Can we get rid of JHACO already?

[Alvarez13]

Getting sick of the *****ic alphabet people telling me to hide my water. Read this and had a good laugh:

Joint Commission Loses Accreditation After Failing Joint Commission Survey | GomerBlog

“As the head of an organization that enforces some of the world’s most arbitrary rules, I hold my staff to an equally ridiculous and arbitrary number of illogical standards”

gomerblog.com

One study I found on pub med states: "US hospital accreditation by independent organizations is not associated with lower mortality, and is only slightly associated with reduced readmission rates for the 15 common medical conditions selected in this study. There was no evidence in this study to indicate that patients choosing a hospital accredited by The Joint Commission confer any healthcare benefits over choosing a hospital accredited by another independent accrediting organization."

Given the push for reducing healthcare costs in the coming years and given this arbitrary bullsh** doesn't help patients, maybe we stop paying $40,000 per yr per hospital for maintenance and another $20,000 for each 3 year inspection? Does CMS really need this dumb seal to reimburse? Is there any other evidence these audits help our patients?

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[deleted109597]

The easy answer is "no".
The longer answer is "no, because people need their yelp ratings for healthcare"

 

[gro2001]

Getting sick of the *****ic alphabet people telling me to hide my water. Read this and had a good laugh:

Joint Commission Loses Accreditation After Failing Joint Commission Survey | GomerBlog

“As the head of an organization that enforces some of the world’s most arbitrary rules, I hold my staff to an equally ridiculous and arbitrary number of illogical standards”

gomerblog.com

One study I found on pub med states: "US hospital accreditation by independent organizations is not associated with lower mortality, and is only slightly associated with reduced readmission rates for the 15 common medical conditions selected in this study. There was no evidence in this study to indicate that patients choosing a hospital accredited by The Joint Commission confer any healthcare benefits over choosing a hospital accredited by another independent accrediting organization."

Given the push for reducing healthcare costs in the coming years and given this arbitrary bullsh** doesn't help patients, maybe we stop paying $40,000 per yr per hospital for maintenance and another $20,000 for each 3 year inspection? Does CMS really need this dumb seal to reimburse? Is there any other evidence these audits help our patients?

The key is some sort of accreditation though. Without looking into it in more depth, I would bet that the independent organizations have very similar accreditation standards to JHACO, so one would expect neither a difference in quality nor in the amount of accreditation related pain. Having worked at a hospital before and after JCI accreditation (the international equivalent of JHACO) I would say that accreditation of this type is a transformative process and the difference in pre/post quality is huge. This might be hard to appreciate in the US where lots of best practices have become standard in many/most hospitals.

 

[gutonc]

Our large academic hospital recently switched to an alternate certification agency. So far, at least from the "middle medical management" level, it seems a bit less draconian. It's also less than half the cost of JC certification.

 

[GeneralVeers]

It will never die. It's part of the Nursing-Administration-Industrial process. Joint Commission exists to employ nurse administrators to make up arbitrary metrics. In response hospitals have to employ more nurse administrators to comply with the arbitrary metrics.

It's also an effective tool to keep the rank and file nurses in line. Any question relating to why a hospital is doing something inevitably provides the response: "The Joint Commission says so!"

 

[wholeheartedly]

I'm glad my current little facility isn't accredited by the JC. I'm the infection preventionist here (not a nurse though) and I feel like it allows me to take a more practical and common sense approach to things. Coming from a big tertiary place, there were so many things that were done because they were "regs" that actually weren't if you ever bothered to look it up. It got really old doing asinine stuff because some clueless admin said it met a reg.

In regards to the water, CMS and Joint Commission only require you to follow OSHA and your own facility policy. OSHA basically says you can't have food or drink where there's a reasonable chance of exposure to blood or other potentially infectious material. And not where meds are prepped. So long as you aren't eating off a counter where specimens sit, it shouldn't be an issue from a regulatory standpoint. Our state OSHA guy told me that unless he see's a coffee cup next to a specimen cup they really aren't going to do much with that. He then referred me to this Gomerblog post. Beverage Container Left Open at Nurses Station, Three Dead as a Result | GomerBlog

I agree a lot of these regs are at best pointless and at worst detract from care, increasing costs and administrative bloat.

 

[Alvarez13]

I'm glad my current little facility isn't accredited by the JC. I'm the infection preventionist here (not a nurse though) and I feel like it allows me to take a more practical and common sense approach to things. Coming from a big tertiary place, there were so many things that were done because they were "regs" that actually weren't if you ever bothered to look it up. It got really old doing asinine stuff because some clueless admin said it met a reg.

In regards to the water, CMS and Joint Commission only require you to follow OSHA and your own facility policy. OSHA basically says you can't have food or drink where there's a reasonable chance of exposure to blood or other potentially infectious material. And not where meds are prepped. So long as you aren't eating off a counter where specimens sit, it shouldn't be an issue from a regulatory standpoint. Our state OSHA guy told me that unless he see's a coffee cup next to a specimen cup they really aren't going to do much with that. He then referred me to this Gomerblog post. Beverage Container Left Open at Nurses Station, Three Dead as a Result | GomerBlog

I agree a lot of these regs are at best pointless and at worst detract from care, increasing costs and administrative bloat.

