Joint Commission


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Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 42 years experience. 4 Articles; 20,908 Posts

It is true that JCAHO is paid by the hospital to do the survey, but unless the hospital is JCAHO certified, they are not eligible to treat Medicare pts. Therein lies the rub. JCAHO was originally intended to, and still does in some ways, pinpoint failures in and improve upon hospital policies and procedures. However, they have become a self-fufilling organization. Unless they they find fault, they will cease to exist; therefore, they will ALWAYS find fault. Hence, some of the most ludicrous and shortsighted rules imaginable that hospitals MUST follow.

Just think of the INSANE amount of duplicate charting that you must do. Thank JCAHO.

The rules of JCAHO mean less time at the bedside for us all. But those paper trails look great!

Technically...yes that's true. NO accreditation......NO money. Joint Commision is not the only accreditating body there is NCQA (National Commitee for Quality Assurance) through the National Accreditation of Hospitals Board. and a couple other I can't think of right now. But yes, they are paid to come in by the hospital to get their survey for accreditation in order to continue to recieve Medicare/medicaid reimbursment. A "minimal standard" so to speak. Trust me there is always fault to find because it is human nature to cut corners. What seems like ludicrous rules were made and thought of because of overwhelming documentation of the general ineptness of some healthcare providers. I agree JACHO (which I believe they are back to just Joint Commision again) at times takes themselves too seriously and get carried away in that anal retentive pencil pushing mentality. But, overall, they really do mean well.

The insane amount of charting comes from your facility. Joint Commision gives out requirements/recommendations they want addressed.......however difficult or simple is strictly left to the individual institution. The problem it that most facilities tend to make it extremely difficult to achieve and follow the policies which is what is what gets them dinged. Joint Commision doesn't set the paper work nor the policy just the recommendations to follow. The facility make it hard to follow.........that's the facilities problem. Joint Commision just wants it followed with all on the same page..........but everyone tends to over think the solution. Most of the double paper work can be minimized with creative thinking and changing flow sheets ect........but that is up to the facility. Joint commision doesn't care how you get there just that you get if the paper work is duplicated, where you work that set the paper work and the policy....get on a commitee to help change it.

Joint Commision is a not for profit private organization that has nothing to do with the government is an interesting link to joint commision...............



102 Posts

So, I'm supposed to be happy to be employed to do "mountains of paperwork"? As opposed to having the time to think and plan and teach and actually make a difference in my patient's lives? The paperwork" existed 30 years ago, albeit handwritten and all in one easy to find place. Now it is scattered across 15-20 computer pages. Go figure. The "proof" of my actions and outcomes was solidified the day I graduated from nursing school 30 years ago, and it lives on in every pt. I discharge safely home. I do enough charting to satisfy the most rabid lawyer, never mind my managers. I haven't seen anything good from JCAHO before or since the Medication Reconciliation Form. Somehow, I can't think that's worth the billions they rake in every year.

It isn't the Joint Commission or the most rapid lawyer that forces you to write reams of paper work. It is you and your facility that makes all the paper work necessary. The first time I heard the phrase, 'if it isn't documented you didn't do it,' was almost forty-seven years a go during my first semester in nursing school. I was taught to document but without all the unnecessary clutter that seems to fill patient's charts today. The Joint Commission wants a very clear set of policies and procedures. How detailed they are is up to the individual facility. And that is where the individual facilities go wrong. And with the push of documenting prior to a visit, instead of being certain the policies and procedures are regular documented is what leads to the big push and he sense of overwhelming work.

As for the billions the Joint Commission takes in, they really do not. By law, they are limited as a non-profit how much of a profit they can make, just like a not for profit hospital is.

I worked as a case manager for ten years. I had to document everything I did, in order to bill the insurance companies that had hired me. Well, I did document, but I didn't write reams of paper reports. I asked them what they wanted in terms of documentation and gave it to them. My reports were clear and concise and limited. And they with stood even the most aggressive attorney. And I got paid for every minute I spent on every client. My longest report was the initial one-seven to twelve pages. Everyone after that two to three pages covering a month. But that is me.