The Joint Commission has announced additional revisions to its Environment of Care (EC) and Life Safety (LS) chapters. The revisions are meant to bring the accreditor in closer alignment with the National Fire Protection Association’s 2012 Life Safety Code® (LSC). The LSC was adopted by CMS and The Joint Commission last year. The revisions go into effect July 1, 2017 and apply to hospitals, critical access hospitals, ambulatory healthcare centers, home care, and nursing care centers.
At the National Fire Protection Association’s (NFPA) annual conference in June, members will be asked to vote on changes to NFPA 99 and NFPA 101. While CMS and various accreditors recently adopted and implemented the 2012 edition of the NFPA’s Life Safety Code®, the NPFA is currently working on changes to the 2018 edition. The American Society for Healthcare Engineering (ASHE) called to members who are part of the NFPA to take part in the voting process.
“ASHE has been working hard to align all of the various codes and standards to have less overlap, fewer gaps and fewer code conflicts,” wrote Chad Beebe, ASHE’s deputy executive director. “This work doesn’t happen over one code development cycle, however. Aligning the codes is a long process that occurs over several editions. Each code cycle is a chance for negotiations with code development committees to draw the boundary lines between codes to ensure that the codes don’t overlap, which is where most of the conflicts occur. To maintain these boundaries, continuous involvement in the development of the codes and standards is necessary.”
On February 10, the U.S. Senate voted 52 to 47 confirming Rep. Tom Price, MD (R-GA) as the new head of the Department of Health and Human Services (HHS). Price is an orthopedic surgeon and the first physician to head the HHS since the George H.W. Bush administration. He’s known for his opposition to the Affordable Care Act.
Price’s appointment has been highly controversial, in part due to his investments in healthcare companies that could potentially benefit or be harmed by his actions as HHS secretary.
A recent survey of nearly 1,100 physicians revealed a sharp divide in opinions on Price’s appointment; with 46% feeling positive and 42% leaned negative. The survey also revealed that 47% of respondents believe that Price will diminish patients’ ability to access quality care, with 42% who believed the opposite.
To improve medical outcomes in intensive care units, some hospitals are attempting to make units more accessible for patients’ family and caregivers. Allowing patients to have more access to their families have been shown to reduce hospital stays, improve satisfaction, and help prepare patients for post-discharge, according to Giora Netzer, MD, a critical care specialist at the University of Maryland Medical Center (UMMC) in an interview with The Baltimore Sun.
“It’s not just more humane care, it ends up being better healthcare,” Netzer said.
Netzer also helped develop guidelines for the Society of Critical Care Medicinethat give providers strategies to better include family members in patient care. This includes having an “open or flexible” place by the patient’s bed, having a place for family members to sleep, and educating the family as part of clinical care. It also includes giving patients’ family’s mental, emotional, and spiritual support to reduce anxiety, stress, depression, or risk for post-traumatic stress disorder in certain instances.
The UMMC has implemented the guideline recommendations and now offers larger rooms to accommodate family members. The facility eliminated visiting hours and makes social workers available to work with relatives on the discharge instructions. UMMC is also has a pilot program where family members attend medical rounds.
Last Chance: “How Parkland Health & Hospital System Successfully Implemented a Suicide Risk Screening Program Webinar”
Date: Tuesday, February 7
Kimberly Roaten, PhD, CRC
Celeste Johnson, DNP, APRN, PMH CNS
Level of Program: Intermediate
Suicides were the third most common sentinel event of 2015. Universal screening is the best strategy to identify patients in general healthcare settings whose suicide risk would otherwise go undetected. This webinar will take a case study approach to bring to light proven methods to reduce patient suicide.
Join Parkland Health and Hospital System expert speakers Kimberly Roaten, PhD, CRC, and Celeste Johnson, DNP, APRN, PMH CNS, as they explain how Parkland became the first in the nation to establish a universal suicide screening program in all its departments. Parkland was recognized in Sentinel Event Alert 56 for making significant progress in suicide prevention. Roaten and Johnson will discuss processes for implementation, strategies to obtain support, universal screening data, and lessons learned from implementation.
At the conclusion of this program, participants will be able to:
- Discuss the process for implementation of a hospitalwide suicide screening protocol
- Describe strategies for obtaining nursing and physician stakeholder support for universal suicide screening
- Describe the prevalence data collected from the first two years of a universal screening program
- Apply lessons learned from the implementation of the program in a large hospital system
In the wake of a CMS ruling that will make antibiotic stewardship programs (ASP) mandatory, The Joint Commission recently announced that it will roll out a similar standard. Effective January 1, 2017, the new Medication Management standard 09.01.01 requires facilities to create an effective ASP. The standard applies to:
To help facilities with the new requirements, The Joint Commission has compiled a set of FAQs on antimicrobial stewardship, which can be viewed here.
