Apply for COTE

CENTER OF THERAPEUTIC EXCELLENCE

SURVEY

1. Basic Information:

Name of center

Name of center
Country
COTE accreditation code

Parent company

Parent company
Country

2. Identifying Information

Leadership

COTE Compliance Coordinator

3. Type of facility:

Type Check best type describe the facility
In Patient Hospital/Medical Center
Outpatient Ambulatory Surgery Practice
Medical/Multidisciplinary Practice
Behavioral Health/Mental Health/Nutrition Health Practice

Reason for deviation (if any)

4. Business Model:

Type Select type
Not-for Profit
Corporation
Limited Liability Corporation
Sole Proprietor /Private Practice
Government Center
Other

Comment:

5. Executive Summary and Background: Surveyor to capture key points from applicant submission to check during the surveying process, confirming that all information validated through documents review, feedback from discussion, interview with concerned applicant’s team and or other sources.

Key Point captured from Applicant executive summary Source of validation Confirm by marking each point (✓)

6. Legal standing (attestation)

Item Source of validation Checked by Surveyor
The applicant is a legal entity and is properly licensed, certified or accredited to operate in the jurisdiction in which it is located. Official document(s) provided by applicant Other

Comment (if any):
The applicant or any of the applicant’s employees, agents, independent contractors or sub-contractors have not been convicted of, pled guilty to or pled nolo contendere to any
  • Applicant feedback
  • Media Search
  • Other

Comment (if any):
The applicant has no current or pending disciplinary actions.
  • Applicant feedback
  • Media Search
  • Other

Comment (if any):
The applicant is in good standing with all regulatory agencies
  • Applicant feedback
  • Media Search
  • Document(s) provided by applicant
  • Other

Comment (if any):
The applicant has read, understands, and accepts the mandatory requirements, responsibilities, and terms and conditions associated with these COTE accreditation standards.
  • Applicant feedback
  • Other

Comment (if any):
The applicant does not discriminate in its employment practices with regard to race, color, religion, age, sex, marital status, sexual orientation, political affiliation, national origin, or handicap.
  • Applicant feedback
  • HCP Interview
  • Media Search
  • Patient survey
  • Other

Comment (if any):
The applicant follows all required safety protocols, has safety policies in place
  • Document reviewed
  • Applicant feedback
  • HCP interview

Comment (if any):
The applicant has established emergency protocols for health and safety related incidents
  • Document by applicant
  • Presentation by applicant
  • Feedback from staff

Comment (if any):
The applicant has in place all furniture, fixtures and medical and surgical equipment and appropriate infrastructure needed to accommodate and facilitate the care of obese individuals:

Facility and space requirements:

Entrance and route:

  • Wide easy access with ramps provided
  • with handrails
  • Conveniently located elevator

Doorway and corridor widths

  • Large doors (min 1.2 m/4 ft)
  • Widedoorway for bariatricstretchers (min 1.4 m/4 ft 8 in)
  • Wide corridors (min 1.5 m/ 5 ft) to accommodate bariatric wheelchairs and stretchers.

Lobbies and waiting areas

  • In shared areas, up to 10-20% of general seating should be bariatric. And well-integrated with general furniture to avoid separating bariatric patients in specific areas
  • At least 20% in emergency departments and up to 50% in cardiac and bariatric units with steel reinforced furniture to support a minimum of 340 kilograms.
  • Reasonable seat height (min 0.45 m/1 ft 6 in) to help patient to stand.

Bariatric patient room

  • Proper size of bariatric inpatient rooms to accommodate bariatric patient equipment’s (min 16.61 m2/179 ft2 with min 1.5 m/5 ft door width)
  • Provision of convenient tools for patient lift and transport.Providedwhether by an overhead lifting system or a portable lifting assist (min 363 kilograms/800 lb).
  • Bariatric bed that accommodates all treated patients

Bathrooms

  • Sized to allow for staff assistance on two sides of the patient at the toilet and shower. Can accommodate wheelchair and lifts (optional)
  • Bigger shower stalls with sufficient opening and space to feature heavy-duty wall-mounted grab bars that hold at least 340 kilograms/750 lb.
  • Handrail designed to support a minimum of 181 kg/400 lb shall be provided adjacent to the sink to support the patient if required
  • Sinks shall be floor mounted with clearance on either side to accommodate a caregiver.

