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Joint Commission changes to Comprehensive Stroke Measure Set

This year, The Joint Commission will not collect any data on the Comprehensive Stroke (CSTK) measure CSTK-07: Median Time to Revasculation. One of eight measures aimed at treating ischemic and hemorrhagic stroke patients, CSTK-07 was suspended because of difficulties collecting data on the date and time of the first usage of a clot removal device on a patient. The measure is undergoing a review that will determine whether it will be reinstated.

Meanwhile, a new CSTK measure is expected to go into effect on January 1, 2017, although details haven’t been released yet. The Joint Commission will be announcing the measure specifications on its “Specifications Manual for Joint Commission National Quality Measures” webpage.


The $5 million guarantee: No more retained surgical sponges

Last year, The Joint Commission received 116 reported cases of surgical items being left inside a patient’s body, making retained items the top sentinel event of 2015.  Retained items can be harmful to the patient’s health, a surgeon’s reputation, and the hospital’s finances if someone decides to sue.

Enter Stryker’s SurgiCount Safety-Sponge System. By using bar-coded surgical sponges and towels and a simple real-time scanner, the company promises to end any possibility of retained items.

How confident is Stryker? The company promises that if its system is properly used and a sponge is still left in a patient, it will pay up to $5 million to cover legal costs for the hospital. In addition, the company will give a total refund for the system.

So far, according to Stryker, more than 480 U.S. hospitals have used the system without a single sponge out of the 170 million used misplaced.


New 2017 National Patient Safety Goal focuses on CAUTI prevention

The Joint Commission today announced plans for a new National Patient Safety Goal (NPSG) aimed at reducing catheter-associated urinary tract infections (CAUTI). The prepublication standards for the NPSG are online and cover standards for accredited hospitals, critical access hospitals, and nursing care centers. The NPSG is intended to align CAUTI treatment and prevention with the updated “Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2014.”

The NPSG goes into effect on January 1, 2017.

Featured webcast: Drug Diversion in Healthcare: Improve Security and Avoid Fines

HCPro Webcast IconPreventing the theft of controlled substances at hospitals continues to be an tremendous issue even with increased security measures. Failed drug diversion programs in hospitals have led to record fines and in the midst of heightened scrutiny over drug security, hospitals must improve their processes to avoid litigation.

On Thursday, April 26 from 1–2:30 p.m. Eastern Time, join us for a live webinar with expert speaker Kimberly New, JD, a nurse, attorney, and consultant who specializes in helping hospitals prevent, detect, and respond to drug diversion.

During this program, New will discuss drug diversion by healthcare personnel and present specific steps facilities can take to minimize the risk of patient harm. She will discuss fundamental components of a diversion prevention, detection, and response program through an overview of the scope of the problem, including case studies. New will also review regulatory standards and best practices relating to controlled substance security and diversion responses. She will additionally provide tips on how to promote a culture in which all employees play a significant role in the deterrence effort.

At the conclusion of this program, participants will be able to:

  • Identify risk factors and signs of employee drug diversion
  • Fully comply with regulatory requirements of the DEA and other accrediting organizations
  • Train staff on how to report suspected abuse and who to report it to
  • Create a culture of accountability and develop an effective drug diversion prevention plan

Don’t miss this opportunity to hear practical advice and have complex regulations simplified in this program suitable for your whole organization. For more information or to order the webcast on demand, call HCPro customer service at 800-650-6787 or visit the HCPro Marketplace.

All 2016 National Patient Safety Goals are online

The Joint Commission has published links to all its National Patient Safety Goals (NPSG) programs for 2016. The NPSGs cover ambulatory healthcare, behavioral healthcare, critical access hospitals, home care, hospital, laboratory services, long-term care for Medicare and Medicaid, nursing care center, and office-based surgery.

Each topic is linked to the NPSG chapter plus an easy-to-read version of each chapter. Click here to see the page. 

Joint Commission seeks electronic quality measure success stories

As part of its new Pioneers in Quality portal, The Joint Commission is asking hospitals to give their stories on the electronic clinical quality measures (eCQM). Hospitals are asked to share the problems they overcame and the successes they had while implementing the eCQM and transmitting eCQM data.

Anyone interested in participating is encouraged to use The Joint Commission’s Core Measure Solution Exchange to submit their stories. Click here to get more information on the Core Measure Solution Exchange and to sign up.

How many will adopt the new CDC opioid guidelines?

After several months of debate, the Centers for Disease Control and Prevention (CDC) have finally published its Guideline for Prescribing Opioids for Chronic Pain on March 15. The agency’s recommendations are aimed towards primary care physicians, since family physicians alone account for 15.3 million opioid prescriptions annually. Currently, 44 Americans overdose and die each day after abusing prescription painkillers and the CDC hopes its recommendations can noticeably reduce the use of opioids in pain care.

However, the Guideline for Prescribing Opioids for Chronic Pain are voluntary and some question how many in the healthcare sector will adopt them.  Several healthcare professionals and patient groups protested the guidelines after their first draft was unveiled for comment, claiming they were too restrictive on pain care. The outcry was enough that the CDC had to organize an extra review process for the guidelines back in January.

