In late 1999, the Institute of Medicine issued a report regarding medical errors in United States hospitals. The report concluded that every year, as many as one million hospital patients are injured and 98,000 die as a result of preventable medical errors, costing the nation an estimated $40 billion annually. In response, the Joint Commission on Accreditation of Health Care Organizations (JCAHO) issued uniform standards for caregivers to follow in order to reduce the occurrence of medical errors.
Joint Commission on Accreditation of Health Care Organizations
The JCAHO is an entity that develops standards for health care organizations intended to improve the safety and quality of care provided to the public. Comprised of a board of physicians, nurses, and consumers, the JCAHO is an independent non-profit organization which provides health care accreditation to health care organizations. In mid-2002, the JCAHO issued National Patient Safety Goals (NPSGs), addressing common medical error problems.
Common Types of Medical Errors
- Medication – being given the wrong drug or dose, or drugs given at the wrong time or to the wrong patient
- Wrong-site surgery – surgeries performed on the wrong part of the body or on the wrong patient; sometimes the wrong operation is even performed
- Hospital-acquired infections – infections caused by lack of proper hygiene (usually occurring when a physician or nurse fails to sufficiently wash their hands) or use of defective medical equipment
Common Reasons for Medical Mistakes
- Misplaced patient charts or illegible handwriting
- Overworked, inexperienced and unsupervised interns and residents, particularly at teaching hospitals, who may work as many as 130 hours per week
- Nationwide shortage of registered nurses
- Increasing caseload demands on emergency rooms with limited funding
Precautions a Health Care Organization Should Take – NPSGs
The NPSGs issued by the JCAHO seek to provide uniform standards by which health care organizations must comply. The JCAHO has outlined several NPSGs for 2010. The JCAHO intends to issue new or revised NPSG requirements every year.
The 2010 NPSGs include:
- Improve the accuracy of patient information
- Improve the effectiveness of communication among caregivers
- Improve the safety of using medications
- Reduce the risk of health-care associated infections
- Accurately and completely reconcile medications across the continuum of care
- Reduce the risk of patient harm from falls
- Reduce the risk of influenza and pneumococcal disease in older institutionalized adults
- Reduce the risk of surgical fires
- Encourage patients' active involvement in their own care as a patient safety strategy
- Prevent health care-associated pressure ulcers
- Identify safety risks inherent in the patient population
Compliance with NPSGs
The JCAHO evaluates more than 15,000 health care organizations including ambulatory care, assisted living facilities, behavioral care facilities, home care, hospitals, laboratories, long term care facilities, HMOs, and office based surgery facilities. In order to earn and maintain accreditation, these health care organizations must go through extensive on-site reviews by a JCAHO team at least once every three years. If the health care organization's performance complies with the standards to the satisfaction of the JCAHO, they will be awarded accreditation. A list of accredited organizations is posted on the JCAHO's website and updated periodically.
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