In a new blog post, CMS announced that it was extending its electronic clinical quality measure (eCQM) submissions to March 13, 2017 at 11:59 p.m. PST. This gives facilities and extra 13 days to get their submissions in on time.
The data being submitted is from the 2016 reporting period, which will impact facilities’ 2018 fiscal year (FY) payments. The deadline applies to hospitals and critical access hospitals enrolled in either the Hospital Inpatient Quality Reporting (IQR) program or the Medicare Electronic Health Record (EHR) Incentive program.
“CMS also intends to initiate the rulemaking process regarding modifications to the eCQM requirements established in the FY 2017 Inpatient Prospective Payment System (IPPS) final rule in response to concerns raised by stakeholders,” Kate Goodrich, MD, CMS chief medical officer, wrote. “In order to help reduce reporting burdens while supporting the long term goals of these programs, we intend to include proposals regarding the 2017 eCQM reporting requirements for the Hospital IQR and EHR Incentive Programs for eligible hospitals and critical access hospitals in the FY 2018 IPPS proposed rule that we anticipate to be published in the late spring of 2017.”
CMS says it will address stakeholder concerns with the FY 2018 IPPS proposed rule. In particular, they will look at
• Challenges associated with hospitals transitioning to new EHR systems or products
• Upgrading to EHR technology certified to the 2015 Edition
• Modifying workflows
• Addressing data element mapping
• Time allotted for hospitals to implement eCQM specifications updates in 2017
The agency is also proposing to adjust the number of eCQMs required to be reported for 2017 as well as to shorten the eCQM reporting period.
“We believe that these efforts reflect the commitment of CMS to create a health information technology infrastructure that elevates patient-centered care, improves health outcomes, and supports the healthcare providers who care for patients,” she wrote. “We continuously strive to work in partnership with hospitals and the provider community to improve quality of care and health outcomes of patients, reduce cost, and increase access to care.”
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On January 30, President Trump signed a new executive order declaring a “one-in, two-out” rule for executive departments or agencies, including healthcare. Under the executive order, for a new healthcare regulation to be implemented, two older regulations will have to be eliminated.
“If you have a regulation you want, number one, we’re not going to approve it because it’s already been approved probably in 17 different forms,” Trump said during the signing. “But if we do, the only way you have a chance is we have to knock out two regulations for every new regulation. So if there’s a new regulation, they have to knock out two.”
The order also sets an annual cap on the cost of new regulations and cuts the regulatory budget for fiscal year 2017 to zero. This means the only way to afford new regulations issued between now and September 30, 2017 is by repealing existing regulations.
While each agency will decide which regulations they think can be cut, the White House will ultimately decide which ones to gut. Regulations dealing with national security, foreign affairs, and the organization, management, or personnel of federal agencies are exempt.
Accredited organizations now receive a new SAFER Matrix Tool and a user guide, following their first survey with the new matrix. The SAFER Matrix was announced last July as a replacement for the old “Category A and C” method of evaluating safety issues. As of January 1, all accredited organizations now receive the SAFER matrix after their surveys.
The new tool can be used to filters out specific portions of the SAFER report, such as Requirements for Improvement, which then can be saved and sent to people within the facility. The guide shows users how to:
- Use filters
- Select specific survey or review events to view
- Switch between different accreditation programs
- Switch between accreditation and certification
The tool and guide can be found on Joint Commission Connect in the “Post-Survey” section of the “Survey Process” tab.
Earlier this month, the American Society of Health-System Pharmacists (ASHP) released a new set of nationally recognized drug diversion prevention guidelines. The purpose of the guidance is to help healthcare facilities create effective strategies to prevent the theft and misuse of medications and controlled substances.
“Diversion of controlled substances by healthcare workers remains a serious problem that increases the potential for serious patient safety issues, causes harm to the diverter and elevates the liability risk to healthcare organizations,” said David Chen, BSPharm, MBA, senior director of the ASHP Section of Pharmacy Practice Managers, in a press release. “These guidelines give pharmacists tools to not only improve controlled substances management, but also to play a prominent role in systemwide diversion prevention efforts at their practice sites.”
The 2015 National Drug Threat Assessment found that controlled prescription drugs are abused more often than cocaine, methamphetamine, heroin, Ecstasy, and PCP combined. And there have been cases of healthcare workers potentially infecting patients by using needles filled with diverted drugs and putting them back into circulation.
The guidelines can be applied to a number of healthcare settings and is based off best practices and recommendations from the Drug Enforcement Agency, state hospital associations, and scientific literature. You can read the guidelines in full here , along with the ASHP announcement.