Key Takeaways
AAAHC's 2026 Quality Roadmap analyzes accreditation survey results from January 1 through December 31, 2025, across ambulatory surgery centers, office-based surgery centers, primary care organizations, and Medicare Deemed Status facilities.
Infection prevention and control (IPC) continues to be one of the most frequently cited deficiency categories in both surgical/procedural and primary care settings.
The most common IPC findings centered on sterilization and reprocessing practices for instruments and equipment, and on the scope and documentation of written infection prevention programs.
Infection control practices were also among the leading causes of Immediate Jeopardy citations over the past year.
The findings point to a consistent pattern: written policies exist, but the oversight, surveillance, and follow-through behind them often don't.
The Accreditation Association for Ambulatory Health Care (AAAHC) has released its 2026 Quality Roadmap, an analysis of onsite accreditation survey results from January 1 through December 31, 2025. This year's report is the first to combine data collected under both the v43.1 and v44 Accreditation Handbooks, with all findings mapped to the current v44 framework for consistent comparison.
The report covers ambulatory surgery centers, office-based surgery centers, primary care organizations, and Medicare Deemed Status facilities, and highlights the standards surveyors cite most often across each. Infection prevention and control continues to be one of those categories, in both surgical/procedural and primary care settings.
Where Infection Prevention and Control Fell Short
Surgical and Procedural Organizations
For ambulatory surgery centers (ASCs) and office-based surgery centers, the IPC findings cited most often involved sterilization and reprocessing — cleaning, decontamination, high-level disinfection, and sterilization of instruments, equipment, supplies, and implants — along with the scope and content of the written infection prevention and control program itself. Surveyors also frequently noted gaps in safeguards meant to prevent cross-infection within the surgical environment.
A common thread ran through these findings: written programs that were incomplete, outdated, or missing defined oversight; surveillance activities that weren't catching environmental or process risks; and sterilization records — logs, biological indicators, equipment parameters — that were inconsistent or absent. In a number of cases, the same deficiencies had been identified in a prior survey and hadn't been resolved.
Primary Care Organizations
In primary care settings, IPC was one of the most frequently cited categories overall. As with surgical/procedural organizations, sterilization and reprocessing practices and sharps injury prevention programs were among the most common findings, alongside gaps in the scope of written infection prevention programs and, in some cases, the absence of a designated, qualified professional to direct the program.
AAAHC notes that primary care settings face their own set of challenges: leaner staffing, less access to infection-prevention-trained personnel, and a tendency to treat infection control as a lower priority than it would be in a surgical setting.
Infection Control and Immediate Jeopardy
The report's Immediate Jeopardy section is where these gaps carry the most weight. Infection control practices were among the leading causes of Immediate Jeopardy citations issued over the past year, behind only crash cart readiness issues.
These findings centered on instruments cleaned, disinfected, or sterilized without following manufacturer instructions; sterilization monitoring programs that weren't catching or acting on failed results; lapses in aseptic technique; and unsafe injection practices, including single-dose vials used across multiple patients.
What The AAAHC Data Shows
Across both settings, the pattern looks similar. Most organizations have some version of an infection prevention policy in place. What's frequently missing is the program behind it — the oversight, training, surveillance, and documented follow-through that turn a policy into a working safeguard.
None of the standards cited most often are unusual or obscure. They're foundational requirements that, followed consistently, prevent the exact kinds of events that show up in the Immediate Jeopardy data. That's part of what makes this year's Roadmap useful: it gives infection prevention and control professionals a current benchmark against which to compare their own survey history and self-assessments, and a starting point for where quality improvement efforts might be best focused.
Where to Go From Here
If your organization's last survey turned up findings in any of the areas covered here — a written IPC program that needs an update, sterilization and reprocessing practices that don't fully line up with manufacturer instructions, or a sharps injury prevention program that hasn't been reviewed in a while — these are the areas ICCS works with ambulatory organizations on every day. Our team can review your current IPC program against the current Standards, identify gaps ahead of your next survey, and help build out the documentation and training to support it.
Contact ICCS to talk through where your program stands.
Note: For the full breakdown — including specific deficiency rates by category and standard, plus findings across Administration, Medication Management, Credentialing & Privileging, Emergency Management, and Facilities and Equipment — the 2026 AAAHC Quality Roadmap is available directly from AAAHC's Quality Institute.