presentation in JCIA awareness week

Access to Care and
Continuity of Care (ACC)

© Copyright, Joint Commission International
1

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.

2

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

3

CARE
ACCESS TO

4


ELEMENTS OF THE CHAPTER
–Admission to the Organization
–Standards
–Continuity of Care.

–Discharge, Referral, and Follow-Up

–Transfer of Patients

–Transportation

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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.

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–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

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 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.

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Measurable elements of ACC1
Patients are admitted to receive inpatient care or registered 1. Screening is initiated at the point of first contact within or
for outpatient services based on their identified health care outside the organization.
needs and the organization's mission and resources.

2. Based on the results of screening, it is determined if the
needs of the patient match the organization’s

3. Patients are accepted only if the organization can provide
the necessary services and the appropriate

4. There is a process to provide the results of diagnostic
tests to those responsible for determining if the

5. Policies identify which screening and diagnostic tests are
standard before admission.

6. Patients are not admitted, transferred, or referred before
the test results required for these decisions are available.

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Measurable Elements of ACC.1

The organization has a process for admitting 1. The outpatient registration process is standardized.
inpatients and for registering outpatients.
2. The inpatient admitting process is standardized.

3. There is a process for admitting emergency patients to
inpatient units.

4. There is a process for holding patients for observation.

5. There is a process for managing patients when bed space

is not available on the desired service or unit or elsewhere in
the facility.
6. Written policies and procedures support the processes for
admitting inpatients and registering outpatient.

7. Staff are familiar with the policies and procedures and
follow them.

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OF CARE
2.CONTINUITY

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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.

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2.CONTINUITY OF CARE:
– ACC.2.1
During all phases of inpatient care;
there is a qualified individual identified as
responsible for the patient’s care.

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Follow-Up
3.Discharge,
Referral, and

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3.Discharge, Referral, and Follow-Up
– ACC.3.1 The appropriate referrals
– 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 - 17

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
t
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.

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Patients
4.Transfer of

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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.

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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.

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of the patients
5.Transportation

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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?

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Questions?

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