JCAHO, how you annoy me.

Nurses Safety


So, JCAHO is at my facility this week and, of course, we've been prepping out the wazoo for their arrival. I work in the ER, so there are a lot of department specific stuff for us, as there is for every department. We were lucky enough to not get a visit today. That will probably occur tomorrow. Anyway, I digress.

I come to work and have a patient in a trauma room that doesn't belong in a trauma room and has been admitted for observation. I need that room clear, as we are starting to get busy, and I have a bed ready on the medical floor. However, the nurse that will be taking report is the charge nurse as all other nurses are full. To make a very long story short, it took me a little over an hour from the first time I tried to call report to the point where the patient got transported to their room. What caused such a ridiculous delay, you ask? JCAHO.

Yes, while I was trying to maintain a standard of care, continuity of care, and clear my trauma room at a peak time on a peak day, JCAHO was busy making the charge nurse perform the walk through of their department, with their arbitrary checklists and so on. I even called the charge nurse at one point and was told that JCAHO was behind this delay, as they were adamant that they finish the walkthrough. Finally, our nursing supervisor had to go inform them that he would help them with the walkthrough, that the charge nurse had to take a patient that had been waiting an hour to be moved.

I just feel the need to rant about these ridiculous visits in which we mask any problems with our facility in hopes that JCAHO and their mighty pen doesn't give us a bad checkmark. I understand the importance of pleasing JCAHO and meeting their standards, but at the same time, know what is more important than your surveys: everything in the hospital that involves patient care.

I'm sure the poor charge nurse there just got saddled with a surveyor that slipped and sat on a broomstick and I doubt this is a common occurrence, but it just irked me.

Also... can anyone tell me why JCAHO needs to regulate our food in our break room?

Sigh. /vent

Thanks for reading. :)

Also... can anyone tell me why JCAHO needs to regulate our food in our break room?

Because each regulation they come up with keeps them in a job.

Specializes in Oncology.
Because each regulation they come up with keeps them in a job.

I hear in the next revision they'll be visiting our home kitchens as well. I've bought a thermometer that measures to the tenth of a degree in accuracy to prepare.

Specializes in Emergency.

Sounds like the last survey JCAHO did at my facility. They pulled the primary nurse out of a rapid response code that had just started. Manager didn't stop it from happening, in fact, she encouraged it.

Sounds like the last survey JCAHO did at my facility. They pulled the primary nurse out of a rapid response code that had just started. Manager didn't stop it from happening, in fact, she encouraged it.

And probably asked questions like, "And what is done during a rapid response?"

The only good thing is that you actually get adequate staffing during their visits... hmmm...

JCAHO knows every place they go is putting up a good front, so what the point?

Specializes in Emergency.

Only thing worse than jcaho is the state. Jcaho can snarl & write you up but the state levies fines.

what always scorched my buns was that jcaho is not free-- and the hospital pays for its visits. and if there are deficiencies and there have to be return visits, the hospital pays for those, too. seems like a massive conflict of interest here.

there have been calls to ditch the jcaho, as their methodology has not been good; they are not a governmental or quasi-governmental agency, and there's no objective reason for their approval to be required for licensure or other operational requirements. as a matter of fact, in many settings, it isn't.

as to the surveyors, most are ordinary folks like you and me, just trying to do a lousy job. and it is a lousy job-- i had a patient once who was one of their surveyors, and she told me how they worked them to death, sent them all over the country, and paid poorly. she was required to carry her laptop and a printer with her at all times, meaning carry-on luggage, and if there were a puddle-jumper flight she still had to have them in her lap, couldn't leave her direct control. this is why she became my patient-- blew out her shoulder.

The biggest laugh ..

Nobody regulates JCAHO.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

"Nobody regulates JCAHO" Aint that the truth.....;)

There are other regulatory agencies to get accredited but "The Joint Commission", as they wish to be called now, is the "gold standard". If a facility is receiving government funds....ie: medicare/medicaid, there must be an accrediting body to certify the facility is "up to snuff" to be paid for those specific patient populations. Therefore "minimal" standards have been adopted for patient safety and quality of care. They are not a government entity and have a "not for profit" status for taxes, which means they don't pay taxes "per-se", postage...etc.

