Magazine article Drug Topics

JCAHO Puts Teeth into Patient Safety Goals

Magazine article Drug Topics

JCAHO Puts Teeth into Patient Safety Goals

Article excerpt

Healthcare organizations that don't focus on patient safety are about to come up short. Starting next January, the Joint Commission on Accreditation of Healthcare Organizations will add six patient safety goals to its survey standards. Organizations that are not taking concrete action to meet the goals could lose their JCAHO accreditation.

"We have a requirement now that hospitals adhere to these National Patient Safety Goals," said Darryl Rich, associate director, surveyor development and management for JCAHO. "We absolutely expect organizations to be in compliance by Jan. 1, 2003." That's when JCAHO surveyors start evaluating healthcare organizations on specific steps taken to improve the safety of high-alert medications, reduce miscommunication between caregivers, improve the safety of infusion pumps, improve the accuracy of patient identification, eliminate wrong-site surgery, and improve the effectiveness of clinical alarm systems.

The six National Patient Safety Goals (NPSGs) were adopted by a JCAHO advisory committee headed by Henri Manasse, executive vp. and CEO of ASHP. New goals will be identified during 2003 for implementation during 2004, Rich said. Surveyor findings on compliance with the new goals will be incorporated into accreditation reviews immediately.

Compliance data on individual organizations that have been surveyed will be made public starting in mid2004 when JCAHO reformats its organization performance report.

Meeting the new goals should not be a problem or even a significant expense. None of the six safety issues is new, noted Kasey Thompson, director of ASHP's Center on Patient Safety. And none of the steps JCAHO suggests to meet the goals requires major changes in equipment or even workflow for most institutions. The biggest change is that hospitals no longer have any excuses not to take what safety experts call obvious steps to correct safety problems that the profession has known about for years.

Each of the six JCAHO goals includes specific recommendations to help organizations reduce certain types of errors. "The commission is finally putting teeth into patient safety recommendations that have been around for decades," said Michael Cohen, president of the Institute for Safe Medication Practices.

Cohen is also a member of the JCAHO advisory panel. "ISMP is a reporting organization, not an enforcement agency. We need support from groups like JCAHO. Their support gives safety some clout," he said.

Not all pharmacists are convinced that JCAHO can change institutional behavior. "These goals are givens," warned Steve Meisel, director of medication safety at Fairview Health System in Minneapolis. "Any institution in moderntimes should have done all of these things years ago, but clearly not all have. Changing policy does not necessarily change practice."

The new program includes two recommendations to improve the safety of high-alert medications. Organizations should remove all concentrated electrolytes from patient care units. The recommendation includes, but is not limited to, potassium chloride, potassium phosphate, and sodium chloride solutions greater than 0.9%.

Surveyors will also expect to see groups standardizing and limiting the number of drug concentrations available in the organization. …

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