Core Standards Accreditation Standards Summary
Accreditation Overview.
Core Standards are basic standards with which all URAC-accredited entities must comply. These standards address several key organizational management functions that are important for any health care organization. The Core Standards provide the basic structures and process any organization must have to maintain a level of quality expected in a URAC-accredited organization.
URAC uses the Core Standards in two distinct ways. First, the Core Standards serve as a common foundation for all of URAC’s accreditation programs. (The process of revising all URAC’s accreditation programs to incorporate the Core Standards will be complete by year-end 2002.) This means that all URAC-accredited companies will need to meet the basic requirements of the Core Standards, as well as the function-specific requirements for a particular accreditation program. For example, a UM-accredited company will need to meet the Core Standards and the UM Standards.
Second, URAC offers stand-alone accreditation under the Core Standards for any health care organization that does not otherwise qualify for a URAC accreditation program. The health care marketplace is very diverse, and many types of health care organizations have not had an opportunity to demonstrate a commitment to quality by seeking accreditation simply because there was no accreditation program appropriate for them. URAC Core Accreditation provides a general set of quality requirements that can be applied in any health care organization setting.
Scope of Standards.
The Core Standards address several critical areas of basic structure and process including organizational structure, personnel management, quality improvement, oversight of delegated responsibilities and consumer protection.
Organizational Structure.
The organization clearly defines its organizational structure and oversight responsibility throughout the organization. Organizations maintain policies and procedures that govern all aspects of the operation. Staff members are required to have job descriptions and clinical personnel must have current licensure. Organizations must implement a regulatory compliance program to ensure they are conducting business in accordance with applicable federal and state laws. Confidentiality and conflict of interest policies must be developed and followed. Other requirements include a structured quality management program and processes to protect the safety and welfare of consumers.
Personnel.
The organization must ensure that written job descriptions for all staff clearly define the following qualifications: education, training, professional experience, expected professional competencies, appropriate licensure / certification requirements, scope and role of responsibilities. The organization verifies credentials of licensed or certified personnel and implements any corrective action given adverse changes in licensure or certification status. Likewise, a clear orientation, training and evaluation program must be maintained and staff should be given the necessary guidelines to do its job.
Operations/Process.
The organization should establish communication methods across all departments and disciplines to promote collaboration, coordinate internal activities and provide quality services. Systems and processes must be in place for information management, business relationships, clinical oversight, regulatory compliance and incentive programs.
Quality Improvement.
The organization must maintain a quality management program that promotes objective and systematic monitoring and evaluation of consumer and client service and health care services.
URAC recognizes that actual quality management activities vary by organization, and thus, provides flexibility for an organization to implement its own quality management program. The intent is to ensure there is a framework for a quality management program within which an organization can focus its unique needs.
Delegation of Responsibilities.
The organization maintains responsibility and oversight for any function it delegates to another entity. Oversight requirements are somewhat relaxed if the entity is accredited by URAC.
Consumer Satisfaction and Protection.
Communications to consumers and clients clearly and accurately represents information about the organization's services and how to obtain these services. A complaint or grievance mechanism must be in place. The organization must have a process to respond quickly in situations that create an immediate threat to the safety or welfare of consumers.
CLICK HERE for a list of standards you must comply with in order to obtain accreditation.