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The Joint Commission on Accreditation of Healthcare Organizations reports that its Standards Review Task Force is making progress in rooting out the redundant and overly burdensome portions of its standards.
The task force, whose mission is to review Joint Commission standards for anything unreasonable or unnecessary, recently held its second meeting. At its first meeting in June, the task force reviewed the Patient Rights standards and standards compliance requirements. The Joint Commission reports that the second meeting was devoted to reviewing the Governance standards and approximately half of the Leadership standards. Task force members noted that these chapters have a great deal of redundancy.
"They also suggested modifications to the survey process for many of these standards that would allow surveyors to focus on specific, applicable issues and standards, and drill-down’ in other standards areas if needed," according to a Joint Commission report. "There was a general sense that the Governance chapter could be incorporated into the Leadership chapter. Interestingly, prior to 1994, Governance standards represented a small section of the Leadership chapter."
In another change, the task force said the Leadership and Governance standards should not be subject to on-site survey review. Many of the Leadership and Governance standards are concepts and principles that can be used as a road map for effective management of an organization, the task force said, but now they are practiced so uniformly that on-site survey review is unnecessary.
Two standards were identified as overly burdensome. Standard LD1.7.1 states that "each department provides patient care according to its written goals and scope of services." In most instances, the task force says, hospitals create these documents solely to meet the JCAHO standard — without any meaningful contribution to improving health care. Instead of serving as a useful tool to assist in decision making, the binder of department-specific goals and services "typically sits on a shelf until it is updated prior to the next survey," the task force reports.
Standard LD18.104.22.168 also was cited for its administrative burden and political nature. That standard calls for medical staff approval of sources of patient care provided outside the hospital. In effect, that means that the medical staff reviews every contract for outside sources of care, such as physical therapists and laboratories. That’s too broad, the task force concluded.
Task force members suggested that health care organizations seek medical staff input into the quality and associated measures of the external provider rather than provide a detailed review of all contractual provisions.