Hospital Accreditation - Assignment Example

Hospital Accreditation Assessment STRENGTHS AND WEAKNESSES OF HOSPITAL ACCREDITATION IN THE UNITED S THROUGH THE JCAHO The Joint Commission onAccreditation of Health Organizations (JCAHO) establishes standards for health organizations that cover a wide spectrum of operations and responsibilities. To be accredited by the JCAHO, a health organization must be rated satisfactory on an assessment of the organization conducted by the JCAHO. This assessment covers all JCAHO standards. Assessments are conducted as an on-site survey of a health organizations operations and responsibilities (Joint Commission on Accreditation of Health Organizations, 1996a). The principal focus of all standards developed for the JCAHO is supposed to be on the patient. While the specifics of a standard for a particular performance area may emphasize the clinical or operational aspects of that performance area, the ultimate intent of the performance standard, according to the JCAHO, is the outcome for the patient (Joint Commission on Accreditation of Health Organizations, 1996b). As a part of its health care accreditation program, the JCAHO began almost decade ago to require health care institutions to report sentinel events as a part of the JCAHO accreditation watch program. Sentinel events are patient-care errors or accidents that lead to patient death or major injury (Moore, 1998). In theory, the focus on sentinel events may be considered to be a strong point in the hospital accreditation process. In actual application, however, the value to the consumer of the sentinel event focus is weakened considerably. In 1998, the JCAHO issued a revision to its sentinel event policy that encouraged health care organizations to voluntarily report sentinel events to the JCAHO, while the JCAHO in turn would stop making sentinel events information available to the public. This policy of the JCAHO was just one more example of the health care industry, it lawyers, and it lackeys in government trying to make a silk purse out of a sow ear [e.g., denying public access to specific information about health care mistakes so that the perpetrators of such mistakes could avoid being hauled into court by the people they harm]. Any health care organization that cares about its patients would voluntarily and without any urging of the JCAHO or any other organization develop standard operating procedures and control mechanisms to preclude the occurrence of all medical errors that harm patients. In 1999, the JCAHO published Preventing Adverse Events in Behavioral Health Care: A Systems Approach to Sentinel Events. The manual provides suggestions to health care organizations to help them to integrate standards for the prevention of adverse events (sentinel events) and other organizational risk management strategies (HO Releases Manual on Adverse Events999). Now, health care organizations can report sentinel events on line to the JCAHO and save even more money (that they can use to pay their lawyers to continue to shield their errors from the public). One area for which standards are established by the JCAHO is ethics. Ethical standards for health organizations apply to clinical practice, research, and all other aspects of the management of health organizations (Joint Commission on Accreditation of Health Organizations, 1996c). Patient rights and organization ethics are dealt with together by the JCAHO. Since 1991 the JCAHO has required all hospitals to have in place procedures and resources to deal with ethical issues related to patient care. Again, in theory, this approach may be considered to be a strong point in the hospital accreditation process. The standards on patient rights were supplemented in 1995 with the requirement that hospitals address issues related to organizational ethics. Organizational ethics requires a hospital to conduct iness relationships with patients and the public in an ethical manneroint Commission on Accreditation of Healthcare Organizations, 1997, p. RI-1). The patient rights ethical standards not only require that hospitals respect a patient rights to adequate, respectful care, confidentiality and informed consent, but also require that hospitals educate their patients and staff members about patient rights and the mechanisms in place for the patient or the patient proxy to obtain relief if the health care organization fails to live up to its responsibility to the patient. Additionally, a hospital must operate according to a code of ethical behavior. The code of ethical behavior required by the JCAHO covers marketing, admission, transfer and discharge, and billing practices (Joint Commission on Accreditation of Healthcare Organizations, 1997). The code of ethical behavior also addresses the relationship between a hospital and its staff members to other health care providers, educational institutions, and payers. All of these requirements sound good on paper. In practice, however, the JCAHO puts little pressure on health care organizations, which are, in fact, the JCAHO customers and source of income (Schlosberg, 1999). The National Health Law Program points out that the JCAHO, as it is currently constituted, is a creature that is largely beholden to the health care organizations that it evaluates, as opposed to owing allegiance to governmental organizations that are charged with assuring health care quality for consumers (Schlosberg, 1999). The JCAHO is one more example of the tradition of failure that characterizes self-regulation in any industry. References JCAHO releases manual on adverse events. (1999, September 27). Alcoholism & Drug Abuse Weekly, 11(37), 7. Joint Commission on Accreditation of Health Organizations (1996a). Hospitals. Retrieved from the Internet 2003-07-18 at: http://www.jcaho.org/perfmeas/stds.htm Joint Commission on Accreditation of Health Organizations (1996b). Joint Commission Accreditation. Retrieved from the Internet 2003-07-18 at: http://www.jcaho.org/ perfmeas/stds.htm Joint Commission on Accreditation of Health Organizations (1996c). Joint Commission standards. Retrieved from the Internet 2003-07-18 at: http://www.jcaho.org/ perfmeas/stds.htm Joint Commission on Accreditation of Healthcare Organizations. (1997). Patient rights and organization ethics. In Comprehensive accreditation manual for hospitals: The official handbook. Oakbrook Terrace, Illinois: Joint Commission on Accreditation of Healthcare Organizations. Moore, J. D., Jr. (1998, March 2). JCAHO urges telln sentinel event fight. Modern Healthcare, 28(9), 60-63. Schlosberg, C. (1999, May 30). Letter to J. G. Brown, Inspector General, United States Department of Health and Human Services,. Comment on Draft Inspection Reports on External Review of Hospital Quality. Retrieved from the Internet 2003-07-18 at: http://www. healthlaw.org/pubs/199905ExtRevLtr.html