Joint Commission is a Joke...

[Emergent]

My Hospital has been preparing for the Joint Commission inspection. Frankly, it's pathetic. No saline locks in our pockets, no IV buckets left out on counters, nothing closer than 18 inches from ceiling. And, no concern regarding nurse/patient ratios of course.

Another self-important, entrenched, bureaucratic entity, that is impeding us in our work. People who have spent their time in academia, studying theory that was developed outside of the space/time continuum, in front of a computer spreadsheet. God save us all.

[lub dub]

This discussion is becoming a chorus of the knee-jerk reaction of "Joint Commission BAD. Nurses GOOD". Yes, there are some things that the Joint Commission looks at that seem like they are nit-picking. But please remember that this organization developed National Patient Safety Goals. These guidelines deal with many aspects of patient safety. (http://www.jointcommission.org/assets/1/6/2014_HAP_NPSG_E.pdf )

[MunoRN, RN]

What measure is that?

Proper staffing with the right skill set.

The JC requires that staff be properly trained, maintain appropriate competencies, etc., but they've never established actual staffing ratios that they use as a standard.

[MunoRN, RN]

We aren't supposed to care flushes in our pockets? Even wrapped?[/quote

No medication should be in your pocket, also what temperature is is being stored in your pocket?

Saline flushes aren't considered a medication by the JC or by the FDA, they are considered a medical device. We've had the JC not allow flushes in pockets in the past, but they were allowed on the last two surveys, it would seem to vary by surveyor.

[Biffbradford]

OKay, I'll ask: What does "ding" and "get dinged" mean? Is this an official term?

[imintrouble, BSN, RN]

If you get dinged by Joint Commission, then something is out of compliance with their regulations. Something stacked to close to the ceiling? You get dinged

Cleaning supplied under the sink? You get dinged.

Fridge temps too hot? You get dinged.

It's something that has to be fixed in a certain amt of time.

They come back and make sure. I think.

[tntrn, ASN, RN]

The JC requires that staff be properly trained, maintain appropriate competencies, etc., but they've never established actual staffing ratios that they use as a standard.

And that, too, can be a joke. Where I used to work, we had to do yearly "competencies." These consisted of watching stuff on the computer and answering questions afterward. Being an OB nurse, there were lots of competency quizes on things that I had not ever even seen done, let alone done myself. Yet if I passed the quiz, which we had to keep taking until we did, we were considered competent for that application. WHAT A FRIGHTENING JOKE! But it made them able to float us to med-surg and assign us to patients we should not have been taking care of. On paper, it all looks legit. In reality, it was scary.

I once told the supervisor who called to tell me it was my turn to float that I wasn't going to take any assignment that would jeopardize the safety of the patient or my license. She asked if I was refusing to go. I said no, but I would only take an assignment I could safely manage.

Later that day, my nurse manager, in front of the entire change of shift staff loudly said, "you made the supervisor cry today." Well, boo-*****-hoo. If she cried over what I said, she was on the edge before she ever called me.

That manager now teaches in a local CC. I can only shake my head at that.

[llg, PhD, RN]

I am not a huge fan of TJC, but it is not as useless as many posters seem to think. Yes, we all know that hospitals "put on a show" for the TJC surveyors -- and that things go "back to normal" after they leave. But that doesn't mean that no benefit comes from the visit. The inspections guarantee that everything gets looked at and cleaned at least every 3 years, and that process is healthy for an institution. Areas of weakness are found during the preparation process, policies get up-dated, etc. Some processes get improved on a permanent basis and yes, some people even lose their jobs it major problems are found.

It is like a school exam -- or the NCLEX. Exam questions do not address every possible piece of content. The questions represent only a sampling of the topics a nurse should know -- and everyone knows that students study specifically for the test, cram a lot information in at the last minute, and that they will forget a lot as time passes. But that doesn't mean that every test is completely bogus.

It is far from perfect -- and like many others, I wish TJC paid more attention to employment conditions, work environments, treatment of employees, etc. -- but that is not their purpose and not the focus of their visit is. That is why the ANA established the Magnet Program -- and most nurses don't like that program either.

[HouTx, BSN, MSN, EdD]

OK - so what's the alternative? Do you not want ANY type of mandatory criteria for hospital operations? Just imagine how that would turn out. Sheesh. CMS surveys are more exacting than JC - with much more serious consequences for any lapses in compliance. Nothing in life is ever perfect, but I believe that a more professional approach would be to recognize the gaps and shortcomings.... and work to improve them.

Is anyone involved with activities related to JC/CMS compliance?

[dudette10, MSN, RN]

I am not a huge fan of TJC, but it is not as useless as many posters seem to think. Yes, we all know that hospitals "put on a show" for the TJC surveyors -- and that things go "back to normal" after they leave. But that doesn't mean that no benefit comes from the visit. The inspections guarantee that everything gets looked at and cleaned at least every 3 years, and that process is healthy for an institution. Areas of weakness are found during the preparation process, policies get up-dated, etc. Some processes get improved on a permanent basis and yes, some people even lose their jobs it major problems are found.

It is like a school exam -- or the NCLEX. Exam questions do not address every possible piece of content. The questions represent only a sampling of the topics a nurse should know -- and everyone knows that students study specifically for the test, cram a lot information in at the last minute, and that they will forget a lot as time passes. But that doesn't mean that every test is completely bogus.

It is far from perfect -- and like many others, I wish TJC paid more attention to employment conditions, work environments, treatment of employees, etc. -- but that is not their purpose and not the focus of their visit is. That is why the ANA established the Magnet Program -- and most nurses don't like that program either.

Thanks for that. It does provide me a new perspective...that the preps for a survey are probably more useful for patient safety and improvements that really matter than the survey itself. :)

[AOx1]

This discussion is becoming a chorus of the knee-jerk reaction of "Joint Commission BAD. Nurses GOOD".

Yes, this and: bedside nurses GOOD. Academics/Educators/Researchers/Administrators/Managers/any nurse not at the hospital bedside BAD. These arguments are so simplistic and tiresome. There are excellent nurses in all realms of this profession, just as there are terrible ones. I'm as tired of this as the ADN/BSN argument.

I wonder how much complaining actually results in action? How many of us support changes in legislation through activism, lobbying efforts, and collective bargaining?

[wooh, BSN, RN]

Is anyone involved with activities related to JC/CMS compliance?

I used to be. I knew TJC stuff inside out and was responsible for my unit's compliance. Things got cleaned up the week of. Staffing suddenly increased so we could actually do things "right." And I knew how to make things look right even when things were oh so wrong.

Yes, hospitals need oversight. But it needs to be REAL. Surprise inspections. Looking at things that count. Like staffing. Not whether boxes are off the floor. Administration needs to be accountable for making it possible to follow the rules. Not bedside nurses being held accountable for charting that the rules were followed even when there's not time to actually follow them.

[Esme12, ASN, BSN, RN]

Trust me...the JC is far from perfect but there is some scary/crazy stuff (personal knowledge) that goes on out there that they deal with every day. NONE of which is EVER in the paper or on the news. You want them to be out there...TRUST ME!. Don't ask I cannot share.

The stuff that is investigated/reported would make your hair stand on end and make you think you are not even think you are in the USA.

A dirty floor...is peanuts.