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The Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, and CARF, The Rehabilitation Accreditation Commission, in Tucson, AZ, have expanded their cooperative agreement to reduce duplicative on-site evaluations of rehab units within hospitals.
Units that have earned CARF accreditation may undergo a limited evaluation by the Joint Commission when that agency is surveying the rest of the hospital. A former agreement between the two was limited to the recognition of CARF accreditation of programs that were part of a network seeking Joint Commission accreditation.
Under the expanded agreement, the commission will conduct a brief overview of the rehab program with the operational leadership to discuss standards, human resource issues related to staff competencies, medical records standards, performance improvement issues, and Environment of Care/Life Safety issues. The overview will address how the rehab program integrates with the hospital and meets its needs. The rehab program will not be required to participate in the other components of the organization’s survey. For more information about the JCAHO/CARF cooperative agreement, call Sally Saadeh, director of special projects, Medical Rehabilitation Division, CARF, at (520) 325-1044, ext. 190.
On Jan. 13, the Supreme Court made it easier for patients to sue hospitals for "dumping" patients who need emergency care onto other facilities. The decision cited the federal Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986, which says such lawsuits do not have to allege or prove any improper motive behind the transfers from one facility to another and prevents such treatment of patients.
The decision represented a victory for a Kentucky woman who sued Humana Hospital-University of Louisville (KY) for $10 million after she was transferred to an Indiana nursing home following a six-week stay in 1992. She had been treated after being run over by a truck. The woman’s lawsuit contends that her health at the time of her transfer remained in a volatile state, that her health deteriorated significantly after the transfer, and that the transfer was premature. The lawsuit says the Louisville hospital violated the federal law when it sent the woman to a nursing home, from which she later was transferred to an Indianapolis medical center. The patient’s medical bills at that center totaled about $400,000, and Medicaid did not cover them because she was not an Indiana resident. The case is Roberts v. Galen of Virginia, 97-53.
There’s a new quality resource on the Internet — a repository for more than 500 evidence-based clinical practice guidelines developed by the Agency for Health Care Policy and Research (AHCPR) with the American Medical Association and the American Association of Health Plans. The National Guideline Clearinghouse (Web address: www.guideline.gov) contains thousands of clinical practice guidelines created by medical and professional societies, managed care organizations, hospitals, state and federal agencies, and others.
Until now, guideline users often have had difficulty gaining access to a full range of guidelines, and then had difficulty identifying which guidelines are based on evidence. There has been no efficient way of making comparisons to select the guideline that best meets your needs. The clearinghouse responds to that longstanding need by identifying and featuring evidence-based clinical practice guidelines presented with standardized abstracts and tables that allow for comparison of guidelines on similar topics. The tables provide information on the major areas of agreement and disagreement among guidelines, which will help users make informed selections.
"It is well known that variation in health care results partly from uncertainty and a lack of evidence for clinical treatment," said John M. Eisenberg, MD, AHCPR administrator. He said this clearinghouse will help reduce variation and improve health care quality.
The agency will continue to receive guideline submissions. Organizations wishing to submit should contact Vivian Coates, ECRI, NGC Project Director, 5200 Butler Pike, Plymouth Meeting, PA 19462-1298. For questions about guideline submissions, contact Jean Slutsky, NGC Project Officer, (301) 594-4042; firstname.lastname@example.org.