Toilet rooms

  • Provide floor-mounted toilets with weight capacity of at least 454 kg/1000 lb with oversized toilet seats a clearance of 1.5 m/5 ft. Toilet seat height shall be 0.45 m/1 ft 6 in to aid patient to rise.
  • Provide reinforced grab bars that hold at least 340 kg/750 lb.

Other Furniture provided for bariatric patients use

  • Proper sized chairs in seating area
  • Proper sized chairs in examination room
  • Proper stretcher in examination room

Equipment

  • Bariatric wheelchairs
  • Scale up to 454 kg/ 1000 lb
  • Scale positioned in private area.
  • Measuring tape for waist circumference
  • Appropriately sized gowns
  • Large sized Bariatric Blood pressure cuff.

Bariatric Surgery room Requirements:

Comment (if any):

Final comment by Surveyor on attestation section:

7. Administration & Data Management

Insert [ x ] in each of the following statements

Key Point captured from Source of validation Confirm by marking each point (✓)
The applicant supports Continuing Education Programs to keep health care providers current with emerging science related to obesity/diabesity management.
  • Feedback by applicant
  • Applicant record provided
  • Other

Comment (if any):
The applicant has policies and procedures in place to protect sensitive patient health care information from being disclosed without the patient consent or knowledge.
  • Feedback by applicant
  • Applicant record provided
  • Other

Comment (if any):
The applicant has process in place for dispute resolution for both patient and staff.
  • Feedback by applicant
  • Applicant record provided
  • Other

Comment (if any):
The applicant agrees to participate in collaborative sharing of anonymous data to aid in applicable research
  • Feedback by applicant
  • Confirmation e-mail received from Applicant authorized person

Comment (if any):
The applicant has a referral plan in place for allied supplementary support services.
  • Feedback by applicant
  • Document(s)/SOPs provided by applicant
  • Other

Comment (if any):

1. Overall comments on administration &data Management section:

8. Education

Item Source of validation Confirm by marking each point (✓)
1. The number & Name of Health Care Professionals who are AABC Board Certified
  • HCPs’ Certificate copy
Name of HCP AABC certification no
2. The number of Health Care Professionals on the Interdisciplinary Team who will enroll in the AABC Board Certification in Bariatric Science Program in the next year
  • Feedback by applicant
  • Enrollment started
  • e-mail confirmation received

Overall comment on point 1&2 (If any)
3. The applicant has an Interdisciplinary Team in place to provide for the multifactorial needs of the bariatric population or selected specialized supplementary referral services
  • Info from applicant
  • Name, specialties, and role of the team verified

Comment (if any):
4. The applicant has on file a current record of all CV’s, resumes, license/certification/registration of all health professionals

Comment (if any):
5. The applicant has a plan in place to support Continuing Education in Bariatric Science for all health Care Professionals.
  • Plan discussed with applicant
  • Document provided
  • Other

Comment (if any):
6. The applicant provides sensitivity training for all Healthcare Professionals and ancillary staff.
  • Training record reviewed
  • Trainings future agenda reviewed
  • Training discussed with applicant

Comment (if any):
7. The applicant will actively participate in and promote Public Health Education in the community it serves.
  • Record Reviewed
  • Plan Reviewed
  • Plan discussed with applicant
  • Patient survey

Comment (if any):

Overall comment on education:

9. Management of Obesity

Item Source of validation Confirm by marking each point (✓)
1. The applicant recognizes Obesity as a chronic condition that requires life-long Interdisciplinary approach.
  • Discussion with applicant
  • HCP Interview
  • Patient Educational material
  • HCP educational Material
  • Applicant Website
  • Patient survey
  • Other

Comment (if any):
2. The applicant has treatment protocol in place for relapses as well as relapse prevention.
  • Protocol in place and reviewed
  • Discussion with applicant
  • HCP Interview

Comment (if any):
3. Mental Health Professionals employ evidence-based counseling techniques and interventions that target the psychosocial implications of obesities
  • Discussion with applicant
  • HCP Interview

Comment (if any):
4. The applicant informs patients of all available treatment options, both surgical and non-surgical.
  • Discussion with applicant
  • HCP interview
  • Patient survey

Comment (if any):
5. The applicant recognizes the significance of psychological and behavioral achievements and not merely weight reduction.
  • Discussion with applicant
  • HCP interview

Comment (if any):
6. Health Care Professionals are knowledgeable about long-term, psychological, nutritional, medical needs of patients who have had bariatric surgery and provide care consistent with established best practices
  • Discussion with applicant
  • HCP interview members

