1082 Accreditation of Home Sleep Apnea Testing in British Columbia, Canada: The Types of Nonconformance

Accreditation of Home Sleep Apnea Testing (HSAT) has been conducted in British Columbia (BC) since 2021. BC is one of only two provinces in Canada that require accreditation for HSAT facilities. In this study, we analyzed the types of nonconformance cited, based on the first facilities completing on-site assessments.

The accreditation process was divided into three phases: an initial attestation, a desktop audit, and an on-site assessment. In 2022-2023, we analyzed data from 46 HSAT facilities who have completed an onsite assessment based on 329 standards. The assessment approach included reviewing evidence, interviewing staff, and observing patient practices. All assessment questions were categorized and included a complete set of HSAT Accreditation Standards (1). The outcomes of these assessment activities highlighted nonconformance for the facilities to meet to obtain full accreditation.

By December 2023, 46 out of 172 facilities in BC (26.7%) had completed on-site assessments, and 480 nonconformance were cited. The nonconformance identified in the on-site assessments was analyzed. Among the nonconformance, we found 105 (21.9%) in procedural and documentation areas, 78 citations (16.3%) in human resources standards, 54 (11.3%) in the medical director’s duties, 38 (7.9%) in HSAT equipment evaluation and maintenance aspects, 32 (6.7%) in reporting, 29 (6.0%) nonconformance were identified in ethical standards, 28 (5.8%) in complaint and feedback processes, 22 (4.6%) were related to technical HSAT issues, 18 (3.7%) in safety and privacy and the same number 18 (3.7%) were associated with patients communication problems, 13 (5.0%) nonconformance were in scoring and interpretation area, and 34 (7.1%) in referral process, infection prevention and control, and information management groups of standards.

Standalone HSAT facilities will continue to play a significant role in providing diagnostic sleep services. HSAT facilities have welcomed the accreditation process to facilitate continuous patient care and safety improvement. Our study, showing the first experience of the HSAT accreditation process, strives to create a path for further research on the positive influences of accreditation programs on public health indicators.