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News from CARF
CARF…THE REHABILITATION ACCREDITATION COMMISSION
The Importance of Participation in CARF Field Reviews of Standards
Christine M. MacDonell, FACRM
Case managers have the unique opportunity to work across all health and human services. They bring a wealth of knowledge and competencies to a variety of provider settings and their own businesses. They serve populations with physical disabilities, behavioral health needs, intellectual disabilities, addictions, and pediatric and geriatric concerns. Case management services are in every CARF-accredited program area in a role as a person who coordinates services. In many of the standards manuals there are specific program-level case management standards.
CARF’s standards development process could be enriched with more case managers participating in what CARF calls “field review.” When developing a new set of standards or revising an existing set of standards, CARF implements a variety of steps that case managers could consider participating in.
First, we are always looking for feedback from individuals working in the field to alert us to changes, new evidence, practice guidelines, or new approaches in any of the areas we accredit in. This information comes from payers, trade associations, individual providers, CARF- accredited programs, and CARF surveyors.
Our next step is to decide whether a new set of standards should be developed or if an existing set needs to be revised and updated. If this is the direction we take, we then invite the “field” (providers, consumers, payers, surveyors, national and international level individuals) to participate in an International Standards Advisory Committee (ISAC). The ISAC is usually 12-15 individuals who represent these areas. The most recent work of an ISAC was on the revision of Interdisciplinary Pain Rehabilitation (IPR) Program standards.
The IPR ISAC was unusual in how it was conducted because of COVID19. Just like many of you who may have turned to telehealth to provide your services, we developed a virtual ISAC system. The normal process is a 3-day meeting where the experts identify where a particular set of standards could be revised, improved, and enhanced. The virtual ISAC was over a 7-week process with 1-hour sessions every other week and homework for each of those sessions. The homework was reviewed and discussed to make the changes. Just like in a normal ISAC process, on the last session they received their work in the form of a set of standards for a final review.
The next step is a review of the proposed set of standards by CARF’s International Advisory Council (IAC), which is comprised of trade associations from the different areas CARF accredits in and individuals interested in the quality standards that CARF produces. Their review generates comments that are considered for changes before general field review occurs.
All case managers are welcome to participate in field review. Every year there are a variety of these field reviews. They are posted on the CARF website and all are welcome and encouraged to participate. It is an easy process. We ask for some demographic information and we use SurveyMonkey to list each standard; you tell us whether you are very satisfied, satisfied, dissatisfied, or very dissatisfied with the proposed standard. We leave room for all comments, especially for feedback when you do not agree. We listen and respond to field review. Changes come about from this process. All responses
Christine M. MacDonell, FACRM,
is the Managing Director of Medical Rehabilitation and International Aging Services/Medical Rehabilitation in Tucson, Arizona. She is part of the medical rehabilitation team responsible for the training of CARF surveyors and for the development and revision of CARF standards.
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