JCAHO Suprise

Agnus · Apr 6, 2003

Some times I think we confuse state inspections with JAHCO. My guess is the complaint that NICUGAL talks about was filed with the state.

JAHCO is a voluntary acrediting agency and is not a requirement. JAHCO conducts inspections by invitation of the facility seeking acreditation.

State inspectors on the other hand do not need and invitation and have the power of state laws behind them. JAHCO does not.

That is not to say JAHCO acreditation cannot be withdrawn. However, it takes a LOT for that to happen. Unless a facility ops to forgo recertification when it is due.

JAHCO would not drop a facility for a single reported incident any more than they do when finding these during certification inspections.

Keep in mind that just because something was reported and did acuality happen does not mean it can be adequately substantiated with inspectors.

VickyRN, MSN, DNP, RN · Apr 6, 2003

Question for you--has JCAHO ever done anything POSITIVE for nurses' working conditions????

deespoohbear · Apr 6, 2003

How about requiring JCAHO inspectors to work in the REAL world of hospitals, pharmacies, and whatever else they accredited. Let's say if you have an inspector who is a nurse then he/she should be required to work a floor (such as M/S, ER, ICU,) for a certain amount of time. Let them see what it is like to have to function under some of their own asinine rules.

Gee, I HATE JACHO. Hypocrites.

susanmary · Apr 6, 2003

Unannounced? I'd be very surprised -- will probably follow the time frame of all previous visits. JCAHO should visit, unannounced, on ALL shifts EACH year -- no forwarning. The state should also do the same. It's a sham to be able to "fix" everything for several days -- blame staff for whatever is NOT perfect -- then go back to even less staffing. It's so frustrating & such an easy thing to do. Volunteers for "unannounced" JCAHO visits -- of course they will be ready! Why will it take THREE years for this to happen, at a minimum? They should start this week -- and the hospitals & administrators should be held responsible for providing adequate staffing, training, etc. so that it is possible to always maintain the highest possible standards -- no "it's not in the budget" stuff. My 2 cents.

Agnus · Apr 8, 2003

Originally posted by VickyRN
Question for you--has JCAHO ever done anything POSITIVE for nurses' working conditions????

Hmmm? That's not thier function. Don't get me wrong I am NOT a fan of JCAHO. I see too many hospitals that claim high scores that JCAHO should be embarrased for giving them.

Often all they do is create more burocratic paper work that is entirely meaningless. Personally I see a lot of harm and little good done. But the public like to hear words like, "Accredited" even if they are in reality meaningless, Even if it has nothing to do with the quality of care.

I know an EMT who is sure a certain hospital is the VERY BEST because it is the only Level II trauma center (we don't have a level I) And the fact that this hospital pays for advertising to the effect that they are "the best" probably helps. Yet in reality it is a hell hole. Even the Doc's complain about how nurses are treated there. I have yet to hear a patient who came from there say anything good. So people will believe that if you have credential then you are good. (never mind that they have no idea what those crecentials are or what they mean. ) Never mind that they may have no meaning what so ever.

judy ann · Apr 8, 2003

Investigators for JCAHO do indeed have to have a background in whatever they are looking at. For instance: my uncle had been a family doctor for 30 years when he sold his practice and went to work for the JCAHO. The people who look at the administration have been administrators, nurses have been nurses, etc. They also have an extensive training that is required and spend quite a while with preceptors before they are on their own.

Unless the rules have changed, Medicare requires JCAHO accreditation.

One of the reasons that the inspections have been announced has been that the facility will do it's best to look really good. Everything will be top notch for JCAHO. Then, as time goes by, things go downhill. Pretty soon, it's time for JCAHO again. At least it will be good every three years. Otherwise, who knows. This is an inside joke among the inspectors. "I'll bet they're scrambling out there!" They want to see you at your best, not at your worst!

JCAHO isn't there to trick you, nor are they there to make you or your hospital look either bad or good. They aren't there to make things better for nurses, or housekeepers, or anyone else, except the patients. They aren't even there to make thing better for the doctors! They are there to keep healthcare safe for Americans. You might be surprised at some of the stuff they find when they arrive when expected! They are invited by the facility, and the facility pays for the priviledge of their inspection. So, when they come to your place, at least smile at them. Please:saint:

Agnus · Apr 8, 2003

Lets face it JCAHO spends MOST of its efforts and time looking at documentation. MOST of that documentation is about events and patients who are LONG GONE.

