JCAHO, how you annoy me.

[brainkandy87]

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. :)

[wooh, BSN, RN]

The ridiculous part isn't so much the JC rules, it's the way the hospitals interpret them. Why actually make something safer when instead we can just come up with another script for the nurses to say and another form for them to fill out?

[Ginger's Mom, MSN, RN]

It is Joint Commission, not JCAHO. Second, Joint Commission is not the only agency acts as an agent - as works as s a condition of licensure and the receipt of Medicaid for reimbursement. The issue is with Medicare and their conditions of participation only going to get worse with Affordable Care Act.

You are so busy at work, unstaffed, lack of equipment etc, who is going to ensure that Medicare and Medicaid guidelines are met? Who is going to ensure the Patient Safety Issues are addressed? Who is going to ensure minimal standards are met ? Who is going collect and analyze data? It sounds you work an unsafe hospital and I am glad someone is trying to ensure that my federal money is spent providing quality care. The inspectors I have seen would defer to a clinical person taking care of a patient, it sounds like your management didn't provide enough staff.

There are other agencies less known available on the Medicare web page. If you have issue with JC, suggest to management you swtich to another agency.

Personally I find TJC more reasonable then dealing with CMS.

[prmenrs, RN]

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

1--food poisoning. You know as well as I do, folks will just about anything not nailed down in the break room.

2--Vector control--Insects and rodents are attracted to food that is improperly stored and/or left in the back of the refrig for millenia. Rarely, if ever, is someone assigned to clean the cupboards and frig in the break room, and they do get extremely gross.

[prmenrs, RN]

ps-if the hospital doesn't OVERstaff the joint while the accreditors are around, they deserve what they get, imho. That said, it's been almost 2 years since I've had to face that JACHO crap, and I absolutely do not miss it!!

Retirement rocks

[Ginger's Mom, MSN, RN]

There is no JCAHO anymore!

Second, the work should not be a dog and pony show, that is why they changed format to unannounced surveys.

[Mukfay]

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

1--food poisoning. You know as well as I do, folks will just about anything not nailed down in the break room.

2--Vector control--Insects and rodents are attracted to food that is improperly stored and/or left in the back of the refrig for millenia. Rarely, if ever, is someone assigned to clean the cupboards and frig in the break room, and they do get extremely gross.

Even if we agree that those are important reasons, we still have to justify that JACHO is the appropriate entity to regulate things like that.

Regards,

Mukfay

[brainkandy87]

Oh, yet another fun encounter with these people today...

I am working in a typically high acuity set of rooms that includes our main trauma room. I've got two CP's, a vent, and an amnesia x 3 days with BP of 200/100. One of my CP's is starting to get a little unstable and so I am running to the Omnicell to get NTG because, of course, having NTG handy in a cabinet where we usually have it would not be kosher with TJC (there, happy JCAHO haters?!). As I'm about to put my fingerprint on the Omnicell, some little spaz walks over to me and says, "Don't touch anything!" and tries to pull open all the doors. Literally, he said it where an exclamation mark fits how he said it. And he said it like a complete tool on a power trip. He didn't even have the courtesy to say "thank you" or even smile afterward. I mean, I smiled at the guy as he approached me. No smiles.

CLEARLY the things he needed to do were more important than patient care. I'm wondering if, in some roundabout way, they've caused a patient death somewhere. You know, with their "our survey takes priority over your patient" ideology.

I've been trying to bribe someone in dietary to spike their meals with ipecac and Haldol. No such luck yet. I'll keep you all posted.

[Ginger's Mom, MSN, RN]

Who do you suggest CMS use to enforce regulations?

[Sacred eagle]

Personally, I want to see the Joint Commission with more powerto investigate patient complaints.

[iluvivt, BSN, RN]

Tx you for the correction..drives me crazy when called by their old name.....it' TJC now. I for one am appreciative of the work they do. I have found that very effective policies have been put in place in order to achieve the NPSGs that have dramatically improved patient care. Sure, the whole process can be annoying but we need to focus on the greater good.

[wickeddiazrn]

The people on here who are complaining about the JC I believe have issues with how their administration is handling the visit. Patient safety is a huge issue. Keeping our care driven by EBP and not just random ideas is so Important. In my 20 years of nursing I have never had an issue with a JC visit. They wanted to see the events then ask process and review questions. I have heard of facilities acting confrontational to the JC during the visit, and yeah I could see that causing some strife for everyone. All facilities should be in a constant state of preparing for a JC or CMS visit. That is what keeps places at the top of their game. Keep in mind that regulations and standards do not prevent you from having a bad day with poor through put. Instead of complaining or blaming someone about the delay in admission, why not look at your facilities process? What if that charge nurse had been involved in a patient emergency? What if she had already taken an admit or transfer and simply could not take the patient? What plan of action does your facility have in place to work through this? Then again keep in mind even with a plan in place things happen. As far as your person with an attitude even though they were possibly stressed out of their mind, that does not excuse being rude. Unfortunately some of those people work in healthcare.

If you truly do not like or agree with how this is handled why not get involved at at a closer level with keeping up with the JC standards?