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Greeley Reflections

Accreditation Connection, September 21, 2009

Prudence or wisdom? Can your policies pass muster?

Part 1 of 4

In 1751, Dr. Thomas Bond and Benjamin Franklin founded the first hospital of the 13 colonies. At that time, Philadelphia was the fastest growing city, boasting a population in 1730 of 11,500 that grew to 15,000 in 1750. The mission of Pennsylvania Hospital, as it was then known, was “to care for the sick, the poor, and the insane who were wandering the streets of Philadelphia.”

Patients were expected to follow strict rules and policies. They had to comply exactly with orders given by physicians and nurses. There was no talking allowed on the wards when the physicians were present. Patients could not be in the bed unless they were in bedclothes— no street clothes were allowed. There was to be no profane language, gambling, or spitting on the floors. And the one that I personally like the best...If you were able, you were expected to help the nurse with her duties.

Imagine updating those policies to match practice today?

Organizations have developed processes to ensure that policies are reviewed and revised as appropriate. This practice can vary a great deal from one organization to another. Many organizations divide the policies and they are reviewed and revised, often by people who do not have first-hand knowledge of the process. Others may choose to accomplish this by committee, which results in policies being revised without the input of those who must comply with the policy.

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