Most of the OSHA stuff is reasonable:

29 CFR 1910.141(g)(2): Eating and drinking areas. No employee shall be allowed to consume food or beverages in a toilet room nor in any area exposed to a toxic material.

Yah, okay, no hotdogs on the pot. The dept wide ban on water at a few of my spots is excessive and punitive.

 

[deleted109597]

For the record, I had this argument with one of the hospitals I worked at. Told them that the place they said was appropriate wasn't, and my workstation was. They pushed back. I told them the relevant OSHA policies. They told me that OSHA listened to them.



So I reported them to OSHA.




Their location was removed and labelled unsafe. Mine was labelled safe.


To this day their location isn't allowed to be used, but they also wouldn't let it happen at the doc station either because ADMIN IS TERRIBLE. That is all.

 

[TooMuchResearch]

OSHA can't tell me if I can poop and eat at the same time.

Most of the OSHA stuff is reasonable:

29 CFR 1910.141(g)(2): Eating and drinking areas. No employee shall be allowed to consume food or beverages in a toilet room nor in any area exposed to a toxic material.

Yah, okay, no hotdogs on the pot. The dept wide ban on water at a few of my spots is excessive and punitive.

 

[GeneralVeers]

OSHA can't tell me if I can poop and eat at the same time.

How would they even know? "No food in the bathrooms" seems unenforceable and comical.

 

[Alvarez13]

OSHA can't tell me if I can poop and eat at the same time.

OSHA: doctor, why is there tomato sauce dripping out of your white coat pocket? What were you doing in that bathroom?
TMR: *eyes dart left and then right*
OSHA: ...
TMR: Look! There's a small amount of water on the floor near the ice machine! *shoves other half of meatball sub in mouth*

 

[WilcoWorld]

Most of the OSHA stuff is reasonable:

29 CFR 1910.141(g)(2): Eating and drinking areas. No employee shall be allowed to consume food or beverages in a toilet room nor in any area exposed to a toxic material.

Yah, okay, no hotdogs on the pot. The dept wide ban on water at a few of my spots is excessive and punitive.

...puts down hotdog...😳

 

[VA Hopeful Dr]

...puts down hotdog...😳

Ignoring OSHA for a minute, I think you're going to get some funny looks if you go into the bathroom with a hotdog and come out without one...

"Sure, you were just in there eating it..."

 

[deleted109597]

Ignoring OSHA for a minute, I think you're going to get some funny looks if you go into the bathroom with a hotdog and come out without one...

"Sure, you were just in there eating it..."

You know I stay strapped

 

[TooMuchResearch]

So much thumbs up to this.

You know I stay strapped

 

[bravotwozero]

Well if we can’t get rid of them then can we a at least get a decent zdogg md style music video that mocks them mercilessly?


Sent from my iPhone using Tapatalk

 

[emergentmd]

JCAHO is a joke. The people doing the survey is a joke. Just another big bureaucratic, money wasting government entity.

If they really want to make changes, then just show up unannounced so hospitals actually have to meet standards all the time. What is the point of giving 1-2 wks warning so the hospitals can get everything tight then go back to the old ways when they leave?

Thats like the food inspector giving a restaurant a weeks notice. Everyone would pass.

 

[deuist]

Just another big bureaucratic, money wasting government entity.

JC is a private organization, not a government entity.

 

[GeneralVeers]

JCAHO is a joke. The people doing the survey is a joke. Just another big bureaucratic, money wasting government entity.

It's a private organization. It's run like a mafia and strong-arms hospitals into paying them money and doing what they say

If they really want to make changes, then just show up unannounced so hospitals actually have to meet standards all the time. What is the point of giving 1-2 wks warning so the hospitals can get everything tight then go back to the old ways when they leave?

Because it's a scam

Thats like the food inspector giving a restaurant a weeks notice. Everyone would pass.

Because it's a scam

 

[emergentmd]

My bad. What a scam. Why would private organizations allow a for profit to make money holding them hostage?

 

[GeneralVeers]

My bad. What a scam. Why would private organizations allow a for profit to make money holding them hostage?

When it was formed it was a way for hospitals to demonstrate to the government that they were policing themselves. Theoretically it prevented a lot of government oversight, and fewer CMS site visits. It has since morphed into an unstoppable monster

 

[Renaissance Man]

It's a private organization. It's run like a mafia and strong-arms hospitals into paying them money and doing what they say

Besides first person experience, do you have any articles/sources about any of these claims? I am not trying to disagree or come off as confrontational...I am just genuinely curious and can't find a ton with simple Google search.

 

[GeneralVeers]

Besides first person experience, do you have any articles/sources about any of these claims? I am not trying to disagree or come off as confrontational...I am just genuinely curious and can't find a ton with simple Google search.

Hospitals pay the Joint Commission up to $37,000 in fees annually to maintain their accreditation status. Inspections cost approximately $18,000 every three years.
Type: Non-profit organization
Industry: Health care
Joint Commission - Wikipedia

https://en.wikipedia.org › wiki › Joint_Commission