JCAHO Releases 2006 Draft Standard Updates

The Joint Commission on Accreditation of Healthcare Organizations has released draft 2006 standards for various care settings. Links to the draft standards are posted below.

Among the changes is an expanded primary source verification requirement under HR.1.20:
For all practitioners for which a license, certification, registration is required to perform their job responsibilities, the following information is verified from the primary source at the time of hire (and at least every two years): licensure, certification, or registration.

There is also expanded language under LD.3.70 pertaining to credentialing of non-employee allied health or CAM providers.

Critical Access Hospitals
Ambulatory Care
Behavioral Health
Long Term Care
Office-Based Surgery

The Disagreeable Physician: Disruptive or Disputative?

Defining disruptive physician behavior can be challenging. The Health Care Law Blog addresses the question of Disruptive v Disputive behavior. (April 28, 2005)

Abusive conduct leads to team dysfunction in the hospital which can translate into real and immediate patient harm. The hospital and its medical staff can and should act to suppress or control this kind of disruptive behavior. See Evan v. Longmont United Hospital Assn., 629 P.2d 1100 (Colo. App. 1981)

On the other hand, what about the physician who is constantly a thorn in the side of hospital administration…


State Association Meetings

I’ve been traveling recently, which is why I haven’t posted for a few days.

I had the opportunity to attend a couple of different State Association conferences during April, and really enjoyed both programs as well as the opportunity to network with peers.

I’ll post a few highlights here on the MSSPNexus Blog in the next several days.

If you’ve recently attended a conference and learned something new, or had a bit of knowledge reaffirmed, send me a note and I’ll try to include it here.

One of the best features of the medical staff services profession is that we offer great peer to peer support.

JCAHO Issues Several Updated FAQs

The Joint Commission recently updated several of the FAQs posted on their web site pertaining to Hospital Standards:

What level of credentialing, if any, must occur for a non-medical staff member licensed independent practitioner who order laboratory tests or radiology procedures?

Does the requirement for a fair hearing and appeal process apply only to members of the medical staff and others holding clinical privileges who have completed the credentialing and privileging process or does it also apply to individuals holding temporary privileges?

Who can provide a peer reference for independent or dependent allied health practitioners such as nurse practitioners, physician assistants, and psychologists, midwives, and social workers when there is no other similar practitioner on staff?

Can the responsibility for performing the admission history and physical examination be delegated to a practitioner such as an advanced practice nurse, physician’s assistant, or registered nurse who are not licensed independent practitioners (LIP)?

Hospital Follows Bylaws and gets HCQIA Immunity

The Horty-Springer web site reports on a professional review action taken against a physician in Ohio. The physician’s suit in response against Parma Community General Hospital was unsuccessful in part, because the hospital had followed its Bylaws.

The court ruled that the hearing process met all of the peer review requirements under the HCQIA and, as a result, the hospital and participating physicians were entitled to statutory immunity.

Read the Case Summary

Surviving a Hotel Fire

Many of us stay in hotels when we travel for work or pleasure. The US Naval Safety Center reports that about a thousand fires occur in hotels and motels every year. Hotel fires can be particularly disorienting because we’re in unfamiliar surroundings.

I’ve experienced two hotel fires in the past few years. I was evacuated from the 17th floor in one of them. It was during the day so at least I wasn’t trudging down 17 flights of stairs in my nightgown, and there was no obvious flame or smoke in that one. What was eye-opening was how completely panicked some guests were. A few ran past me at such speed that I half expected to hear them tumbling down a flight of concrete steps. In each case the fire was quickly brought under control and I was able to return to my room, but obviously that’s not always the case.

Therefore, I’m posting a few survival tips from the US Navy:

  • Pack a flashlight.
  • As soon as you check in, take time to identify exits, stairwells and escape routes. Count the number of doorways between your room and the nearest exit.
  • Put your room key on the nightstand or in a clothing pocket so you can find it easily.
  • In case of fire, stay low by crawling to the door, feel it. If it or the knob is hot, don’t open it. If it is cold, open it slowly, and be prepared to shut it quickly if smoke pours in.
  • If you’re trapped in your room, fill the bathtub. Soak towels and sheets, even the mattress, and put them around cracks in the doorway and any place else smoke can seep into the room.
  • If the window won’t open, you may not want to break it because you won’t be able to close it if smoke appears.

More fire survival tips from the US Naval Safety Center

Keyboard Use Contributes to Spread of Bacteria

It comes as no surprise to those of use who use computers frequently – keyboards get dirty. That’s more than just an unsightly inconvenience in view of the push toward increased use of electronic medical records and order entry in healthcare settings.

Even if a healthcare worker is diligent about hand washing between patients, all it takes is a few keystrokes to contaminate hands or gloves. A study recently completed at Northwestern Memorial Hospital in Chicago shows that harmful bacteria can survive up to 24 hours on computer keyboards.

It’s time to issue a challenge to computer designers and manufacturers to develop an improved keyboard that is both easy to use and easy to clean. It could be a matter of life and death.

CNN Report

Seattle Post Intelligencer Report

Do Doctors Encourage Their Kids to Go to Medical School?

In a recent poll on DocsBoard physicians were asked whether they would encourage their children to go to medical school. At the moment the results are running 81% No, 19% Yes.

Among the comments:

  • Yes, but not necessarily for clinical practice… I’ll need someone who knows something to protect me from all of the “allied health professionals” when I get old.

  • OK, the social respect ain’t what it used to be, and the pay isn’t what hard-driving MBAs get nowadays, but the intangibles are terrific.

  • I would rather raise my children to get adequate life-satisfaction from some endeavor less likely to drain them or disillusion them.

  • In good conscience, I couldn’t. There are simply too many negatives nowadays. Medicine has its rewarding moments, but they are fewer and farther between all the time and the future looks only worse. There are other careers that are as fulfilling and rewarding with less burdens and frustrations.

Read the Discussion Board Thread

Powerful Language Skills

I’m reading a book called “How To Say It – For Women” by Phyllis Mindell, Ed.D. Over the years I have witnessed many women damage their own chances of being respected and taken seriously through choice of words and communication styles. At times, I’ve been among them.

The author advises women to “trim their hedges.” Women (more often than men) use hedges to soften their statements so as not to appear aggressive or difficult.

For example, do you find yourself frequently using these openers?

In my opinion…
I guess..
I just…

If so, think about the impact of the following two statements:

I feel that my team has way too much work to do and will never be able to get it all done.

The heavy workload assigned to the team prevents our meeting deadlines.

The same information is conveyed, but the first statement focuses on the speaker – I feel, the second statement focuses on the problem – the heavy workload.

I suspect that for most of us, trimming hedges is going to take some practice.

Watch for more communication tips in future postings.