Courtesy of VA Greater Los
Angeles Healthcare System
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| For
members of the nursing team of the VA Greater Los
Angeles Healthcare System, participation in pilot
testing of surprise JCAHO visits is about continuous
readiness and maintaining quality patient care. |
One hundred hospitals have volunteered to take part
in the pilot testing of unannounced accreditation surveys-which
many nurses dub "The Visit"-and Annya Slaughter,
RN, said the surprise inspections could be a healthy
change.
"I've been through accreditation at several facilities,
and there was definite anxiety as the date approached-everybody
wanted to take a vacation," said Slaughter, who
works as a critical care nurse for the Veterans Administration
Greater Los Angeles Healthcare System. "It's always
been 'Let's get ready,' and now it will be 'Let's be
ready, all the time.' "
That sentiment is also what prompted Children's Memorial
Hospital in Chicago to be the first in the nation to
volunteer for unannounced regular surveys in 2004 by
the Joint Commission on Accreditation of Healthcare
Organizations, which sets compliance standards for quality
care and patient safety.
The pilot program is designed to smooth the way to
make such unscheduled visits permanent in 2006.
"We always felt well-prepared for JCAHO visits,
but I like the change to unannounced surveys,"
said Shelley Uttley, RN, special projects manager at
Children's. "There was a tendency to go into high
gear as the survey time got closer, and the approach
now is that we always want to be in high gear.
"What I'm really trying to do is change people's
mind-sets, so if surveyors walk through the door tomorrow,
we're ready."
Linda Murphy-Knoll, vice president for accreditation
service operations for the Joint Commission, said a
paradigm shift will take place in survey procedures
starting Jan. 1, with the transition to unannounced
visits in 2006 being the final step in the process.
Under revised JCAHO guidelines, scoring will be eliminated,
along with general departmental inspections and many
formal interviews, Murphy-Knoll said. Instead, surveyors
"will really look at patient care. They'll follow
specific patients through the system and look at the
critical issues from that point of view."
Before such performance evaluation, hospitals will
prepare self-assessments-now called periodic performance
reviews-related to quality care and patient safety.
"We'll look at the processes and make sure they're
in compliance with our standards before ever going on-site,"
Murphy-Knoll said.
She said she has received positive e-mails from staff
nurses who like the new idea of randomly selecting patients
for evaluating standards of care.
"Nurses see the process as very credible, and
many have been pushing for this for years. They want
us to really look at what's happening in hospitals,
not at what is prepared for an accreditation visit."
Uttley said she's been "living and breathing"
JCAHO awareness since being in charge of preparing Children's
Memorial nurses and staff for unannounced visits and
the changes in how evaluations will be done.
She said nurses were taking part in a big push to keep
patient safety and staff effectiveness "in people's
heads" and that a JCAHO preparedness fair was being
planned. The fair would use entertaining ways to educate
the staff, such as flash cards, games and interactive
computer programs that focus on safety standards and
optimal practices, Uttley said.
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