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The JCAHO expects consistent answers from your staff during survey

Accreditation Connection, June 25, 2004

One nurse surveyor toured Shriners Hospital for Children over a three-day period in February, and rather than meet with hospital leaders, the surveyor preferred to chat with frontline works, patients, and their families, says Mary Jaco, RN, MSN, the facility's nursing director of inpatient services. The surveyor expected consistent answers among staff.

For example, after talking to the nurse about the dietician's role, a surveyor will then talk to the dietician to find out whether he or she offers the same information, according to Jaco. The surveyor wants to see consistency between what the nurse says and the dietary screens show.

Likewise, the surveyor asked one nurse about how she treated a patient's pain on a particular shift. The surveyor checked with other nurses on the same shift to see whether everyone treats pain in the same manner and can respond accordingly.

"The surveyor asked about patient-specific issues when looking for information, rather than general hospital questions," she says.

The surveyor also asked physicians about ordering medications for pain. After asking as many as eight questions about pain medications and the ordering process, the surveyor would then walk up to a nurse on the unit and query about the same process.

Double checking the same piece of information among many staff members means that surveyors will surely discover any weak areas, Jaco says.

"I see that the JCAHO is training surveyors to be patient-focused since our surveyor really knew what she was doing and what she was looking for," she says. "It wasn't just about looking over policies on pain management."

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