JCAHO surveyors focus on preparedness

New wording calls for coordination of planning

Amid this new reality of bioterrorism, the Joint Commission on Accreditation of Healthcare Organizations announced it will be taking a closer look at compliance with a year-old emergency management standard. The Oakbrook Terrace, IL-based organization also added a section to the standard requiring hospitals to coordinate their emergency management with other health care facilities and community organizations.

Joining the survey in 2003

Compliance with that portion will be a part of survey scoring beginning in January 2003. The rest of the standard, EC 1.4, became effective on Jan. 1, 2001. (For more on the emergency management standard, see Hospital Employee Health, November 2001, "Survey: Most hospitals are unprepared to protect their staffs in case of an attack.") While the Joint Commission standard requires a review of emergency management plans once a year, hospitals should be rethinking their plans in light of the Sept. 11 attack and the anthrax attacks.

"If an organization didn’t begin to re-examine its plan immediately, [it] may find [itself] being caught short," says Robert Wise, MD, vice president of the division of research standards for the Joint Commission. Wise termed the new provisions for coordination "a big step forward in making it clear that an attack of the magnitude that’s being threatened [by terrorists involves] not every organization preparing individually, but really moving toward a community coordinated response."

In its December Perspectives, which is available online (www.jcaho.org), the Joint Commission said surveyors will look for evidence that hospitals have assessed their risks and established contingency plans. (See "What the survey process expects of your organization: Questions to ask yourself" in this issue.)

A more likely threat

Certainly, all hospitals now should include bioterrorism in their hazard vulnerability analysis as a potential emergency scenario. Wise points out that, as seen in the anthrax mail contamination, bioterrorism would not be limited to major cities. "Now the possibility of a terrorist attack, including a biological attack, has to be seriously considered," Wise says. "What’s changed is that the threat has now moved from a possible’ to a much more likely’."

The Joint Commission will expect hospitals to have established contact with local emergency management and public health agencies, fire and police departments, among others. "One of the things we’re asking is that the organizations . . . have their plan coordinated with the response of the community," he says. "If you’re the only organization that’s planning for a chemical attack, it’s no response. You have to figure out how you’re going to coordinate your response with other responders in the environment."

The Joint Commission reviewed the response of New York City hospitals in the aftermath of the World Trade Center attack. "They did an incredible job," he says. One step they took as a part of their emergency management: The hospitals moved patients to long-term care facilities to make room for victims. That highlights the need for hospitals to work with other health care facilities in the community as a part of a coordinated response. "This attack is certainly a wake-up call to new kinds of emergencies communities may face," says Wise. "A properly put together emergency management plan will assist them in all types of events."