Comment (if any):
7. Health Care Professionals will discuss with patients, and or prescribe approved medications for the treatment of obesity
  • Discussion with applicant
  • HCP Interview
  • Medication available in hospital formularly/pharmacy

Comment (if any):
8. Health Care Professionals will not recommend or refer patients to obesity treatments for which the potential risk and cost outweigh the expected health benefits for a given individual.
  • Discussion with applicant
  • Interviews with applicant’s team members

Overall comment on Management of obesity:

10. Patient Education Standards and Consent for Services

Item Source of validation Confirm by marking each point (✓)
1. The applicant provides ongoing in-service professional education addressing the needs of bariatric patients.
  • Training record reviewed
  • Trainings future agenda reviewed
  • Training discussed with applicant
  • Patient Survey

Comment (if any):
2. The applicant has in place a process and resources for ongoing patient and staff education (Nutrition, Mental Health, Physical Health, Behavioral Health etc.).
  • Training record reviewed
  • Trainings future agenda reviewed
  • Training discussed with applicant
  • Patient Survey

Comment (if any):
3. The applicant provides both pre and post bariatric surgery education for patients and staff.
  • Training record reviewed
  • Trainings future agenda reviewed
  • Training discussed with applicant
  • Patient Survey

Comment (if any):
4. The applicant provides evidenced based weight management options for patients not requiring or desiring weigh loss surgery.
  • Applicant discussion
  • HCP interview
  • Patient Survey

Comment (if any):
5. The applicant has a procedure in place to inform patients of their responsibilities as a participant in the program.
  • Applicant discussion
  • Document Reviewed
  • HCP interview
  • Patient Survey

Comment (if any):
6. The applicant requires all program participants to sign consent forms for service and to give permission to release health information to all Health Care Professionals within their COTE network.
  • Form reviewed
  • Applicant feedback
  • HCP interview
  • Patient Survey

Comment (if any):
7. The applicant maintains all consent forms in the patient’s medical record.
  • Record checked
  • Applicant feedback
  • HCP interview

Comment (if any):

Overall comment on patient education:

11. Surgical Services

Item Source of validation Confirm by marking each point (✓)
Type of surgery services provided in your facility
  • Applicant feedback
  • HCP Interview
  • Patient Survey
  • Applicant website
  • Other

Comment (if any):
Services you currently provided:
  • Comprehensive Weight Management Program with individual counseling
  • Metabolic health and Weight Management Support Group
  • Has network of selected specialties for easy referral
  • Applicant feedback
  • HCP Interview
  • Patient Survey
  • Applicant website
  • Other

Comment (if any):

Overall comment on services provided:

12. Quality Assurance:

Item Source of validation Confirm by marking each point (✓)
1. The applicant has a Continuous Quality Improvement Program in place to monitor the care provided and identify opportunities to improve patient care services.
  • Applicant feedback
  • Program document
  • HCP Interview
  • Other

Comment (if any):
9. The applicant adheres to all accreditation standards that support quality improvement and that lead to patient satisfaction and successful outcomes.
  • Applicant feedback
  • Document reviewed
  • HCP Interview
  • Other

Comment (if any):
10. The applicant agrees to provide quality Improvement data to AABC if requested.
  • Applicant feedback
  • Confirmation received by applicant
  • Other

Comment (if any):
11. The applicant conducts regular Quality Improvement surveys.
  • Applicant feedback
  • Record reviewed
  • HCP Interview
  • Other

Comment (if any):
12. The applicant schedules interdisciplinary staff meetings to discuss all aspects of patient care.
  • Applicant feedback
  • Record reviewed
  • HCP Interview
  • Other

Comment (if any):
13. How often the QI Plan is updated:
  • Annually
  • Bi-Annually
  • Other
  • Applicant feedback
  • Record reviewed
  • HCP Interview
  • Other

Comment (if any):

Overall comment on services provided:

13. Administrative Support Functions

Item Confirm by marking each point (✓)
The applicant permitted AABC/COTE accreditation vetting team inspection access to their center, upon mutually scheduled request.
The applicant permitted AABC/COTE accreditation vetting team to perform, all background, investigative and auditing procedures necessary for the accreditation.
The applicant cooperated with COTE surveying team to facilitate the accreditation process and provided all needed documents on timely manner.