Joint Commission issues 2005 patient safety goals

Bar-coding proposal could stir controversy

Last year, quality managers who were expecting major changes from the Joint Commission on Accreditation of Healthcare Organization’s 2004 National Patient Safety Goals got a bit of a surprise: The goals were largely the same as the previous year’s. This time, however, that won’t be the case.

The 2005 National Patient Safety Goals and Requirements have been released for public review and comment and will be finalized this summer. Two of the new proposed goals include reducing the risk of harm from patient falls and reducing the risk of surgical fires.

But it’s another new goal that might stir up some controversy — the proposal that hospitals develop plans for implementing bar-code systems for patient identification and matching patients to their medications or other treatments by Jan. 1, 2007.

Most organizations have not yet implemented bar-coding systems, and this may be viewed as unduly burdensome, says Kathleen Catalano, director of regulatory compliance at Provider HealthNet Services in Addison, TX.

"People may be asking, Is it really doable by 2007? Will the cost be prohibitive?’" she says. "For those institutions that have never introduced bar-coding, a thorough and credible evaluation must be made of how the facility will move forward to meet this goal." She recommends considering this a performance improvement project. "Go through all of the steps outlined by the Joint Commission for designing a new process, including review of literature and budgets."

Still, it may be that the bar-coding goal will be accepted and eventually implemented by organizations, Catalano says. "I think we’ll have to wait and see about who makes the most noise. It could be this will be viewed as necessary."

Catalano says she expects that the final goals will be very similar to what was proposed.

"I don’t believe there will be major changes in the finalized goals unless the outcry from the field review is really loud about the bar-coding," she says.

In general, the proposed goals are in line with the number and severity of sentinel events that have occurred in these particular areas, Catalano says. "Most of these patient safety issues have already been evaluated to some degree by many facilities," she adds.

For instance, most facilities have implemented a falls reduction program. "The question on the falls issue is whether or not facilities have the resources for the number of bed alarms and low beds they need, or will they come up with alternative safeguards," Catalano notes.

Reducing the risk of surgical fires may be a bit challenging, due to the requirement of educating staff, licensed independent practitioners, and anesthesiologists/anesthetists. "Most will listen because it’s not just a question of the patient’s safety; it’s the operating crew’s safety as well," she says. "But there are usually some who feel they don’t need the training."

Testing the OR staff for their response to surgical fires easily can be added into the facility’s fire drill plan, Catalano notes. Since the goals are being adopted in the summer, they definitely will become effective Jan. 1, she says.

"This will still leave a little time to put the necessary pieces in place," Catalano adds. "Most of these will require interdepartmental collaboration and a work plan before rollout."

[For more information on complying with the 2005 National Patient Safety Goals, contact:

Kathleen Catalano, Director of Regulatory Compliance, Provider HealthNet Services, 15851 Dallas Parkway, Suite 925, Addison, TX 75001. Phone: (972) 701-8042, ext. 216. Fax: (972) 385-2445. E-mail: Kathleen.Catalano@phns.com.]