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JCAHO announces shift to unannounced surveys
SARS restrictions cause stress for Toronto hospitals
Some Florida hospitals treat patients to valet service

Patient Safety Monitor Alert, April 8, 2003

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JCAHO ANNOUNCES SHIFT TO UNANNOUNCED SURVEYS

Expect the unexpected: that's the message from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), which recently announced it will not forewarn hospitals about the date of their regular triennial surveys beginning in 2006.

Both the JCAHO and industry experts claim that the evolution to unannounced surveys is a logical progression of the JCAHO's new survey process, "Shared Visions-New Pathways," which takes effect in 2004.

"The new accreditation process creates the expectation that each accredited organization will be in compliance with 100% of the Joint Commission's standards 100% of the time," said Dennis O'Leary, MD, the JCAHO's president, in a press release last week.

Next year, the JCAHO will pilot test the unannounced triennial survey process at 100 volunteer hospitals. Children's Memorial Hospital in Chicago will be the first in the country to participate, according to the JCAHO's press release.

In 2005, the JCAHO will continue to conduct voluntary unannounced surveys on a limited basis, "opening up the option to all types of accredited organizations" and then transition to a completely unannounced survey program in 2006. During this time the JCAHO will work with its advisory groups and accredited organizations to seek input and refine the new process to make this transition as smooth as possible, according to the release.

SARS RESTRICTIONS CAUSE STRESS FOR TORONTO HOSPITALS

For health care workers in Toronto, dry coughs, headaches and fever aren't the only symptoms of the Severe Acute Respiratory Syndrome (SARS) virus. They're also experiencing stress from the hospital closures and restrictions caused by the outbreak.

As of Sunday, nine people in Ontario had died from the disease, and the province had reported 179 suspected cases.

After staff and other patients began to develop headaches, dry coughs, and fevers-common symptoms of SARS-officials closed Scarborough Grace Hospital, where Chi Kwai Tse, the son of the woman who reputedly brought SARS to Canada from China, died. They later closed two additional hospitals-York Central and Toronto Western-where SARS patients died, according to the Atlanta Journal-Constitution.

Other hospitals have had to create special SARS isolation units, and are operating under "code orange"-which means they only provide essential services. Restrictions such as these threaten to overload Toronto hospitals. "We have a system that's already backlogged," Barb Wahl, president of the Ontario Nurses' Association, told the newspaper. "This will backlog it even further." Authorities have restricted or forbidden family members from visiting patients at some hospitals.

Murray Martin, the chief executive officer of Hamilton Health Sciences, Toronto's largest hospital, told the [Toronto] Hamilton Spectator that the organization is screening everyone who walks in the door for the virus, a process which eats up valuable time and resources.

SOME FLORIDA HOSPITALS TREAT PATIENTS TO VALET SERVICE

Patients pulling into a handful of Jacksonville, FL hospitals' parking lots may think they've taken a wrong turn and mistakenly driven up to the Ritz Carlton. In the name of patient safety, Lt. Luke's Hospital and Memorial Hospital are borrowing an idea from hotels and fine restaurants: valet service.

The facilities contracted with valet companies to provide the service for both patients and visitors, according to the [FL] Augusta Chronicle.

"Hospitals and health care centers are always trying to find ways to make things safer," Carol Chaffin, a spokesperson for St. Luke's, told reporters. The valet service is safer than commonly used shuttle services, she said. "These people, in addition to parking cars, can assist visitors in and out of their cars at the entrance, since there are a lot of people who need help."

St. Luke's charges visitors $3 for the service. Other area hospitals offer a similar parking service for free. Geri Evans, a spokesperson for the Florida Hospital Association, told reporters that though many major hospitals in Orlando provide some form of parking assistance, she hasn't heard that it's a big trend elsewhere.

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