URAC Core 12 -- Inter-departmental Coordination

Standard Core 12 reads:

The organization establishes and implements mechanisms to promote collaboration, coordination, and communication across disciplines and departments within the organization, with emphasis on integrating administrative activities, quality improvement, and where present, clinical operations.

This seemingly straightforward standard has been the subject of increasingly rigorous interpretation in the last couple of years. It is rated "4", and is therefore worth spending a little extra time on.

The Program Guide is quite clear about the documents that will be reviewed on Desktop Review:

• Agenda and attendance roster for recent three (3) inter-departmental meeting minutes: please identify the attendees by name, credentials, and affiliation/department
• Job descriptions or temporary staff assignments for staff functioning as a liaison to other departments
• QI project description: see “Accreditation Tools” for a sample template

Despite the clarity of this guidance, however, some applicants have overlooked essential requirements. For example, some have submitted minutes of inter-departmental meetings without identifying the name, credentials, and department affiliation of the attendees. Without this information, there is no way for the reviewer to know that the meeting was, in fact, "inter-departmental".

Some applicants have failed to demonstrate in their documentation that interdepartmental meetings dealt with quality improvement issues. The reviewer will need to see relevant documentation addressing the mechanisms to promote communication, collaboration, and coordination across disciplines and departments as they relate to quality improvement initiatives, not merely the integration of administrative activities. Don't overlook the possibility of submitting a quality improvement project description form that, in and of itself, contains documentation of inter-departmental coordination.