Accreditation Field Report: Surveyors like process used to reconcile meds
Surveyors like process used to reconcile meds
During a January 2006 survey at Merrimack Valley Hospital in Haverhill, MA, Joint Commission surveyors looked closely at patient safety, medication reconciliation, fall prevention, handoff communication, and changes made as a result of performance improvement activities.
The organization chose option three for its periodic performance review (PPR), which consists of an onsite survey of about one-third the duration of a full survey. "Our PPR survey was approximately 15 months prior to our triennial survey," says Gloria Swanbon, director of quality improvement and risk management. "The surveyor was very informative and served as an instructor as well as a surveyor. It was a very positive experience."
The PPR survey was a good "dry run" for the actual survey, says Swanbon. "It's more consultative in nature, and there is no written report on file," she says. "We received a verbal report; hence there was nothing for the surveyors to look at when they came for the triennial. We did not have to prepare any measures of success for them."
During the actual survey, surveyors traced a surgical patient, a psychiatric patient, a critical care patient, and patients who transferred from one unit to another, looking for the continuum of care and the handoff sharing of information.
Handoff communication was a topic of discussion during all of the tracers and during individual sessions in specialty areas, such as radiology and nuclear medicine. "The expectation was that all caregivers share common knowledge about their patient's needs," says Swanbon. "The most common queries were 'How did you find out about this patient?' and 'What were you told about this patient?' This was very similar to the PPR survey."
The surveyors were impressed with the consistency of the medication reconciliation process. A single form is used to document a patient's medications on admission, on transfer, and upon discharge, with forms color-coded and placed in the same spot in every record.
"They liked our format and could see that everyone was working with it including the medical staff," says Swanbon. "It is a combined effort between nursing and medical staff and is a great tool for assisting medical staff both upon admission and at discharge."
During a January 2006 survey at Merrimack Valley Hospital in Haverhill, MA, Joint Commission surveyors looked closely at patient safety, medication reconciliation, fall prevention, handoff communication, and changes made as a result of performance improvement activities.Subscribe Now for Access
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