The Joint Commission - role in heath care - Research Paper Example

? The Role of Joint Commission in US Healthcare The Role of Joint Commission in US Healthcare Introduction Healthcare industry has been a ‘bone of contention’ between political parties in the United States for the past several decades. The industry is unique for its free market where healthcare organizations, medical practitioners, and pharmaceutical groups are highly vulnerable to medical fraud and misconduct. Although US hospitals are highly equipped with the advanced technology and modern facilities, majority of people do not have adequate access to healthcare; and this condition could be attributed to the escalating cost of drugs and services. This is the context when the services of organizations like The Joint Commission become relevant. The Joint Commission (TJC), formerly Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is an independent non-profit organization that accredits and certifies healthcare organizations in the United States. It sets certain standards for the health care organizations to achieve in order for getting certified. The accreditation it renders is admired nationwide and is the symbol of accepted level of hospital quality. This paper will discuss the functions of the Joint Commission and its impacts on the industry as a whole. This will also analyze the areas where the organization has excelled and flawed giving special focus to the ways it impacted healthcare professionals and healthcare organizations as a whole. Joint Commission: An overview According to the data published on its website, the Joint Commission accredits and certifies more than 20000 healthcare organizations and healthcare programs throughout the United States. The main objective of the organization is “to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value” (Mission statement). With regard to the accreditation processes, the client hospitals have to undergo certain inspections during a three-year accreditation cycle. Obviously, hospitals have to endeavor in order to undergo Joint Commission survey. For instance, the applicant has to be adequately knowledgeable about the current standards, policies, and other requirements so as to ensure compliance. Furthermore, the organization will have to address several standards-related concerns even during the entire accreditation term. Admittedly, there have been several criticisms regarding the reliability of the organization’s surveys and inspections. However, despite such flaws, TJC plays a very crucial role in the quality improvement process of the US healthcare system by updating its accreditation standards on time. For example, very recently the commission has highlighted the significance of medical library on the grounds of the growing web-based information management systems. It stated that “the increasing use of the Internet and new information technologies by medical, nursing, and allied health staffs; patients; and the community require new strategies…………..”: and “to assess the quality of a hospital the library should be evaluated for resources and technologies” (as cited Paradise, 2004). Patient Safety as a Major Issue To be succinct, the following part of the paper will discuss how patient safety has become one the major concern of the Joint Commission and the way it affected the stake holders. JCAHO sees medical errors very seriously in its assessment of hospitals for accreditation. It gives sentinel event alert and checks if “the event has resulted in an unanticipated death or major permanent loss of function, not related to the natural course of the patient's illness or underlying condition” (as cited in Paradise 2004). The patient safety standards include ‘improving the accuracy of patient identification, improving staff communication, using medicines safely, preventing infection, identifying patient safety risks, preventing mistakes in surgery (Pozgar, 2011, p. 540). Evidently, the issue has great impact on the healthcare organizations that intend to achieve or maintain Joint Commission accreditation. The organizations have to strive a lot to avoid all medical errors in their premises at every cost. In order to achieve this objective, quality improvement (QI) has become an essential area of hospital administration. Although regulation and accreditation are not same, they both play important roles in improving the quality of care. Regulation indicates rules that must be strictly followed whereas accreditation is the approval from an authentic body for voluntarily meeting their specified standard of quality. Although Joint Commission is not the sole accreditation agency in the United States, it has grown to be the major force driving the quality of US healthcare system. Patient Safety Issues in US: An Overview A study proves that ‘as many as 1,95,000 people may well be dying in American hospitals each year because of avoidable medical errors, and as many as 1.5 million may well be misdiagnosed’ (Coates, 2007, p.62). Furthermore, around 50% of people are estimated to be uninsured or underinsured in the States. It is obviously an alarming ratio for a developed country like the United States. As compared to any other country in the world, the United States spends a higher proportion of its gross products on healthcare services; 13.7% in 1999 (Stat.2001. as cited in Jonas, 2003, p.2). It shows the exceeding level of exploitation prevailing in the U.S. medical field. Democrats, Republicans, Liberals, and Conservatives all do converge at the point that American healthcare system needs to be reformed. However, at the political level debate, the argument field is split into two as liberal camp and conservative camp. Liberal view is that the US should adopt universal system like Canada or United Kingdom. Conservatives are against this view because they believe that ‘socialized medicine’ would hamper the effectiveness of healthcare and moreover it would become a burden to the government. According to the conservative perspective, healthcare system has to be renewed by promoting competition between health insurance and pharmaceutical companies. Furthermore, health care reform has to be implemented by enacting serious reforms in taxes and insurance regulations other than imposing heavy burden on government. According to them, socialized medicine would affect the current quality of American healthcare service and therefore, the reformers have to consider the alternatives to make the healthcare more affordable and accessible without hampering the free market and medical advancement. Although since 1920s Federal government has been taking several attempts to establish some forms of national health insurance schemes, both Liberal