AAAHC report spotlights top accreditation deficiencies, strategies for safer ambulatory care

Editor's Note

Ambulatory care leaders can now sharpen compliance strategies with the release of the 2025 Quality Roadmap from the Accreditation Association for Ambulatory Health Care (AAAHC), published September 22. The annual report distills more than a year of survey findings into practical guidance for addressing the most common accreditation deficiencies and improving patient outcomes.

According to the press release, this year’s edition introduces a new section dedicated to Life Safety Code® findings, equipping organizations to better identify fire safety and facility readiness risks. It also expands focus on Medicare Deemed Status, offering detailed recommendations for facilities participating in CMS programs, and provides insights into Immediate Jeopardy findings, which represent the most critical threats to patient safety.

The report highlights the leading deficiencies across three major categories. For surgical and procedural care, the top issues are Facilities and Equipment, Medication Management, and Credentialing & Privileging. In Life Safety Code compliance, Fire Emergency Plans, Smoke and Fire Protection, and Essential Electrical Systems rank as the most common challenges. In primary care, Infection Prevention & Control, Emergency Management, and Credentialing & Privileging continue to be the leading problem areas.

Noel Adachi, MBA, AAAHC president and CEO, stated the 2025 Quality Roadmap “raises the bar” by offering expanded analysis and tools that organizations can immediately put into practice. Julie Lynch, RN, director of the Institute for Quality Improvement, emphasized the report goes deeper than previous editions by drilling into high-deficiency standards and incorporating surveyor recommendations to reveal “a clear path” for corrective action.

Beyond deficiency data, the Quality Roadmap reinforces that accreditation is a continuous 1,095-day journey, not a periodic event. The release encourages leaders to benchmark their results against national survey findings, compare them with recent onsite reports and self-assessments, and review policies and practices for alignment with AAAHC standards. It also points organizations toward toolkits and resources that can enhance both patient and team safety.