Looking to bridge the gap between hospitals’ work to meet accreditation requirements and efforts to improve patient safety and quality of care, the Joint Commission repackaged some of its existing standards into a leader’s guide to patient safety systems.
The accreditation giant took the unusual step of publishing the chapter for free to anyone on an affiliated website in order to make the outline for an integrated patient-centered system as widely available as possible.
Publishing the chapter also aims to draw the connection between the commission’s standards and patient safety. “If you were to sit down and look at our accreditation manual for hospitals, it would be very hard for you to tell the story of how accreditation relates to patient safety, because everything is in these very precise chapters,” says Ana Pujols McKee, M.D., executive vice president and chief medical officer for the Joint Commission. An individual standard in, say, the human resources chapter wouldn’t be easily relatable to the broader purpose of patient safety, Pujols McKee says.
The new chapter takes the standards and creates a framework for what an organization’s infrastructure should look like to support patient safety, from the board to the front lines, she says.
Commission officials say that in addition to the hope that hospitals use the chapter to draw the connection between accreditation and patient safety, they also would like to see hospitals use it as a means to critique their operations and educate trustees and front-line staff. Pujols McKee notes that the chapter can be applied to settings other than just acute care, although the commission would consider adapting it to such settings as ambulatory care.
Quality experts say that the chapter provides useful information for hospitals that need guidance in the area. “To highlight all the various components related to patient safety in a clear, concise way is really important,” says Tejal Gandhi, M.D., president of the National Patient Safety Foundation. “I’m glad to see they’re making patient safety a priority.”
But John Toussaint, chief executive of the ThedaCare Center for Healthcare Value, says the chapter, though difficult to argue with in terms of what’s included, would be more useful with added specifics. The chapter is missing a plan for action, offering a methodology for identifying problems, but not necessarily one for solving them, he says.
More could be included for how management can change to speed progress. “There are certain things that management has to do to create a culture of safety,” Toussaint says. “For many of the [hospitals and health systems] we work with, this is old news,” Toussaint says.
Pujols McKee says that the Joint Commission recognizes that high-performing hospitals are unlikely to get much out of the chapter. It can serve as an affirmation of their efforts, she says.
But, hospitals below that top tier can potentially boost their patient safety work using the chapter. “I think there are some opportunities there,” she says.