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What to expect during the JCAHO's patient safety and med interview

Nurse Leader Weekly, March 21, 2003

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As of January 2003, surveyors from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) are replacing their patient care interview with a 30-45 minute "patient safety and medication use interview." The interview, which applies only to hospitals, is held just prior to unit visits. For a two- or three-day survey, only one surveyor will conduct the interview. For a four- or five-day survey, all the surveyors will visit your hospital.

(Note: The JCAHO will likely eliminate the patient safety interview come 2004-see the box below for more information on what to expect next year.)

Mark Forstneger, a spokesperson for the JCAHO, recommends that hospitals up for survey this year forego a large group or manager/ director-level attendees at the interview in favor of "knowledgeable individuals with direct, hands-on responsibilities." These individuals could include direct caregivers such as nurses, doctors, respiratory therapists, pharmacists, or social workers.

Medication, pharmacy and therapeutics (P&T), and pain control committee members also might be good additions, says a JCAHO observer. In addition, facilities should include performance improvement (PI) representatives-if they've had any patient safety PI projects-and someone who can talk about your Failure Modes and Effects Analysis (FMEA).

Focus areas

Not surprisingly, the new interview will focus on issues such as patient safety, medication management, and caregiver communication, according to Forstneger.

Part of its purpose is to help surveyors understand a facility's policies so they can determine whether the policies jibe with what they see actually happening in the units. For instance, staff might tell a surveyor during the interview that they moved intravenous (IV) pumps closer to the nursing station because they couldn't hear them at the end of the hall. Then, when a surveyor conducts a unit tour and sees someone with an IV pump at the end of the hall, he or she may say "Gee, are you supposed to be doing that?" according to the observer.

Surveyors will be specifically interested in how you've implemented the 2003 National Patient Safety Goals, as well as how you've measured your success, through tactics such as random audits. "That's probably the number-one thing," says the JCAHO observer.

Adapted from: Briefings on JCAHO, www.hcmarketplace.com/Prod.cfm?id=16&S=ENMW

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