Who died and made Joint Commission "God"

[1Tulip]

I am not saying that I work in the world's greatest hospital. But I've been a nurse for 38 years and it's the best one I've ever worked in. Have you ever worked in one that didn't sometimes make you crazy????

I live in a not so densely populated area of the country. Our chachement area covers three states. If all those areas are surveyed, it is clear that they are significantly under-bedded. Joint Commission has been on our case for several years. They found problems they wanted fixed. The hospital fixed them, but not in a way that JC apparently wanted. It's been like playing a game where every time you get the ball, they move the goal line.

We were informed last week that statistically, a hospital that has run the string out as far as we have does not pass. I've been in on the Quality efforts that have been made, and the extensive staff training that has gone on. Our hospital exceeds standards in so many ways it's rediculous.

But here's the bottom line. Joint Commission is crazy enough to essentially close a hospital that provides over 75% of the operating rooms for this huge area. The only trauma ER. We do the heart caths and have the interventional radiology. We bring the technology that keeps people alive, while the other hospitals are small and colloquial, though also very good. AND we're going into a flu season where we KNOW the area hospitals have a serious shortage of ventilators. (There have been meetings among the hospitals to develop action plans for the conventional and H1N1 flu.)

They don't care if my neighbor's kid gets hit by a car and there isn't any place to take her. The next gaggle of surveyors that probably live in other places like Nebraska or Missouri or whatever. A surveyor that lives in Atlanta doesn't care if my mother in law gets the flu and there are no ICU beds to support her when she gets pneumonia.

This is nuts! If the place was a snake pit... I'd be the first one to say it should be shut down. But in our state, we KNOW there have been seriously deficient places that were fiscally poorly run and in decline but they did NOT lose their accreditation.

Would they close us down and give no thought to the immediate public health crisis they create? I think they would.

They are unelected, unaccountable and so powerful I think they are dangerous.

[Ginger's Mom, MSN, RN]

Joint Commission is a voluntary program but Medicare and Medicaid use JC as way to verify standards, so if you loose JC status you loose the right to bill Medicare.

Not aware of the particular situation in your hospital, it is very serious to be closed by failing JC Survey. Usually you have many chances to improve the system before they fail you. The surveyors don't know your hospital but they do know proven Patient Safety issues that have been vetted through National Quality Forum and AHRQ. I am surprised your Department of Public Health hasn't come to verify the JC findings. It is a more complete survey that lasts a week and it will be completed by Local Health Officials. If they don't agree with JC findings you will have a fighting chance.

Has your hospital system hired a Joint Commission Consultant ? Have your hospital leaders engaged your congress and senator reps ? Sounds like your hospital management needs a shake up . Unfortunately it is the front line people and patients who suffer when Management does adhere to national standards.

http://www.jointcommission.org/CertificationPrograms/09_cert_decisions.htm

I hope you system is fighting this.

[CathyLew]

One of the last times JC was at our hosp, they told us we were doing things the right way, just that our written polices were a mess. So we got dinged big time for that. hmmmm... so is it better to have great policies, and just do things the wrong way?

Right now we have dual acredidation. JC and DNV http://www.dnv.com/focus/hospital_accreditation/

[Kyrshamarks, BSN, RN]

Jchao cannot close a hospital and not being Jchao does not mean you acannot bill mediciad or medicare. That is an old wives tale. Infact, the insurance companties by law ,and that includes medicare and medicaid cannot ask even if you are JC certified. To bill medicaid and medicare you apply for a license from the government to bill them. It has nothing to do with JC certification.

[CathyLew]

the joint commission (tjc) operates voluntary accreditation programs for hospitals and other healthcare services. tjc certifies hospitals as having met the condition of participation required for reimbursement under the federal medicare program. a majority of state governments recognizes tjc accreditation as a condition of licensure and receiving medicaid reimbursement. inspections are typically tri-annual with accreditation and survey findings made publicly available.

http://www.ashe.org/ashe/codes/jcaho/index.html

[flightnurse2b, LPN]

the reason why i get fed up with the joint commission is that they take our valuable time away from patient care with their chart checks, room checks and probing questions when we are already spread thin enough.

for this reason, i think they are dangerous too.