Every nurse knows that documentation does not give a whole, true nor real picture of anything.

Because of the excessive emphasis on documentation time is stolen from real patient care.

Documentation has to do with covering one's back side. Which would be much better covered by spending that time with the patient meet thier needs instead of documenting. We all know that because of the time required to document that everyday there are things that don't actually get done because of the over emphasis to do it on paper. That those things that are not required in documentation by may be even more important for the patient such as a human presence are neglected for the sake of documentation. Consequently we develop an attitude where we don't meet the patient needs because we are drained and burned on on documentation and the patient with thier needs is just one more demand.

Ever JCAHO mandate is related to more detailed and more cumbersome paper work than previous. We need to get our head out of the sand. Patients who sue feel neglected. We neglect them in favor of documentation. Study after study has demonstrated that patients who feel that care givers spend enough time with them and are responsive to them and that are "nice" do not sue even when they could. How can you be "nice" when you can't even to find time to be human and connect with a patient?

NicuGal, MSN, RN · Apr 8, 2003

Also, if I believe you have to be accredited to receive reimbursment from Medicare and Medicaid, so I guess they help me keep my job at the county hospital LOL.

I just can't stand all the extra paperwork....so, how can I really connect with family when I am filling out 50 pieces of paper and PIP charting every 4 hours.

Agnus · Apr 8, 2003

Originally posted by NicuGal

I just can't stand all the extra paperwork....so, how can I really connect with family when I am filling out 50 pieces of paper and PIP charting every 4 hours.

Thank you

deespoohbear · Apr 8, 2003

originally posted by judy ann
investigators for jcaho do indeed have to have a background in whatever they are looking at. for instance: my uncle had been a family doctor for 30 years when he sold his practice and went to work for the jcaho. the people who look at the administration have been administrators, nurses have been nurses, etc. they also have an extensive training that is required and spend quite a while with preceptors before they are on their own.
unless the rules have changed, medicare requires jcaho accreditation.
one of the reasons that the inspections have been announced has been that the facility will do it's best to look really good. everything will be top notch for jcaho. then, as time goes by, things go downhill. pretty soon, it's time for jcaho again. at least it will be good every three years. otherwise, who knows. this is an inside joke among the inspectors. "i'll bet they're scrambling out there!" they want to see you at your best, not at your worst!
jcaho isn't there to trick you, nor are they there to make you or your hospital look either bad or good. they aren't there to make things better for nurses, or housekeepers, or anyone else, except the patients. they aren't even there to make thing better for the doctors! they are there to keep healthcare safe for americans. you might be surprised at some of the stuff they find when they arrive when expected! they are invited by the facility, and the facility pays for the priviledge of their inspection. so, when they come to your place, at least smile at them. please:saint:

there is a difference between having a background in your area and actually working the floors (or administration office, or whatever) in the last eon. most of the inspectors are so far out of touch with reality and obssessed with stuff that doesn't matter to a hill of beans in the long run. couple of years ago jcaho made our facility change the door handle on our report room door. why? we had one the was a push in type but they wanted us to have a lever type handle. what difference does this make in patient care? zero, zip, zippo. the documentation they require is excessive and cumbersome. facilities pay big bucks to be told what they are doing wrong. too bad some of that money couldn't be spent on improving nurses' (and other healthcare workers) wages and benefits. :confused: maybe with improved benefits and wages and better working conditions nurses wouldn't be leaving the bedside in droves. jcaho is a farce, period.

ceecel.dee, MSN, RN · Apr 8, 2003

Originally posted by Agnus
Every nurse knows that documentation does not give a whole, true nor real picture of anything.

Because of the excessive emphasis on documentation time is stolen from real patient care.

Documentation has to do with covering one's back side.

1. Documentation should be giving the true and real picture.

2. Acurate, complete and comprehensive documentation IS a big part of your job.

3. Yes, it can and is used as a legal document, so complete it carefully. It can be used as your greatest defense, or very effectively against you.

lateblumer · Apr 9, 2003

I agree that JCAHO inspections should be unannounced. Our facility is a joke when they are there. We have more staff than we ever have, usually working understaffed ( like everyone else!) Our documentation is off the charts! If JCAHO showed up unannounced, all the things we sweep under the rug, forget to do, or time being wasted by poor time management, would all come to a head. I think that for once, something would "GET DONE".