They know everyone "spruces up" for "Their" visits, if fact, "They" find it amusing. They do pay reasonably well, like the Directors in the think tank in Illinois, but the surveyors do have it rough with travel and you are their beck and call girl. The surveyors are "on call" 24/7 when traveling so that when there is a complaint lodged....it is immediately investigated, depending on the complaint. "They" (The JC) have had issues in the past for like any endeavour/corporation where large sums of money are involved, there are those few bad apples who were "on the take" "on the side" and "taking money" (site bribes of surveyors) for good surveys.

"They" openly admit that they are a bunch of anal retentive pencil pushers with nothing better to do with their time but to harass facilities/staff/administration for at least, maybe, they can stop/prevent/intervene before something bad happens. They base many "JC" (I know right:rolleyes:, "JC") rules are developed after real life screw up and failures especially ones that cause a patient harm or death. They are silently amused, at times, at the response by facilities for usually the ones who should be locking their doors in terror think they are the best place on earth...go figure. :specs:

The "JC" sets a mandate that needs this particular task done/improved for patient safety/quality assurance.....however hard or easy a facility makes it to get to that goal is the facilities responsibility but once the policy is approved it better be followed to the letter by everyone. It is the failure of consistency that gets most facilities in trouble. For the bedside nurse.....they are a PITA.

For reasons beyond my control and I cannot share why I know this but........Trust me when I tell you that they do investigate complaints and that there are A LOT OF STUPID people/facilities/administrations out there doing A LOT OF STUPID THINGS that need to be investigated, stopped and punished.:banghead: People are crazy and will get away with whatever they can for however long they can for whatever reason. I have worked at/known of some facilities that have done some pretty stupid/CRAZY things and have crazy/foolish people working for them. I have gotten calls from the staff (from a facility I once worked) and my only response was.......

"THEY DID WHAT????":eek: :banghead: Sometimes :bugeyes: I wonder foolishnes of bright educated medical people.

The general public would be shocked at the antics of these places. It leaves you to shake your head in wonder for just when you think you have heard or seen it all......you are proven wrong. Travel nurses usualy have the interesting stories.

Yes.......they are a pain in the butt. No....... they don't allow food, they know that the moment their backs are turned everyone runs for the water. Fridge temps are monitored. At leas they know 1-2 time a wekk someone open the door to see inside. But if you have ever seen rats eating employee food from trash cans and seen some employee fridges..:eek:.....trust me this is the better alternative, overall. Yes......it is a certain personality that works for them, especially those who have tenure/seniority. But there is a pot for every extra lid, if ya know what I mean;).

Yes...... they are evil, but a necessary evil. For years hospitals policed themselves....they didn't do very well (SUPRISE).

Joint Commission (I always chuckle like an eight grader at the word Joint) essentially started out like "Magnet" and those initial folks with the idea got very rich. I just hope the Magnet folks don't raise to this level of so called "prestige" for to me, I think that is a scary thought.

No the "JC" is not free and the hospitals have to pay them their "entry fees" and "consulting fees"....so your facility actually pays, and pays alot, for this torture.

It's an interesting world out there behind those closed closet doors.:smokin:

Specializes in L & D; Postpartum.

One of the reasons i cannot retire soon enough.

What I wonder is how these crooks sleep at night. They serve no real function other than to "bless" the hospital with their approval. And of course this "approval" costs $$$. And is conditional on continued inspections and consultations, which of course costs more $$$.

Seriously, crap like this is why there is so little respect for these so called inspectors. There are entire job descriptions that revolve around these utterly pointless charades. While the floor staff is doing all the real work, there are "consultants" and "compliance specialists" who do nothing but take up oxygen. At least when the annual farce of "state inspection" occurs in LTC, it's being done by a government entity and not a for-profit business.

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