There’s an incredible feeling of relief you feel when the taillights of the CARF survey team’s vehicle leave the agency parking lot.  You breathe a sigh of relief and hopefully celebrate your achievement with a cocktail (or two).  But that feeling of relief and achievement is quickly in your rear view mirror as you jump back in to the day to day challenges of running a social service organization.  In that day to day buzz, it’s pretty easy (and understandable) to lose sight of all things accreditation.  The problem is that they’re coming back.  And that gap in between surveys goes by with lightning speed.  As I joke when teaching CARF workshops, “This survey never ends!!!”  So, in the spirit of keeping excellence in the forefront, here are some practical tips, advice and wisdom on how best to mind the CARF “gap” so that you’re ready for their return.

Think (and build) Systems that Support Conformance – Although getting prepared for and going through a survey for the first time is quite stressful, I actually think the second survey is harder.  You can treat a first survey like an event (i.e., CARF’s coming – look busy!).  You only need to show six months of conformance, and building a set of plans on a one-off basis is relatively easy.  It’s when you have to show that you’ve lived and breathed those standards for three years that the cracks show up.  The solution is to use systems thinking to make sure that all of the various tasks are part of how business happens at your shop.  Consider using things like perpetual planning calendars or bring forward mechanisms to make sure things don’t get missed.  Some agencies establish standing agendas to ensure that key topics are always in the conversation.

Embed Conformance Deeply in the Organization’s DNA – In the end, you don’t want your conformance with CARF standards to be a thin overlay or veneer.  You want it be deeply embedded so that it’s just how you do business.  That requires making sure that all the pieces of work related to accreditation are integrated.  For example, all plans (risk management, accessibility, technology, etc.) should be integrated into your annual operational cycle, not an overlay that someone has to pay lip service to but that has no meaning outside of CARF accreditation.  In other words, there should be no such things as a ‘plan for CARF’.  They are your plans.  All document processes related to case management with clients should have conformance built in from the start, not added as an afterthought.  Operational activities such as management and team meetings, performance evaluations, supervision, and training offer a myriad of opportunities to embed conformance with numerous standards without adding extra work.

Share Responsibility for Conformance Widely – One of the riskiest strategies for managing accreditation requirements is to invest too much of the responsibility for conformance in one position.  While it will often be the case that one or more people will have primary responsibility, it’s wise to ensure there is some organizational redundancy in terms of knowledge of the standards and how the organization meets them.  The more that staff at all levels of the organization know the standards that are relevant to their positions and understand how their work helps to meet those standards, the easier it will be to consistently meet the standards and maintain a culture of conformance that has everyone contributing to the outcomes and excellence you have committed to through the process.

Stay Current with the Standards – In case you haven’t been told, the CARF standards manual changes every year!  Although missing one years’ worth of changes would likely not have a huge impact, missing three years’ worth could have major consequences.  So make sure you get informed of the changes and address any new requirements.  I would strongly suggest adding the updating process to your perpetual calendar or bring forward file.
Create or Connect to a Supportive Network – I have learned that in order to have at least one good idea, you need to generate several.  Connecting with other organizations who are also accredited can prove to be a helpful way to generate new strategies or solutions to elements of maintaining conformance.  These collaborative connections can offer opportunities to test next ideas.

Audit Yourself Against the Standards Regularly – my final tip is to audit your conformance.  I have clients that do this prior to their next survey and others that do it every year.  It depends on the complexity of the organization and your level of concern that things aren’t being maintained.  If you choose to do it prior to the survey, I suggest having it done at least four months in advance so you have time to address issues.  You may still get recommendations that are in line with the audit findings (depending on how long the you have been out of conformance with a standard), but fixing it will give the survey team confidence in your systems.  You can do the audit yourself, or consider bringing in someone from outside who knows the standards (e.g., a local surveyor or someone from another agency who knows the process and standards well).  It’s a service we offer to our clients that we get huge positive feedback on in terms of making sure the organization is ready.