Archive for July, 2008
Restraint benchmarking survey
Hello, all. I just wanted to share with you some results from our recent benchmarking survey:
Managing the use of restraints and complying with related requirements continue to be major challenges for accreditation professionals throughout the country. And one of the biggest areas of concern is the use of medication restraints, according to AHAP’s most recent benchmarking survey.
According to the members-only survey, conducted in June and July 2008, 46% of accreditation professionals find medication restraints the most troublesome under CMS’ updated restraint Interpretive Guidelines (24% listed soft limb restraints as most troublesome, while 17% listed “other,” 7% listed zippered comforter restraints, and 6% listed low bed restraints).
The number for medication restraints seems high, says Elizabeth Di Giacomo-Geffers, RN, MPH, CNAA, BC, CSHA, member of the AHAP advisory board, healthcare consultant in Trabuco Canyon, CA, and former Joint Commission surveyor. “Perhaps the organizations need to review their definitions of chemical restraint,” she says. “They may, in fact, not be following the CMS/Joint Commission definition—theinappropriateuse of a sedating psychotropic drug to manage or control behavior. To give a medication may in fact be medical management of the patient’s condition and not inappropriate use.”
When asked how they used medication restraints, 51% of survey respondents said they use them to de-escalate aggressive, destructive behavior. Thirty-seven said they use medication restraints to manage behavior, 25% said they use them for other purposes, and 7% said they use them to restrict freedom of movement.
Hope you found this useful. Go to http://www.accreditationprofessional.com/benchmarking_survey.cfm?topic=WS_AHP_QBS to download the full 11-page report, as well as other benchmarking reports from this year.
Medicare Improvements for Patients and Providers Act
I just wanted to update you on a news brief I posted to the group a few weeks back. Congress overruled yesterday President Bush’s veto of the Medicare Improvements for Patients and Providers Act, based on a bill authored by Senate Finance Committee Chairman Max Baucus (D-Mont.).
While the primary focus of the bill is to improve several key aspects of Medicare, for those of us working in the area of accreditation, under the category of “Enhancements for Rural and Other Hospital Care,” note this short passage:
Revokes unique authority of the Joint Commission on the Accreditation of Healthcare Organizations to deem hospitals in compliance with Medicare Conditions of Participation.
There will be a 24-month transition period for The Joint Commission to complete the application process for deeming authority, and “the amendments made by this section shall not effect the accreditation of a hospital by the Joint Commission, or under accreditation or comparable approval standards found to be essentially equivalent to accreditation or approval standards of the Joint Commission, for the period of time applicable under such accreditation.”
Additional information can be found online here: http://finance.senate.gov/sitepages/medicare2008.htm
What are your thoughts? Does this level the playing field for other accrediting organizations? What effect do you think this will have on hospital accreditation, if any?
We have reached out to The Joint Commission and several other organizations for comment; I will be sure to distribute to the group follow-up information as it arises.
Latest Sentinel Event Alert: Disruptive behavior
I just wanted to make you aware of some breaking news: The Joint Commission has issued its latest Sentinel Event Alert today addressing bad behavior by healthcare professionals.
Disruptive behavior was considered as a possible National Patient Safety Goal for 2008 but was not selected. The Joint Commission has stated in this most recent alert that rude behavior, unpleasant language, hostile attitudes and other bad behaviors does not only create an unpleasant environment but are detrimental to patient safety and quality of care.
This alert ties into new standards going into effect January 1, 2009, which will require healthcare organizations to create a code of conduct defining acceptable and unacceptable behaviors as well as crafting a process for dealing with poor behavior.
The Sentinel Event Alert provides 11 steps to curbing disruptive behavior. These range from providing education and training for healthcare providers about professional behavior and appropriate interactions with coworkers; creating accountability for maintaining appropriate behavior; establishing a zero tolerance policy for disruptive behaviors and a means for enforcing this policy; and crafting non-confrontational methods for reporting and addressing inappropriate behavior.
The Joint Commission’s Sentinel Event Alert can be found online here: http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_40.htm
