Behind Closed Doors: ‘The Surveyors Are Here!’

A cautionary tale of panic, perseverance and a well-deserved margarita.

It started like a normal Tuesday morning. Driving to work at 5:30 a.m., setting my intentions for the day, I could not help noticing the full moon, which should have been the first red flag on how the day would unfold.

At work, I poured a cup of coffee that tasted like pure jet fuel — red flag No. 1. The second red flag was when alarms from oxygen tanks that needed to be changed rang through the center. The third was when the pre-op nurse rolled her eyes after finding out the first-case patient had eaten breakfast.

Go time!

Eventually, I settled in my office to start going through emails. And then it happened.

Ring-ring … ring-ring … ring-ring.

“Hey Carson, the surveyors are in the lobby!”

I immediately heard the record scratch like a bad DJ at the Austin City Limits music festival. An immense amount of panic set in, and I deployed our all-hands-on-deck code word — GERONIMO!!! — to our team.

After I hung up the phone, my journey through the various stages of grief began.

The first stage was denial. My inner voice said, “It’s too early for them to come. The receptionist must have confused them for a vendor.”

Next up was the anger, but I couldn’t be mad since we invited them to come evaluate us.

My mind breezed through bargaining, depression and, finally, acceptance.

Then I went into pure survival mode.

This was all slightly dramatic, which I can be at times. After all, this is what I had been preparing for during the three years since our last survey. This was my time to shine — or get fired.

I would know in about eight hours!

After a quick tidy-up of my office, I greeted the surveyors and began the facility tour. During our walkthrough, I noticed some odd, primal behaviors.

Staff who have fight instincts were still with me, while the other half flew away, probably to scroll Indeed for a new job. Walking past the medical director in the hallway, I noticed he was in a lab coat he hasn’t worn since his 2006 residency. I was impressed it still fit, but couldn’t help screaming, “Why are you wearing that thing?” at him in my head.

As we continued through pre-op, everyone was walking around with a pair of gloves on. Like, what?

As we made our way to the break room, I noticed a shiny new label on the microwave that said, “Do Not Use for Sterilization.” Again, what? At that point, I was about to keep walking right out the door to my house. At least 10 times, I asked myself, “Why can’t we just act normal?”

The main event

We returned to my office, where the real fun began. The surveyors asked for policies, procedures, employee files, reports, logs, medical records, patient tracers and other miscellaneous documents.

Finally, the burden of organization paid off. Each moment was a prize reveal on “The Price is Right.” In binder No. 1 we have Emergency Preparedness. In binder No. 2 we have Quality Improvement Program. Through it all, I imagined the studio audience going wild. Even the surveyor, who smiled at my orderliness, was impressed.

After eight grueling hours of painstakingly sifting through mountains of paperwork, we ended the high-stress event. We spent the day showing how we achieve maximum compliance with all the regulatory standards set forth. Surveys are meant to be educational, but they are also a validation of our commitment to providing safe patient care, which everyone deserves.

In the end, the surveyors said the words I’d been hoping to hear and the ones that were the most important — You do a fantastic job, and you have an excellent facility. When they said that, I expected a standing ovation from the medical director and the staff. In reality, it was just me, by myself, in my office.

I breathed a quick sigh of relief and instantly started thinking about a margarita and a basket of tacos I’d have that evening because, after all, it was Taco Tuesday.

I was reminded how great a team I work with. Everyone came together to deliver the same excellent patient care under the scrutiny of a survey visit.

As a clinical director and an active surveyor for one of the accrediting organizations, I’ve learned a few universal lessons about the process:

• Treat every day like a survey day. We do this for patient safety, which is always our No. 1 priority.
• Know where your policies and logs are located at all times. Surveyors love organization!
• Understand all standards on which you are being evaluated. How can you be compliant if you don’t even know what you are being assessed on?
• Never trust a Tuesday! OSM