Chapter 25 - Medical Home

Possible Survey Review Items

This list represents some of the items that an AAAHC surveyor may review during an on-site survey.

Chapter 25 - Medical Home

A.  Physician/team Relationship with a patient

·  Patient can identify

·  Information explained

·  Listens

·  Speaks

·  Easy-to-understand instructions

·  Knows the patient history

·  Spends appropriate time with patient

·  Thorough as patient feels necessary

·  Informed of delay in appointment

·  Addresses principles to prevent illness

·  Speaks about lifestyle changes to prevent illness

·  Inquiries about patient concerns/worries/stressors

·  Inquiries about mental health status

·  Provides services within a team framework

·  Family included in decisions and treatment

·  Treated with cultural sensitivity

B.  Continuity of Care

·  Visits (50%) with same provider/team

·  Consultations ordered documented

·  Referrals documented

·  Consultations returned documented

·  Referrals are disease/procedure specific

·  Referral results documented

·  Follow-up appointments documented

·  After-hours encounters documented

·  Missed appointments documented and managed

·  Critical referrals/consultations/diagnostics are tracked and follow-up

·  Transitions of care planned, coordinated, and documented

·  Electronic data management used as a tool for facilitating the standards

C.  Comprehensiveness of Care

·  Limits of populations served discussed with patients

·  Scope of services includes:

o  Preventive care

o  Wellness care

o  Acute illness and injury

o  Chronic illness management

o  End of life care

·  Provide patient education and self management resources

·  Knowledge of community resources

·  Community service limitations are known

·  Referrals are appropriate to the patients’ needs

·  Needs of personal caregiver is assessed

·  Electronic data management used as a tool for facilitating the standards

D.  Accessibility

·  Written standards support patient access

·  Patients are assessed for their perception of access

·  Patients are provided information about 24/7 medical care

·  On-call coverage exists

·  Electronic data management used as a tool for facilitating the standards

E.  Quality

·  Patient care is physician directed

·  Incorporates evidence based guidelines and performance measures

o  Preventive care

o  Wellness care

o  Acute illness and injury

o  Chronic illness management

o  End of life care

·  Assess effective use of evidence-based guidelines and performance measures

·  Supervision of patient care evidenced

o  Medication review and update

o  Appropriate ordering of diagnostic tests

o  Appropriate management of medical referrals

·  Assess and continuously improves services

o  Measurements

o  Quality studies

o  Data trending

o  Benchmarking

·  Medical home studies – one each every three years

o  Patient/physician relationship

§  Lab study

§  Patient/provider longevity of care

§  Frequency of appointment with the same provider/team

§  ID concurrently and on a prospective basis

o  Continuity of care

§  Sample study to assess 50% of appointments with same team

o  Comprehensiveness of care

§  Complete review of systems

§  Comparison of preventive versus episodic care

§  Comparison of referrals versus consultation

o  Accessibility of care

§  Assess ICC and/or ER use

§  Wait times between appointments

§  Wait time at appointment

o  Clinical study

§  Diabetes

§  Hypertension

·  Electronic data management used as a tool for facilitating the standards

Updated 1.1.2015