Where is JCAHO in all of this mess??

[RNSue]

According to the JCAHO website, their mission statement is as follows..."The mission of the Joint Commission on Accreditation of Health Care Organizations is to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations." Now that the public is becoming more aware of the nursing shortage it won't take long for someone(patient,lawyer) to say "Hey,wait a minute! This health care facility where I was just a patient and got terrible care in is accredited by JCAHO and I thought they were supposed to ensure the quality of my care". I realize that not all health care institutions are JCAHO accredited but all the big ones are. If they are so concerned about "quality of care" provided to the public, why aren't they becoming involved with the terrible working conditions that are definitely NOT improving the safety and quality of care given to the public. Maybe if we directed our complaints to JCAHO concerning our working conditions in the facilities that they have accredited, we just might get some solid action. Management would definitely take notice if they lost their accredition. We have to start playing at their(management's)level. They have ignored us for too long. I know that if I'm ever sued for something that short staffing definitely contributed to, EVERYONE is going down with me. It's long overdue for us to do WHAT WE CAN, to GET HEARD! The public also needs to know what and who JCAHO is. I'm surprised the lawyers haven't thought of them by now. Thoughts, anyone?

[natalie]

Have we been part of the problem by complying with all the paperwork demands? For 25 years I've been doing it and it's insane and I plead guilty. Now, because I'm so disheartened and ready to quit or be fired, I'm starting to fight back a little.

Take the dreaded restraint form. In my 12 hour shift, I am notating on a piece of paper on one patient 144 times that they needed hand restraints because of intubation. On my last shortshift, I filled out the protest form and refused to fill out the restraint form. I didn't have the time. My manager was very upset, stating it was a dreaded TYPE 1 VIOLATION. I told her the hospital violated my nursing standard of practice and violated the patients safety by staffing 2 nurses for 8 patients in ICU. Guess what. I didn't get fired.

All that paperwork filled out has been done by the nurses.

[Charles S. Smith, RN, MS]

Originally posted by cmggriff:

RNSue,

Go back to the web site and look dowwn toward the bottom of the page "About Us". There you will find a list of the "corporate members". I believe this will answer the question. There are no nursing or nurse friendly groups mentioned. Essentially Joint Commission is a branch of the industry it purports to be inspecting. This is like letting the prisoners run the jail.

JCAHO was founded by MDs. Up until recently there were no RNs on the governing board. There clearly are no nursing friendly organizations represented. Why? Again, it is a control mechanism. MDs found a way to exploit dollars from hospitals and healthcare organizations (with their permission, I might add) in a way that is palatable to the public and to governmental regulatory agencies. What we, as nurses, must do, is to educate the public and our legislators about the multiple failings of the JCAHO to accurately assess an institution, and the fallacy about JCAHO accreditation guaranteeing quality, especially where nurses are concerned. JCAHO

accreditation is required for certain governmental reimbursement. Is this wise? I think not. A stellar examination can and is bought every day for a price tag of $10,000 to $30,000 per day per visit. Who ultimately suffers? The patients and the nurses. The JCAHO is invited into a institution for a fee. There are hospitals who are rebelling against the monopsony power of this organization and nurses must also inform their legislators at the state and federal levels. Did you know that your state government can close down a hospital? If you have whistleblower protection in your state, use it. Call your state regulatory agency and give them facts. They are required to assess the situation. Any hospital can be sanctioned negatively for unsafe conditions, but the state has to know about them, before they can investigate.

just my thoughts

best regards

chas

[Windy]

Originally posted by NorthNurse:

Hi Sue,

Some hospitals are more concerned with trying to promote agenda's such as therapeutic touch and bringing prayer to the bedside, not that there isn't a place for alternative therapies, BUT, I think they should spend time/effort/money on meeting the basics of care FIRST, that are substantially lacking ie.. having enough staff to make sure the patients call light gets answered timely and patients get bathed, rather than who can perform TT and pray with the patient. I think they use this stuff to be impressive for JCAHO visits, and somehow hide the real issues. I can't tell you how many home care patients have complained that no one helped them do anything in the hospital, but they did get a tape recorder, headphones, and music tapes to help them relax. This patient came home with crusted betadine all over his back, because no one helped him bathe, and he was in the hospital over a week. Unbelieveable eh?

Government intervention/regulations have their place in health care but it has become a massive tangle of red tape. Nurses cannot do the job they wanted to do when they went into nursing because they are back logged with a paper/computer trail. I work in a small but very busy emergency department and have found that if I record what JACHO wants to see I have not given the care to my patients I like to give. If I spend the time with my patients my charting sadly lacks. Any suggestions?

[Mijourney]

Hi. All of you make valid points. I do feel that some sort of external mechanism of policing quality is needed and some of the licensing/accrediting agencies may have been planned with good intentions.

The problem, in my opinion, is that the job consists mainly of generating boring or interesting reports (depending on your point of view) off of accumulated written information from someone else's job (namely mine and yours if you're in the trenches) making that agency representative's job justifiable in some way. The underlying problem never gets addressed and someone gets to keep a good paying 9-5 job.

Charles, I like what you had to write on this topic.