Wordcount = 985Hospital Accreditation Assessment STRENGTHS AND WEAKNESSES OF HOSPITAL ACCREDITATION IN THE UNITED STATES THROUGH THE JCAHO The Joint Commission on Accreditation of Health Organizations (JCAHO) establishes standards for health organizations that cover a wide spectrum of operations and responsibilities. To be accredited by the JCAHO, a health organization must be rated satisfactory on an assessment of the organization conducted by the JCAHO. This assessment covers all JCAHO standards. Assessments are conducted as an on-site survey of a health organizations operations and responsibilities (Joint Commission on Accreditation of Health Organizations, 1996a). The principal focus of all standards developed for the JCAHO is supposed to be on the patient. While the specifics of a standard for a particular performance area may emphasize the clinical or operational aspects of that performance area, the ultimate intent of the performance standard, according to the JCAHO, is the outcome for the patient (Joint Commission on Accreditation of Health Organizations, 1996b). As a part of its health care accreditation program, the JCAHO began almost decade ago to require health care institutions to report sentinel events as a part of the JCAHO accreditation watch program. Sentinel events are patient-care errors or accidents that lead to patient death or major injury (Moore, 1998). In theory, the focus on sentinel events may be considered to be a strong point in the hospital accreditation process. In actual application, however, the value to the consumer of the sentinel event focus is weakened considerably. In 1998, the JCAHO issued a revision to its sentinel event policy that encouraged health care organizations to voluntarily report sentinel events to the JCAHO, while the JCAHO in turn would stop making sentinel events information available to the public. This policy of the JCAHO was just one more example of the health care industry, it lawyers, and it lackeys in government trying to make a silk purse out of a sow ear [e.g., denying public access to specific information about health care mistakes so that the perpetrators of such mistakes could avoid being hauled into court by the people they harm]. Any health care organization that cares about its patients would voluntarily and without any urging of the JCAHO or any other organization develop standard operating procedures and control mechanisms to preclude the occurrence of all medical errors that harm patients. In 1999, the JCAHO published Preventing Adverse Events in Behavioral Health Care: A Systems Approach to Sentinel Events. The manual provides suggestions to health care organizations to help them to integrate standards for the prevention of adverse events (sentinel events) and other organizational risk management strategies (HO Releases Manual on Adverse Events999). Now, health care organizations can report sentinel events on line to the JCAHO and save even more money (that they can use to pay their lawyers to continue to shield their errors from the public). One area for which standards are established by the JCAHO is ethics. Ethical standards for health organizations apply to clinical practice, research, and all other aspects of the management of health organizations (Joint Commission on Accreditation of Health Organizations, 1996c). Patient rights and organization ethics are dealt with together by the JCAHO. Since 1991 the JCAHO has required all hospitals to have in place procedures and resources to deal with ethical issues related to patient care. Again, in theory, this approach may be considered to be a strong point in the hospital accreditation process. The standards on patient rights were supplemented in 1995 with the requirement that hospitals address issues related to organizational ethics. Organizational ethics requires a hospital to conduct iness relationships with patients and the public in an ethical manneroint Commission on Accreditation of Healthcare Organizations, 1997, p. RI-1). The patient rights ethical standards not only require that hospitals respect a patient rights to adequate, respectful care, confidentiality and informed consent, but also require that hospitals educate their patients and staff members about patient rights and the mechanisms in place for the patient or the patient proxy to obtain relief if the health care organization fails to live up to its responsibility to the patient. Additionally, a hospital must operate according to a code of ethical behavior. The code of ethical behavior required by the JCAHO covers marketing, admission, transfer and discharge, and billing practices (Joint Commission on Accreditation of Healthcare Organizations, 1997). The code of ethical behavior also addresses the relationship between a hospital and its staff members to other health care providers, educational institutions, and payers. All of these requirements sound good on paper. In practice, however, the JCAHO puts little pressure on health care organizations, which are, in fact, the JCAHO customers and source of income (Schlosberg, 1999). The National Health Law Program points out that the JCAHO, as it is currently constituted, is a creature that is largely beholden to the health care organizations that it evaluates, as opposed to owing allegiance to governmental organizations that are charged with assuring health care quality for consumers (Schlosberg, 1999). The JCAHO is one more example of the tradition of failure that characterizes self-regulation in any industry. References- JCAHO releases manual on adverse events. (1999, September 27). Alcoholism & Drug Abuse Weekly, 11(37), 7. Joint Commission on Accreditation of Health Organizations (1996a). Hospitals. Retrieved from the Internet 2008-11-18 at: http://www.jcaho.org/perfmeas/stds.htm Joint Commission on Accreditation of Health Organizations (1996b). Joint Commission Accreditation. Retrieved from the Internet 2008-11-18 at: http://www.jcaho.org/ perfmeas/stds.htm Joint Commission on Accreditation of Health Organizations (1996c). Joint Commission standards. Retrieved from the Internet 2008-11-18 at: http://www.jcaho.org/ perfmeas/stds.htm Joint Commission on Accreditation of Healthcare Organizations. (1997). Patient rights and organization ethics. In Comprehensive accreditation manual for hospitals: The official handbook. Oakbrook Terrace, Illinois: Joint Commission on Accreditation of Healthcare Organizations. Moore, J. D., Jr. (1998, March 2). JCAHO urges telln sentinel event fight. Modern Healthcare, 28(9), 60-63. Schlosberg, C. (1999, May 30). Letter to J. G. Brown, Inspector General, United States Department of Health and Human Services,. Comment on Draft Inspection Reports on External Review of Hospital Quality. Retrieved from the Internet 2008-11-18 at: http://www. healthlaw.org/pubs/199905ExtRevLtr.html Wordcount = 985 Read More