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Friday, November 26, 2021  

Making the Most of an Audit ExperiencePublished 7/21/2009

I loved to watch Flip Wilson on television when I was younger.  
For some of you, you might not know who Flip Wilson was. He was a very entertaining comedian that was featured on the Ed Sullivan show and later went on to have his own comedy show.  
He was a comedian similar to Bill Cosby. “Here comes the judge, Here comes,” the judge was one of his popular sayings. He would do skits and be dressed up as a judge and it was quite amusing.
Even though Flip Wilson made light of a serious situation of capturing that moment when a judge comes into a room, we all can relate to how intense it can be to have an authority figure in our presence. Those same intense feelings run high when an auditor or inspector walks through the door of a health care organization.
As a health care nurse or a health care administrator, having an audit conducted within your organization is not that uncommon in today’s workplace. We are all probably use to having safety inspections and state health department reviews. If you have worked in a hospital for any length of time you are familiar with Joint Commission reviews or audits.
There is a great deal of anxiety with the thought of an upcoming audit or when the auditors or inspectors walk through the doors. It really doesn’t have to feel like the moment when a judge walks in the room. To lessen the fear of the nurses or the staff that is being audited follow these simple rules.
v Communicate to everyone involved the goals of the process. The more communication about what is expected can definitely lessen the fears and anxiety of all parties involved.
v Use the audit as an educational tool. The audit itself can be an eye-opener and can be used to save money,  time and point out small issues before they become large ones.
v Let the results of the audit drive education for each person on the unit. Do not place the audit findings on a shelf until next year’s review. The results need to be implemented.
v If you are the nurse or administrator involved in assisting the auditor, then remind the staff that no one is perfect.
v Use the audit to set individual performance goals. You can even use the findings in the evaluation process.
v Establish an appeals process or at least know what it is and how it works. Yes, sometimes things need to be appealed.  
It is also very important to explain to the staff the process of audit or a review. Most reviews follow a certain format. First there is a preparation stage.  Some hospital prepare for joint commission with a mock survey from an outside agency.  Some clinics prepare for a reimbursement audit by auditing their staff quarterly. None the less, there should be a preparation stage. During this stage you should set clear goals, engage executive support and prepare the staff. It is also a good idea to have several meetings and let the staff discuss situations that could be improved upon.  For nurses they might have a particular case that they know did not go well and they could discuss better solutions for a better outcome.  
During the auditing phase, it is best  to have one person as the designated contact person throughout the process in a clinic setting. For the hospital setting, the Joint Commission process can be different; they may eventually meet with a several different people since they are looking at all the different departments in a hospital. Keep in mind clear channels of communication need to be sought out ahead of time to make the review successful. The key is here is to communicate and coordinate.
After the audit, there is still work to be done. Most of the time there is an exit interview. The exit interview is typically a time to reflect. Most of the time, the auditor will not give the site a complete summary of findings. That will come at a later date. Usually there is enough information given to shed some light on any concerns though.  Usually a formal final report will come and this is considered a dashboard for corrective action. The report will be set up with three major headings. Information or what was actually reviewed,findings and recommendations.  Read everything carefully and share appropriately.
The final step is to share this information with everyone involved and work on effectively implementing the recommendations. The key here is to work on it slowly but consistently. This is really the best approach to lessening the anxiety.  

Deresa Claybrook, MS, RHIT has over 25 years in the health care industry.  She is the president of Positive Resource, which specializes in Human Resource (HR) Management and Health Information Management (HIM). She fills her days with assisting health care organizations with their management concerns.

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