Mittens Are Not Restraint

Reading CMS interpretive guidelines can be rewarding … sometimes. The 2008 set for restraint has the following nugget on page 16:

Interesting!

Click this link to get a copy of the CMS guidelines.

Data Collection for 2009 / 10 Safety Goal: Central Line Infections

A questioner at a recent audioconference asked whether data on line-associated bloodstream infections would have to be collected for all patients, not just for critical care patients as is the current practice. Here is my response:

Although I predict this answer will be consistent with future opinions of the Joint Commission, I do not speak for them and we have yet to see any written information that would directly address all the nuances of your question. We know, to quote the safety goal, “This requirement covers short and long term central venous catheters and peripherally inserted central catheter (PICC) lines.” [NPSG 07.04.01] [more]

And They Mean “Universal” Protocol

We have seen a lot of questions and concerns about the Joint Commission’s new scope for site marking. UP.01.02.01 EP.1 in the 2009 version of the Universal Protocol says that site marking is performed “for all procedures involving incision or percutaneous puncture or insertion.” They further modify this in EP.7 to require a “defined, alternate means of site identification … for interventional procedure cases for which the catheter/instrument insertion site is not predetermined (for example, cardiac catheterization, pacemaker insertion)”. [more]

WHO Surgical Checklist and TJC’s 2009 Universal Protocol Requirements

Just a quick note to alert folks that the World Health Organization (WHO) has published a surgical check list that requires multiple patient process “checks” before anesthesia induction (sign in), before skin incision (time out) and before the patient leaves the operating room (sign out). While this is a useful tool to ensure patient safety in the operating room environment, it does not include all the Joint Commission 2009 Universal Protocol requirements. The WHO checklist can be found by accessing the following link: http://www.who.int/patientsafety/safesurgery/tools_resources/SSSL_Checklist_finalJun08.pdf

If your organization is thinking about using the WHO surgical checklist, we encourage you to [more]

An interesting find in the 2009 updates to the Provision of Care:

Under 2009 Provision of Care standard PC.03.02.11, elements of performance one through eleven, there are now specific elements of non-behavioral restraint (protective or medical/surgical restraint) that must be measured for performance improvement purposes. There are eleven (11) elements of performance, each scored separately, that outline what and how these elements of restraint are to be measured. [more]

Blog Basics

What is a blog? A blog (short for Weblog) is a Web site where you post thoughts, articles, and ideas on an ongoing basis. New posts show up at the top, so visitors can read what’s new. Then they comment on it. The posts can be broken down into categories and topics for easier navigation.

What is a blogger? A blogger is someone who posts an article on a blog. [more]

Medication Reconciliation … More a Problem Than Ever

Most of you have not quite figured out how to make medication reconciliation work. And now we’re presented with a whole new list of documentation challenges for 2009, not least of which is figuring out exactly what the new requirements mean. What does it mean that providers must communicate about current medications when patients are transferred from unit to unit? Which units? What about from the OR? What does the communication look like? What does the documentation look like? What kind of documentation is required when there is a difference between the home medication list the admitting order set? etc. etc.

We’ll be addressing these and other issues as best we can over the next few months, but one thing is clear: our design process just got much harder.

Environment of Care Standards Changes – 2009

Did you hear that great sighing sound earlier today? That was (among others) the Environment of Care community’s reaction to the (finally!) publication of the EOC standards changes, which will come into play beginning January 1, 2009. In all candor, I have to tell you that I was one of those sighers (is that a word? Probably not, but the blogosphere mustn’t rest on such formalities), for, in the words of Sir Arthur Conan Doyle, “the game is afoot”. [more]

Welcome to Center Reflections

The rate of change at the Joint Commission and CMS is accelerating – it often seems chaotic. We at Greeley are extremely excited about the launch of Center Reflections, a blog for our panel of accreditation experts to share emerging trends, new challenges or fresh approaches to staying ahead of the curve. Think of Reflections as an interactive conversation with the very best minds in the country about the universal protocol, medication reconcilation, history and physical requirements, the clarification process, the DNV accreditation process and a host of other accreditation news and emerging challenges.

Enjoy!