Now it’s up to healthcare facilities, including those who protested the guidelines, to decide if they will follow the CDC’s recommendations and to what extent.  The guidelines consist of 12 recommendations total, including:

  1. Using non-pharmacologic and non-opioid therapy for chronic pain whenever possible.
  2. Establishing treatment goals before starting long-term opioid therapy. Physicians should only continue to prescribe opioids if there is “clinically meaningful improvement” that outweighs safety risks.
  3. Discussing the risks and benefits of opioids with patients before prescribing them.
  4. Using short-acting opioids instead of extended-release, long-acting drugs to treat chronic pain.
  5. Prescribing opioids in their lowest effective dosage.
  6. Using short-term opioid treatments instead of long-term treatments for acute pain care. Usually three days’ worth of opioids will be enough, though up to seven days is sometimes permissible.
  7. Patients should be evaluated within one to four weeks of beginning opioid therapy for chronic pain and be reevaluated at once every three months afterwards to assess the pros and cons of continued treatment.

Click here to read The Joint Commission’s “Facts about Pain Management” page and view its Sentinel Event Alert 49, dealing with safe use of opioids in hospitals.


Study: Going cold turkey is best cure for smoking

A new study in the Annuals of Internal Medicine has found that having a patient pick a “quit day,” and stopping all at once increases the odds of long-term tobacco abstinence. Hard-stop patients were 14% more less likely to return to their regular smoking habits after four weeks than patients who tried gradual-cessation methods.

Tobacco use has drawn the attention of The Joint Commission in recent years, with the accreditor releasing its tobacco cessation performance measure set in 2012 and including smoking cessation on its Top Performer on Key Quality Measures program in 2015. Tobacco use is the leading cause of preventable death in America, with 16 million illnesses and one in five deaths annually attributed to cigarette smoke. In response, The Joint Commission added a tobacco cessation performance measure set in 2012.

The study was conducted on 697 adult smokers, all of whom had access to access to nicotine patches, nicotine gum, and support from behavioral nurses. Current guidelines already suggest people chose a “quit day” to stop smoking completely, but many patients prefer to use gradual-cessation methods to ease them off the habit.

“Our study found that less people quit in the [gradual] reduction group because the people using this method were less likely to make a quit attempt than those who quit abruptly,” said lead researcher Nicola Lindson-Hawley, PhD, to CBS News. “The people who did make a quit attempt were as likely to stay quit whatever group they were in. Based on this we have suggested that people who reduce their smoking before quitting find the experience of cutting down difficult and this causes them discomfort, like cravings, which ultimately may put them off quitting altogether.”

Learn more about the steps hospitals are taking on tobacco cessation compliance in this month’s Briefings on Accreditation and Quality.

Senate approves bill to fight opioid abuse

On March 11, the Senate voted 94-1 to approve the Comprehensive Addiction and Recovery Act (CARA), aimed at fighting heroin and prescription opioid abuse. The bill would allow hospitals and other healthcare facilities to apply for federal and state grants to establish safe prescription drug disposal programs. The act will also fund expanded prescription drug monitoring programs (PDMP) and use of naloxone to treat opioid overdoses.

CARA represents three years of bipartisan work and authorizes up to $725 million in funding to tackle the opioid crisis. While the bill doesn’t provide the funding itself, it would utilize $400 million was appropriated by the Senate to combat opioid addiction last December.

CARA’s provisions include:

  • Issuing grants to hospitals, pharmacies, and clinics to establish prescription medication disposal sites.
  • Improving state PDMPs to help physicians monitor and track drug diversion and stay more informed about a patient’s prescription history. 
  • Expanding the availability of naloxone, a drug used to reverse opioid overdoses, to law enforcement agencies and other first responders. CARA would also provide more liability protection for responders using naloxone.
  • More funding towards treating incarcerated individuals suffering from drug addiction.
  • More funding towards treating veterans suffering from drug addiction.
  • Giving federal, state and local grants to non-profits organizations working on opioid prevention and treatment.
  • Launching an evidence-based opioid and heroin treatment and intervention program to expand best practices throughout the country.
  • Launching a medication-assisted treatment and intervention demonstration program.

There had been a push to attach an extra $600 million in emergency funding to the bill, but the proposal was voted down. CARA still needs approval by the House, though most think it will pass.

“I don’t know of a single specific objection on the House side, and they’d be very hard-pressed to find one,” Sen. Sheldon Whitehouse (D-R.I.), who co-authored the bill, told reporters. The overwhelming Senate vote in favor of the bill, he added, should quell any fears in the House about being criticized for supporting the measure.

Updated disease-specific care review process guide released

The Joint Commission has released an updated version of its Organization Review Process Guide for Disease Specific Care Certification. The update includes information on the new Advanced Certification for Total Hip and Total Knee Replacement program.

The updated information went into effect on March 1.