Virtual accreditation: “We can take care of this”

As the iPad in Sara Dingman’s hands swoops through the hallways of Elkhorn Veterinary Clinic in Elkhorn, Wisconsin, the twists and turns get a little dizzying.

“Do you take a Dramamine before you do these?” Dingman asked Beth Armstrong, CVT, CCFP, FT, who was watching the carnival ride from the safety of a sofa on the other end of a Zoom call.

“I’m used to it,” Armstrong laughed. She’s had plenty of practice—as AAHA’s practice consultant for Wisconsin and three other Midwestern states, this was the 140th virtual accreditation she’d done since mid-March, when AAHA went to a virtual accreditation evaluation model for health and safety reasons spurred by COVID.

NEWStat was having a little more trouble with the pitching and rolling of Dingman’s iPad, having tagged along for the virtual ride and not knowing what to expect.

Dingman is Elkhorn’s practice manager and this was her fifth time going through the accreditation process—Elkhorn’s been an AAHA-accredited practice for 25 years—but her first time doing it virtually.

NEWStat wanted to take a look at what was involved in a virtual evaluation on behalf of AAHA members facing one who might be feeling a little leery at prospect: What does a virtual evaluation look like?

According to Armstrong, it looks pretty much the same as it does in person, only sometimes shorter—assuming the hospital digitally submits their protocols and necessary documents ahead of time—and with someone at the hospital leading the consultant on a visual tour via cellphone camera or—in Dingman’s case—that of a tablet.

“AAHA’s standards are still the same,” Armstrong emphasizes, but AAHA’s making allowances for a strange time. “Hospitals may not hit every goal they wanted to, but we absolutely understand that and are here to help them plan to reach those goals in the near future. We want each practice to realize that even in the worst time in history, they can see that they’re still meeting the highest standards of care.”

“The [profession] is beyond compassion fatigue right now,” Armstrong adds. “Many hospitals have experienced so much heartbreaking trauma.” Elkhorn is no exception.

Armstrong said she knew going into the evaluation that Elkhorn had had a particularly hard year due to COVID. Several teammates lost family to the disease, and the staff was still reeling.

Dingman told NEWStat that she was initially disappointed at the idea of a virtual evaluation. “[Accreditation] is usually a team-building experience for us. Usually, we work on this together for eight months in advance. And this year, that just wasn’t going to happen.” She says staff is stretched so thin she couldn’t in good conscience ask any of them to help with it this time. “I wasn’t going to ask one more thing out of my team because the exhaustion is clear on their faces at the end of the day.”

In the end, Dingman wound up taking on the whole thing herself—the preparation, documentation, and, of course, the actual virtual walkthrough.

Although she concedes that the thought of a virtual accreditation was a little anxiety-inducing, Dingman says she wasn’t too concerned about actually doing it—a year full of Zoom meetings was plenty of prep. “Of course, we like to have the consultant here face to face. But it kind of went how I was expecting it to, as far as walking around the hospital and showing everything through an iPad camera.”

Dingman said part of her nervousness was never having met Armstrong before. “Not knowing what to expect, or what her expectations would be—that was a little bit nerve-wracking.”

For her part, Armstrong did her best to keep reassuring Dingman that everything was fine and things were going well. “We can take care of this,” was a constant refrain.

And Dingman, although initially anxious, relaxed visibly as the evaluation progressed, and before long, she and Armstrong were chatting amiably. You’d never know it was the first time they’d spoken, let alone set eyes on each other.

Armstrong says Dingman’s initial trepidation is typical of many practice managers during COVID: “They’re having to do it all by themselves without the team building and without other staff helping out.” She points out that AHHA has more than 900 standards, “so they have to pull all of this information together and have to answer all these questions alone. It can seem a little overwhelming.”

Armstrong says a big part of her job is being there to help members like Dingman get through the evaluation process: “We’re here to help them. I tell them I'm an extension of their hospital. I'm part of their team. They don’t have to do it alone.”

Armstrong told NEWStat that Elkhorn’s was a pretty typical evaluation: “It’s very tense out in the field and [members] need to feel like they’re not alone in this, that they’re not the only hospital feeling this way,” Armstrong says. “They need to know that every hospital is feeling this trauma and sense of burnout and that they don’t have to be perfect.” If the evaluations turn up problem areas, she says, “we let the hospitals know we can work together to fix them.”

Based on her 140 virtual evaluations, Armstrong says the most important thing a hospital can do to ensure things go smoothly is to submit their protocols and paperwork digitally ahead of time: “By the time it’s virtual evaluation day, it seems like a breeze.”

And if there’s one thing she wants practices facing virtual accreditation to know, it’s that “[AAHA’s] here to help you through it.”

And Dingman got through it: Elkhorn passed its accreditation with flying colors.

Based on her experience, Dingman says there’s one thing she’d recommend to practices facing virtual evaluation: “If you’re not very confident with technology, have somebody nearby who is,” in case something goes awry. Armstrong seconds that advice, saying technical glitches are pretty common, though generally not a big deal.

NEWStat witnessed that firsthand.

At one point, Armstrong needed Dingman to show her some hospital records, which Dingman couldn’t access from her iPad. And she couldn’t walk Armstrong through records via her hospital desktop, where she kept them, because it didn’t have a working speaker. So, thinking quickly, Dingman joined the Zoom call from her desktop computer, too, so she was able to share the desktop screen with Armstrong while still speaking to her via the iPad.

It was a nifty little workaround and executed so nimbly that the evaluation continued with barely a blip.

And as happy as she was that Elkhorn passed its evaluation, Dingman admitted that this year, “it feels very anticlimactic.”

She says that usually, after a reaccreditation, the staff throws a big celebration. Not this year. “There’s no popcorn, there’re no balloons,” she said. “We don’t even have cookies. We can’t—there’s no communal food.”

Dingman did have one other piece of advice for practices facing virtual accreditation: “Understand that it’s not going to feel the same as a normal, in-person accreditation. And that’s OK, because we’re all doing the best we can.”

She advises being flexible and open to something new, “Because it’s not as scary as it sounds.”

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