We audit handwashing at supervisory visits- hits everyone at least once a year as we do an supervisory visit for yearly evals on everyone. I ask 10 people each month what our patient identifiers are. I spread it out so that everyone - even non-visit staff get asked. I sit at intake several times a month and listen to them taking orders for the read back of orders and critical labs - I try and keep busy doing something else so they don't know what I am actually doing - but I am sure they do know. We keep a running log of our critical labs and time of notification of physician which I tabulate each month. When unapproved abbreviations were first implemented, I did 100% review for thoes, but now just hit it quarterly as part of our quarterly chart audits for CMS. We have a policy and procedure in place for oxygen and fire risk in the home and each time we need to implement this, I record it on a log for The Joint Commission. Hand off report is the one we are having most problems with - we instituted the sbar and got some really nice samples off www.medqic.com
. I don't have a formal audit tool for most of these, I record all the audit result information for The Joint Commission on a exell spread sheet with graphs, but I do keep copies of the form that I used to record results on.
Keeping up with all the auditing is a full time job. I try to combine several audits at a time. If I am looking at our ACH charts, I also do the medication audit - for our OBQI project and medication reconcilliation. I am looking at advance directive information as well as some other documentation areas while I have the chart out. I find this works well for me.
I try to keep my numbers small - usually 10 - 20 each month since most of our thresholds for The Joint Commission is 90%. I keep my audit questions simple usually answered with yes, no, n/a.
I have found audit tools on the medqic site, and your qio rep should have some or be able to get some for you. I have also found good audit tools on some of the list serves - NAHC has some good ones for OBQM if you are a member and that list serve is a good one - you do need to be a member to use thoes resources.
Hope some of this helps.