for its high-frequency deficiencies from all and primary care categories. Six finalists a culmination before an improvement emphasis on QI as a cycle. surveys performed under the prior year’s (three for each type of setting) are cycle begins again. For AAAHC, a quality improvement study Standards. You can use this publication announced in November and present THE STANDARD is documentation that an improvement in conjunction with your survey report to their studies at Achieving Accreditation 5.I.C. The organization demonstrates that opportunity was identified, a corrective see how your organization is performing in March when winners are announced. ongoing improvement is occurring action undertaken, and a sustainable on individual Standards compared to For more details, visit peers. Free digital copies of the 2016 by conducting quality improvement improvement the result. The ten http://www.aaahc.org/institute/ edition of AAAHC Quality Roadmap can studies when the data collection elements of Standard 5.I.C create a QI-awards/ s processes described in Standard framework and describe the components be found at www.aaahc.org/institute/ 5. I. B indicate that improvement that should be included in your Quality-Roadmap. is or may be warranted. Written descriptions of QI studies document Standard 5.I.C.1 each of the following elements, as P PLAN A statement of the purpose ... applicable: ■ Objective Standard 5.I.C.2 10. Communication of the findings Identification of the measurable performance goal ... ■ Prediction of the quality improvement Standard 5.I.C.3 ■ Data Collection Plan activities to the governing body and A description of the data that will be collected…to determine current performance. throughout the organization, as Standard 5.I.C.4 appropriate, and incorporation D DO Evidence of the data collection. of such findings into the ■ Collect the data Standard 5.I.C.5 organization’s educational Data analysis… ■ Begin data analysis activities (“closing the QI loop”).
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