Emergency management given separate chapter

In The Joint Commission's revised standards, rationales and elements of performance for 2009, which will take effect on Jan. 1, 2009, the emergency management standards have, for the first time, been placed in their own chapter. As a Joint Commission spokesperson explained to ED Management, there are no new standards for 2009; rather, the new chapters resulted from the reorganization of existing standards.

Despite the fact that it does not include new standards, observers see significance in the creation of a new chapter for emergency management. "The Joint Commission has mandated — and rightly so — that this is a high, high priority," says Freda Lyon, RN, BSN, MHA, director of the ED at Tallahassee (FL) Memorial Healthcare.

Lyon believes that this move may encourage facilities to create a new position to oversee all of the hospital's emergency management activities (which her hospital already has), and she thinks this is a good idea. "I will tell you that we are light years ahead because we have someone who can be thinking only about disaster preparedness, mitigation, and recovery," she says.

The person who holds this position at her facility has background as a paramedic and a respiratory therapist, which raises the question of whether an ED manager could (or should) aspire to such a position. "I would say in a facility that has a fairly large volume ED, say 40,000 patients or more a year, it is not a good idea to have the ED manager do [both jobs]," says Lyon.

Other considerations come into play, says John L. Hick, MD, medical director of emergency preparedness at Hennepin County Medical Center, Minneapolis, "I agree this will prompt hospitals to create one position, because this takes a lot of time and dedication. But this would only be appropriate for ED managers who have the interest and the background; I do not see this as necessarily being a natural move for an ED manager," he says.

The changes are part of The Joint Commission's Standards Improvement Initiative, launched in 2006, which focuses on clarifying standards language. The 2009 standards are available online at www.jointcommission.org/Standards/SII/sii_hap.htm.