When discussing an administrative or clinical process with an organization, I am often asked: “Does CARF require us have something written for how we do that?” The question implies that deciding whether or not writing down the steps and/or sequence of how something is to be done somehow rests on whether or not writing it down is required by CARF. What the question tends to ignore is the worth of having “how we do things around here” clearly outlined in written procedures.

For What It’s Worth

The value of written procedures is optimal when they are succinct, clear, sequential, and provide “how to” instructions for completing administrative and clinical processes. As your organizational procedures are developed, revised, condensed, and become more clear and sequential, their worth becomes much greater than “CARF says we have to have something written for that.”  What you want your written procedures to become are guides and “desk references” for both administrative and clinical personnel that increase continuity of operations and care, increase consistency among personnel in following the defined directives, increase staff accountability within the workplace, and significantly reduce “he said, she said’ dynamics within personnel management.

Show Me The Way

CARF requires” entries to the records of the persons served follow the organization’s policy that specifies time frames for entries”. To meet this requirement, the specific time frames for completing and entering  information such as a screening, medical  exam , psychosocial assessment, initial treatment plan, treatment plan updates, progress notes, transitional plan, written discharge summary, etc., would be clearly noted in writing. For example, if the noted clinical activity requirements were written out in a clear manner, counselors could be given this page out of the procedure manual and post it on a bulletin board above their desk for reference, and the time spent communicating this information individually, or in treatment team/record review meetings would be greatly reduced.

I Can See Clearly Now

Once procedures are succinct, clear, sequential, and provide “how to” instructions for completing required processes, many organizations develop  “desk reference” manuals for each job position by organizing a clearly indexed binder containing procedures  for completing the required functions of the position. In addition, position-based procedural reference manuals would also contain responsibilities that are expected of all personnel, such as ethics and safety information.

Ain’t No Stopping Us Now

A huge undertaking?  Not really.  If your written procedures are continuously improved and become sequential step-by-step “how to” guides it is only a matter of putting the job reference binders together. You will know you are there when you can honestly say: “We lost our (fill in the blank) today, but we have a new person to fill that position starting on Monday. He/she should have no problem being up to speed in a week or so. We have all the required duties clearly outlined in our written procedures, and they are well-organized in that position’s reference binder.”