I'm inclined to agree with you Andrew. Seems to me that CAP has become, unintentionally (I'd like to believe) something of an unsavory, bullying sort of entity. I'm not certain about all the factors involved, but I think a few things have definitely contributed to all of this CAP negativity.
First of all - CAP was (is?) considered the accrediting "gold standard". That's pretty heady stuff...possible ego inflation potential...high horse attitude...elitism? Not saying that was the plan, just an unfortunate and unintended consequence. I'm sensing a power trip here, it's partly human nature (I guess) and it can definitely suck! Secondly - as I recall, CAP got egg on their face a few years back in the DC/Baltimore area I believe. Someone can correct me if I'm wrong or provide more specific details. Anyway, the gist being - someplace passed their CAP inspection and someone (an employee I believe) contacted another regulatory agency because there was NO way this place should've passed CAP. When this all came to light CAP had to respond, and as can often be the case, the response was overly compensatory. I'm sure a lot of folks out there know what I mean. Now CAP issues confusing and sometimes unnecessary regulation changes and additions. And of course we're all aware of the "super secret surprise" inspections. I'm not even sure of half the other hidden agendas and possible ulterior motives. Control issues, tarnished pride, bruised egos and all conveniently cloaked in a drive for the best possible patient care...who could argue with that standard? During my previous employment, we "sweated" the details and worked diligently to achieve our 1st CAP accreditation circa 2000. I have to admit, I did/do like the regulation format. Having a question asked, determining if it applies to your service, and then answering yes or no. By taking it from there and doing things on the up and up, most any lab, that's honest and conscientious should have the realistic expectation of passing CAP. That was then, it seems to longer be that way. As I mentioned, confusing language and reg. additions/changes, along with CAP inspectors and their agendas have all been to the detriment of the accreditation. I was trained to look at CAP as "peer review". In my experience, many times this was not the case. Many CAP inspecting "teams" wants to make the "inspectees" (if that's a word) something of a clone, carbon copy or version of the inspecting team's service. This is another huge problem and causes a lot of strife, hard feelings and red tape at and after the summations. The regulations, ideally, should be interpreted in the most objective way possible. Again, maybe it's human nature, but it seems that people can't help being overly subjective re: interpretations of any number of CAP regs. I used to work with a pathologist that regularly attended the CAP committee meetings. At times I would bring issues to him I thought relevant to CAP. I don't recall the specifics but I do know they were of a practical nature from a technical viewpoint. I basically got the brush-off and was led to believe that CAP wasn't interested in the "technical" viewpoint and he wasn't going to bother with it. This may be a stretch in logic on my part...however, I can't help but think if CAP would listen to technical folks as well as MDs, they'd be in a better position right now. I'm not inclined to throw the baby out with the bath water. I think CAP accrediting was established with good intentions. Somehow things have gotten out of hand, and some have gone horribly wrong. I think things like QIP are good, although I've heard complaints about that as well. I'm feeling lucky these days because CAP isn't in my life. But my attitudes and mind-set have most certainly been shaped by my CAP experiences. Please remember this is my opinion only, I am not perfect and am only interested in practical application of sensible regulations for optimal patient care. Regards, Tom Jasper Histology Supv. CORPS -----Original Message----- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Andrew Burgeson Sent: Thursday, April 01, 2010 10:27 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] 72644.18148...@web111105.mail.gq1.yahoo.com Sheesh is right, J. CAP is all politics as far as I am concerned. It is all about protecting the careers and paychecks of the general pathology community. I am thouroughly unimpressed with JCAHO, CAP et al. If all you need to legally run a laboratory is to be CLIA inspected, then WHY BOTHER with these subjective entities? The BS I have heard over the last few months concerning MOHS surgery specimens is one glaring example of the limitations CAP has in understanding fully certain nuances of the lab trade. Ridiculous. Unless you want the marketing and potential "perception" that you are better covered from a legal standpoint, CAP certs are worthless. The more I hear about CAP certifications, the more I see it as a certain community of individuals who are protecting their perceived "TURF." In the end, the pathologists in the group and in the facility in which you are working have to take responsibility for these matters. If the docs think a CAP cert is necessary, then do it and live with it. If not, then consider yourself lucky to not have to see these people in your lab. I have been through MANY CAP inspections in and out of the military. For the most part, though, I see people paying this organization to inspect their lab as the same thing as "burning a pinch of incense in honor of great Caesar, ruler of Rome." It will get you some kudos, but tangibly not change much at all if your pathologists or HR $ hiring hands want to pocket more $ as a result of hiring "pregnant out of wedlock 16 year olds" to gross tissue and cut slides. Seen it. AB _______________________________________________ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet _______________________________________________ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet