EH often sidelined at Joint Commission surveys

AOHP asks for a voice on JCAHO council

Employee health professionals are asking for a greater voice — and more attention — from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) in Oakbrook Terrace, IL.

The Association of Occupational Health Professionals in Healthcare (AOHP) has asked for membership on the JCAHO nursing advisory council. The Joint Commission has not yet responded to the request.

The request was prompted, in part, by the experience of some AOHP members who were involved in recent surveys and found little concern or interest in employee health on the part of surveyors.

"Several AOHP members recently participated in JCAHO surveys and are concerned about the inconsistencies of JCAHO surveyors on reviewing standards that impact health care worker safety," AOHP executive president Denise Knoblauch, RN, BSN, COHN-S/CM, wrote to the Joint Commission. "We feel that our presence on the council would demonstrate that health care worker safety will directly impact patient safety, leading to an improved survey emphasis."

Surveyors need to understand the link between employee health and patient safety, explains Knoblauch, who is clinical case manager for the OSF SFMC Center for Occupational Health at Saint Francis Medical Center in East Peoria, IL.

Standard calls for worker, patient safety

The Joint Commission has previously acknowledged the importance of employee health and safety, although its standards primarily focus on patient safety. In its environment of care standards, the Joint Commission calls for hospitals to manage safety risks related to patients, employees, and visitors. A previous standard, which existed from 2001 to 2003, specifically required hospitals to plan for "worker safety."

Through a partnership with the U.S. Occupational Safety and Health Administration, the Joint Commission also shares information and provides education for surveyors.

Yet when it comes time for an actual survey, it may seem that even employee-related issues are addressed to infection control. When the Joint Commission announced a new standard regarding influenza immunization of health care workers, Lynne Karnitz, RN, MS, COHN-S, employee health and wellness coordinator for Aurora Healthcare Manitowoc County in Two Rivers, WI, expected some new questions to come up at a recent survey.

She was looking forward to the opportunity to share her success — an 80% vaccination rate — and to talk about her methods of obtaining participation.

"Employee health nurses are the ones that promote the flu vaccination, actually give the flu vaccine, and monitor all the outcomes," she says. "Yet when there was a Joint Commission survey, I was never even asked a question as to collecting my statistics, collecting my data, or how many employees receive the vaccine."

Karnitz pulled the employee health files of several employees as part of the tracer methodology that tracks the care of a specific patient. Yet the surveyors only looked at the human resources file and didn't even check immunizations, she says.

"I don't want to say we're overlooked, but that's sort of the impression you get," says Karnitz, who is Region 2 director for AOHP.

Some employee health professionals may be happy to avoid the spotlight of a survey. But that also may mean a lower profile within the hospital.

Low profile at hospital, too

At a recent survey, Kim Casey, RN, BSN, occupational health services manager at Fayette County Hospital in Vandalia, IL, anticipated a review of employee health records. All appropriate employees were fit-tested and immunizations were up to date, but the surveyors only looked at employee education and competencies, she says.

"They didn't even ask for anything [employee health]-related, nothing whatsoever," says Casey, who is Region 3 director of AOHP.

In fact, employee health isn't represented on the hospital's Joint Commission planning committee that oversees the survey preparation. "I think if we had more of a presence with the Joint Commission … we might have a bigger presence within the hospital," she says.