[SuesquatchRN, BSN, RN]

I worked in a CAH that didn't even join JCAHO. We had enough troubles with state surveys.

[1Tulip]

Based upon everything the hospital suits are saying, we will not be allowed to bill Medicare/Medicaid for care we give if we lose accreditation.

We had a visit some time ago and go provisional status, with requirement that we develop an "action plan" for each issue they raised. I can assure you we had plans coming out our ears. Anything that was extreme (whatever that would be) was dealt with a long time ago.

But the seem to 1. keep moving the goal posts with each return visit and 2. demand perfection. For instance (and i'm not making this up...) they said our Anesthesia interoperative documentation was wrong and insisted we change them. (However, these forms were the ones we corrected pursuant to a previous visit.) We got dinged for lab-jackets on our chairs at the nursing station.

We have just changed from paper to e-records and you know what? JC is finding deficiencies in our nsg. records/documentation. We've worked really hard filling in the holes, getting everyone solid on documentation of pain measures and assessments as well as restraint flowsheets. (But criminny, perfection doesn't exist this side of heaven, come on folks!)

The thing that is the latest is that EVERYTHING the doctors put on paper has to be signed, TIMED, and dated. Do you know how much time we spend calling them and saying "yes, you have to come and fix it and NO we cannot take a verbal order on it. Almost 90% of the stuff we're having to fix in the documentation is NOT us, it's the MD's.

And all I can tell you is that the mock survey consultants said we are not going to pass and the real surveyors can come any time.

[Ginger's Mom, MSN, RN]

I would follow up on what consultants told you to do. You are on provisional status. Someone in your organization should have been have conference calls with JC to see if you are on track.

[dscrn]

I remember, prior to a "visit"m all staff members were gien panphlets, with all the correct anxseres. We were given strict instructions that we basically were onle to speak whe spoKen to"...i I used to [ray that I'd be off the day that they arrived. Always seemed that they were big on written policy-whether it was in practice or not...

[dscrn]

I remember, prior to a "visit"m all staff members were gien panphlets, with all the correct anxseres. We were given strict instructions that we basically were onle to speak whe spoKen to"...i I used to [ray that I'd be off the day that they arrived. Always seemed that they were big on written policy-whether it was in practice or not...

sorry for those typos! Can't type in the dark:coollook:

[1Tulip]

I would follow up on what consultants told you to do. You are on provisional status. Someone in your organization should have been have conference calls with JC to see if you are on track.

I'm just a peon, of course, and am not privy to all that transpires, but I'm on a shared governance council and we're the first clinical faces that see the most recent changes. I believe that the hospital administration has groveled, and promised, and performed everything they have been told to do. There has been a bunch of communication back and forth with the JC, in terms of filing their action plans and also explaining why certain things may not be infractions given our particular hospital situation and locality. (However, very little of the latter... mostly the groveling.)

Our hospital has some significant strengths. We have been working out rear-ends off. It's all we've thought about for months and months and months. With the exception of two much smaller hospitals, we are IT for a huge geographical area. Our mock surveyor found a whole long list of things that are outstanding, but found 13 areas that would flunk us (in their view.)

75% or more of all the operating rooms will be gone. I KNOW that if they shut us down, surgeons will be doing stuff in stand-alone surgi-centers that they have no business doing. Patients will have to travel at least 2 hours to the nearest medical center which is, itself stretched to the limit. Our state is one of the worst in nursing shortages. If our hospital closes down any nurse that can leave the area for work will. We'll never get those nurses back.

Dear God help us and thousands of ill patients if they shut us down.

Oh, I forgot. Joint Commission just appointed themselves to be God.