Why Would We Want Oversight Organizations to Require Hospitals, Skilled Nursing Homes and Rehab Centers to go ‘Above and Beyond?’
Julie Kliger
Experienced senior advisor focusing on early stage med-tech commercialization and 'real-world' translational implementation in the clinical setting. Expertise in medical and clinical errors, patient safety outcomes.
Who Is The Joint Commission?
The Joint Commission (TJC), the Federal Oversight organization that enforces quality and safety-setting standards, has been reducing its requirements for receiving a ‘passing grade.’ TJC’s job is to oversee hospitals, ambulatory centers, skilled nursing facilities (SNF), behavioral health centers and surgical centers. And in order for all of these healthcare organizations to receive Medicare payments (which accounts for anywhere from 15%-70% of payment for these organizations), they need to undergo TJC’s survey process and they need to ‘pass’ the Joint Commission survey.
TJC earns money by charging for fees to receive accreditation. And TJC also provides consulting services to these same organizations on how to pass its own surveys! And given that TJC is run by doctors and businesspeople, they are very sensitive to the American Medical Association and hospital executives’ complaints about overburdened requirements by TJC.
The 'Optional' Reality of Healthcare Oversight
You see, as Dr. Jonathan Perlin, president and CEO of the Joint Commission says: “While accreditation of hospitals is mandatory, accreditation with the Joint Commission is not.” Organizations can shop elsewhere so TJC must lower its standards to keep the paying customers coming…and the paying customers are hospitals and skilled nursing homes that are responsible for our lives.
The remedy? Roll back its own mandates and standards to make it easier for hospitals and all these healthcare providing organizations to pass the test! Per TJC: we will “cut down on requirements that go “above and beyond.”
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What Oversight Will Be Removed?
Quote: “In total, 28% of standards for laboratories, 26% for nursing facilities and 25% for behavioral care centers were removed.”
What else has been removed? Quote: “Major standards being removed include those mandating that facilities report and investigate injuries to staff and patients; evaluate medication management effectiveness; and document certain discharge criteria. “
Does This Matter to Patient Safety?
Who needs these anyway? Certainly not patients who want to ensure their care is safe and certainly not staff who need an injury-free work environment!
Consumer advocates hammered this decision by TJC saying “The Joint Commission had an opportunity to push the envelope yet backed down to industry demands. What the Joint Commission is explicitly saying is that our margin or [return on investment] is more important…” Presumedly than caring for patients and staff…
Patients: Beware. Staff: Beware.
About the author: Julie Kliger is recognized by LinkedIn as a "Top Voice" in Health Care in 2015 & 2106, & 2107. She is a Healthcare ‘Strategic Realist’ who is passionate about improving health care and improving lives. She specializes in future-oriented healthcare redesign, optimizing existing operations, implementing new care models and strategic change management. She is an advisor, clinician, health system board member, speaker and author.
Architect and ☢️ Radiology / MRI Safety 🦺 Expert. Expert Witness. Speaker. MRI safety trainer and consultant for 🏥 healthcare providers and industry.
1yQuick question for you, when you wrote "Quote: 'Major standards being removed include...' ", from what were you pulling the quote? Was that something specifically said by Perlin, or from a statement issued by TJC? Thank you in advance.
Architect and ☢️ Radiology / MRI Safety 🦺 Expert. Expert Witness. Speaker. MRI safety trainer and consultant for 🏥 healthcare providers and industry.
1yIn my tiny little slice of expertise in hospitals, radiology departments, I have seen TJC surveyors 'go rogue,' citing all sorts of things that aren't identified by the standards, while failing to have standards (particularly in MRI) that *actually* speak to the real quality and safety issues that face providers and patients. While I think that there is certainly room for TJC to thin-out some of the chaff in their standards, I'm of the opinion that 'dialing-back' standards, instead of 'dialing-in' standards (to make them more direct and effective) is both wrongheaded and a betrayal of accreditation's promise to assure 'quality & safety.'