and Conservative camps with the influence of interest groups defeated those plans. Excessive pharmaceutical fees and exorbitant physicians’ fees are the indicators of prevailing corruption in the system. Any sincere effort to address the healthcare crisis cannot leave these two factors aside. Private medical practitioners and profit determined healthcare organizations take advantage from the fragmented system. Studies show the depth of prevailing medical fraud in the country. Since 1986, judgments and settlements under the U.S. False Claims Act have totaled $12billion with most of these being against well known drug makers (Campos & Pradhan, 2007). Pharmaceutical Regulatory System has failed to prevent pharmaceutical fraud in the U.S. healthcare. Deceptive actions such as illegal off-label marketing and copying color, trademark and packaging have created an unpredictable environment in the service sector. Hence, in addition to the unaffordable expenditure, people are under the threat of low quality medication and fraud. Improper use of Emergency Room (ER) and the misuse of 911 services are other two areas that are highly affected by healthcare abuse in the U.S. Most of the emergency rooms are heaving with excessive number of patients and struggling with insufficient number of nurses. Emergency rooms are being misused either by hospital operators or by people who are not in a condition to be admitted there. Admittedly, the accreditation process of the Joint Commission has curbed the above said issues and fraud to a great extent. Since the Joint Commission certification has become the quality symbol and mandatory Medicare requirement, hospitals are forced to comply with the standards. Effects on Health Care Organizations Joint commission and its various supportive services have greatly influenced the way hospitals and other healthcare institutions carry out their programs. Joint Commission Resources (JCR) is an affiliate knowledge-based organization of TJC which designs innovative solutions to improve patient safety and quality. Its programs involve ‘education programs, publications and multimedia products, Continuous Service Readiness program, comprehensive health care consulting and custom education, and accreditation and consulting for organizations abroad’ (The Joint Commission Inspiring health care excellence). Evidently, because of the organization’s active presence in the industry, patient safety and quality have become the most important concern related to health care all over the world. JCI launched its Clinical Care Program Certification (CCPC) in 2005 which includes 15 categories of clinical services; and this Certification is ‘based on a clear assessment of consensus-based standards and criteria, the effective use of clinical guidelines’ (The Joint Commission Inspiring health care excellence). The accreditation program is highly important that the federal government has made it a mandatory requirement for the health care firms to gain Medicare standards. To be specific, hospitals having Joint Commission accreditation are eligible for Medicare without any further direct review. However, excessively relying on a private agency for public interest has its own advantages and disadvantages. As per certain surveys, benefits include ‘cost savings, national uniformity of standards, and reduction of duplication in surveys’ whereas disadvantages include “the infrequency of JCAHO surveys, loss of input and oversight control by the states, and failure of the Joint Commission to ensure that standards were met’ (Jost, 1994). The agency has expanded its hold over ambulatory surgery centers, critical access hospitals, medical equipment suppliers, laboratories, and home health and thus remains to be the deeming authority in the industry. One of the major challenges hospitals face with the accreditation process is the mounting costs associated the consultation and preparations for surveys. According to the reports (as cited in Elsaid 2011), the services, will cost organizations roughly $ 140,000 whereas, it will exceed $46,000 for international accreditation. Critics point out several issues against the credibility of the Joint Commission. Elsaid (2011) also point out that, the organization is very much lenient and certifies 99% hospitals it surveys. Another criticism is that corporate members from healthcare industry constitute the three-fourth of the seats on the board. Finally, it accumulates around $113 million every year mostly in the form of fees imposed on the hospitals, and this ultimately passed on to the patients who are already burdened by the unaffordable hospital bills (Elsaid 2011). Conclusion To conclude, the Joint Commission has become the most influential factor in the U.S. healthcare industry. It has played a great role in making patient safety and quality the most important aspects of healthcare. Yet the industry needs to be regulated with appropriate social welfare policies and strategies in order to ensure the public safety. Healthcare abuse and corruption are the basic problems that have to be swiftly addressed. Since majority of the country’s population strive for free health care, a ‘nation conceived in liberty’ cannot move further with an endangered healthcare ethics. The Joint Commission cannot ignore the criticism regarding its profit- orientated accreditation system. The Commission also needs to be regulated effectively in order to ensure the envisioned welfare and justice to the citizens. References Campos J, E & Pradhan S. (Eds). 2007. The Many Faces of Corruption: Tracking Vulnerabilities at the Sector Level. World Bank Publications. Coates D. (2007). A Liberal Tool Kit: Progressive Responses to Conservative Arguments. US: Greenwood Publishing Group. Elsaid, A. (2011). Is the Joint Commission enough for accrediting the health care organizations. Retrieved from http://www.slideshare.net/AGILAELSAID/joint-commission Jonas S. (2003). An Introduction to the U.S. Healthcare System. edn.5, Springer Publishing Company. The Joint Commission Inspiring health care excellence. Retrieved from http://www.jointcommission.org/assets/1/18/InspiringHCexcellenceweb1113.pdf Jost, T. S. (1994). Medicare and the Joint Commission on accreditation of healthcare organizations: A healthy relationship? Law and Contemporary Problems. 57 (4): 1-45. ‘Our mission’. The Joint Commission. Retrieved from http://www.jointcommission.org/about_us/about_the_joint_commission_main.aspx Pozgar, G. (2011). Legal Aspects of Health Care Administration. Jones & Bartlett Publishers. Paradise, A. (2004). Why the Joint Commission on Accreditation of Healthcare Organizations should add new regulations regarding libraries. J Med Libr Assoc. 92(2): 166–168. Read More