AHF: How were you notified of the survey?
JM: The accreditation department was notified a few weeks beforehand that the survey would change to a virtual format but were not notified when the survey would occur. The day of the survey our accreditation department notified us that the survey had started.
AHF: How much time did the survey take you (and your team) and what sessions did you take part in?
JM: We took part in the life safety tour for environmental care (EOC), infection control, kitchen/clinical nutrition tracer, and human resources competency sessions. We also anticipated being a part of the Disaster & Emergency Preparedness meetings but were not. The EOC in our space only took about 10 minutes, but the tour of the whole building took place as one session which lasted many hours. We could join the call and participate (watch) the entire tour, which was a unique experience. The Life Safety Tour took up most of the first day, which was a bit of struggle because there were breaks so you were jumping on and off the call. From time to time, we would have technical issues.
AHF: How did the surveyors explain the process and outline their expectations?
JM: At the beginning of each session the surveyors would outline how the session would proceed and what they would do or need. For our life safety tour, the focuses were on (1) fire safety, (2) hand sinks, (3) storage (4) refrigerator and freezer temperature monitoring. For the refrigerator and freezer temperature monitoring we had to have someone go inside the walk-in refrigerator on camera and prove that they could not get locked inside.
On Day 1, they asked us to upload several policies in advance:
- Most recent local health department kitchen inspection report
- Kitchen manual
- Approval by medical staff
- Publication and/or revision date
- Policies and Procedures
- Meal frequency
- Diet ordering/patient tray delivery system
- Non routine occurrence
- Integration into QAPI/Infection Control policy
- Hygiene practices for food service personnel
- Kitchen sanitation
- Service director ensuring policies of
- Safe food handling, emergency food supplies,
- Orientation, assignments, supervision, and personnel performance
- Menu planning, purchasing and essential record retention
- Nutrition Assessment
AHF: How was the virtual survey experience different compared to an in-person survey?
JM: It was a completely different experience however in some ways it felt the same. It was different waiting at your desk for the calls to begin. You did not, of course, need to provide meals to the surveyors which was a change. After each session, it felt as though they had been there in person. The whole team was involved in conversations behind the scenes as normal, and many were involved in the calls with surveyors.
I would have thought there would be a loss of personal interaction, but it felt more personal since you are up close on camera. You had to be engaged even if they were not talking directly to you so it was different than being in a large conference room. During the HR call, for example, when they sometimes asked a question, they expected everyone on the call to individually answer.
AHF: What other unique processes do you feel are worth noting?
JM: For the clinical/kitchen inspection the surveyor joined us on the online meeting platform, and we had someone “walk” them around the property on camera. If you were not walking around with the camera you would join the call from your office. There would be breaks when the camera was walking from area to area.
We had to utilize our own tools such as thermometers. We would take food temperatures on the line ourselves and then show the temperatures on the video for the surveyors to see. For some items they asked for records such as dish machine temperatures and refrigerator/freezer electronic temperature monitoring records for various days.
Because they couldn’t inspect randomly, they asked very pointed questions such as seeing inside the fridge and looking at product dates up close.
AHF: Who took the lead during walk-throughs?
JM: Our Assistant or Associate Directors walked around with the iPad while I was on the call in my office. I was then able to talk to the surveyors and answer their questions during the walk through while the team was moving or taking a temperature. We found this to be more strategic than the director controlling the camera.
AHF: Did your messaging to your staff change since they were not there in person?
JM: I sent out a daily summary to all my staff as normal. We reminded everyone to follow mask, badge, and eye protection protocols at all times; to be able to locate their nearest fire exit and focus on hand hygiene in all areas. We also reminded them to keep spaces clean and to be confident and show the surveyors what we do. However, it was a little easier since the surveyor was not interacting with them in person and asking random people direct questions.
AHF: What are some key take-aways and tips you wish to pass along to other Directors who have yet to go through a virtual survey?
JM: For the Human Resources session be prepared with your documentation in order to be ready for those questions. I would recommend scanning your documents in advance so you can easily pull them up and share them on your screen or send them to the surveyor. Otherwise, you have to hold the paper up to the screen. You might consider scanning them all into ONE document so you can just scroll through them as they ask questions or ask you to share. One new document they asked for was my ServSafe certification documentation after they confirmed it was required by our state.
Be prepared that even though it is virtual, they are still “in” your kitchen right away, just like a normal survey, so you need to be prepared as always!
AHF: Will there be follow-up to the virtual survey?
JM: Yes, they will come back in person unannounced for a 2-3 day survey to confirm their survey findings.