ED Accreditation Update: Joint Commission warns of abbreviations to avoid

Compliance urged by end of 2004

Emphasizing the importance it places on eliminating easily misinterpreted abbreviations and acronyms from written orders and medical records, the Joint Commission on Accreditation of Healthcare Organizations has amended patient safety goals to urge hospitals to achieve 100% compliance by the end of this year.

Standardization of abbreviations and symbols that are used, and elimination of ones that are easily misunderstood or confused, has been a goal of the Joint Commission’s for some time.

The Joint Commission in November issued a minimum list of nine abbreviations and symbols it deems dangerous, and as of Jan. 1, required those abbreviations to be included on all accredited organizations’ "do not use" list.

The abbreviations to be eliminated are: U (for units); IU (for international units); QD and QOD (for once daily and every other day); and MS, MSO4, and MgSO4. In the cases of those abbreviations, the dosage, drug, or instruction should be written out and not abbreviated. Also to be eliminated are trailing zeros (as in 2.0 mg) and failure to use leading zeros (use 0.2 mg instead of .2 mg).

For this year, hospitals will be surveyed and scored only on all handwritten, patient-specific documentation (not just orders). After the end of 2004, surveyors will look for compliance in all documentation media.

Through the end of 2004, organizations that have not achieved 100% compliance will be recorded as "in compliance" if the use of any of the items on the hospital’s list is sporadic, or occurs fewer than 10% of the times the intended term is abbreviated or used in open and closed medical records reviewed; if, when a prohibited symbol or abbreviation is used in an order, there is written evidence of confirmation of the intended meaning before the order was carried out; and the organization has implemented a plan for continued improvement to achieve 100% compliance by the end of 2004.