JOINT COMMISSION SAFETY GOALS

Joint Commission Safety Goals

Joint Commission Safety Goals

Introduction

The goals are being reviewed this year through the Joint Commission's Standards Improvement Initiative (SII) rather than the routine annual process. According to the Joint Commission, the SII process is used to clarify language, ensure that the NPSGs are program-specific, delete NPSGs that are redundant or nonessential in specific programs, and consolidate similar NPSGs. The Joint Commission says the process includes a baseline survey, review of potential changes by the organization's Patient Safety Advisory Group and the Standards and Survey Procedures Committee, and final approval by the Board of Commissioners. Revisions based on SII recommendations will be effective in 2010.

Purpose Of The Joint Commission's Safety Goals

This Joint Commission review also takes into consideration other patient safety and quality initiatives, such as those from the Centres for Medicare and Medicaid Services and the World Health Organization (WHO). Previously, the review was derived from informal recommendations made in the Sentinel Event Alerts, the Sentinel Event Advisory Group (now called the Patient Safety Advisory Group), and review of sentinel events and root cause analyses reported to the Commission. (Reason, 2000)

The other major shift in this review is that the Joint Commission's Standards Interpretation Group is involved, to ensure consistency of interpretation and integration into the Accreditation Standards Manuals. It's common for the Joint Commission to revise the language of NPSGs or to move certain goals onto the list of standards. (Runciman & Williamson & Deakin, 2006)

The goals of Geriatric

•Geriatric Medicine emphasizes “patient safety” as a core value

•Hospital administrators are now highly motivated

•Evidence-based interventions can reduce the risk of “never events”

•The time is now to lead improvement initiatives in acute care

Special skills of the geriatrician I

•Patient focused

•Advance care planning

•Preserve functional status

•Anticipate harm

-Polypharmacy

-Bladder catheters and other “tethers”

-Sleep deprivation

-Delirium

-Skin integrity

Special skills of the geriatrician II

•Care transitions

•Understand the continuum of care

•Minimize readmissions

•Palliative care

•Interdisciplinary team

-Nursing

-Pharmacy

-Rehabilitative services

Future Anticipated Changes and Challenges

According to the Joint Commission, the current extensive review is in response to concerns about the challenges some NPSGs present, and the need for additional information about effective approaches to address these challenges. We expect the biggest changes from this review to be in the Universal Protocol and the medication reconciliation requirement. Because of the complexity of healthcare and the variations in practices, these two goals have been very difficult for some organizations to integrate into current systems. Although for some the reason is just a resistance to change practice, for others it has been difficult to integrate the requirements into existing systems and processes, and required redesign of many processes and habits before the elements of performance could be practiced. (WHO, 2007)

The Joint Commission receives a great deal of feedback about the Universal Protocol from organizations seeking flexibility in integration of the WHO requirements. Possibly, those who are most concerned about the Universal Protocol requirements are surgeons and organizations such as the American College of Surgeons and the American College of Anaesthesiologists. (Runciman & Williamson & Deakin, 2006)

Medication reconciliation has been a goal that ...