The Joint Commission has released an R3 Report to provide the rationale and references employed in the development of new requirements; the most recent R3 report relates to patient flow through the emergency department. The Joint commission has revised standards LD.04.03.11 and PC.01.01.01 with an increased focus on the importance of patient flow in hospitals. Most of the revised elements of performance (EP) went into effect on January 1, 2013, though two EPs–LD.04.03.11 EP 6 and EP 9 –will not go into effect until January 1, 2014.
Standard LD.04.03.11 requires an organization to manage the flow of patients throughout the hospital. The EPs for this standard mentioned in the R3 report focus on measuring and setting goals for the components of a the patient flow process and the boarding of patients who come through the emergency department, determining whether goals are achieved, and involving leadership actions to improve patient flow processes when goals are not achieved.
Standard PC.01.01.01 requires the hospital to accept the patient for care, treatment, and services based on its ability to meet the patient’s needs. EP 4 requires hospitals that do not provide psychiatric or substance abuse services primarily to have a written plan for defining the care, treatment, and services or referral process for those patients. EP 24 requires hospitals to provide a safe and monitored location and to conduct assessments and reassessments for patients waiting for care for emotional illness or substance abuse, as well as providing orientation and training for staff in these situations.