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JCAHO surveyors fail to identify critical patient safety hazards, such as infection control issues and fire-related hazards, according to a scathing report released by the Government Accountability Office (GAO) July 20.

Patient Safety Monitor Alert, July 21, 2004

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JCAHO surveyors fail to identify critical patient safety hazards, such as infection control issues and fire-related hazards, according to a scathing report released by the Government Accountability Office (GAO) July 20.

The GAO reviewed 500 hospitals that were surveyed by the JCAHO and by state surveyors who validate JCAHO surveys. It found that JCAHO surveyors failed to identify patient safety deficiencies 31% (157 hospitals) of the time.

In addition, at least one of the deficiencies that JCAHO surveyors missed is a National Patient Safety Goal required by the JCAHO.

Among the weaknesses that JCAHO surveyors failed to detect, according to the GAO, include:

• An inability to assure competent performance of physicians and nurses 
  
• A failure to adequately protect patients and staff from fire-related disasters 
  
• Inadequate hospital procedures to prevent the spread of infections (National Patient Safety Goal #7).

"A single deficiency in a Medicare requirement can limit the hospital's capability to provide adequate care and ensure patient safety and health," the GAO states in the 56-page report ("CMS Needs Additional Authority to Adequately Oversee Patient Safety in Hospitals," GAO-04-850).

JCAHO dismisses the GAO's findings as "misleading" and says that most of the JCAHO-accredited hospitals that the GAO reviewed were in compliance with Medicare requirements.

"It is irresponsible to alarm the public using statistics that have little meaning, and that do not reflect the true level of diligent oversight of America's hospitals through Medicare's public-private sector partnership with the Joint Commission," the JCAHO says in a written statement.

The GAO report recommends that CMS have the same oversight authority over JCAHO as it currently has over all other organizations with accreditation authority (I'm surprised it doesn't already). U.S. Rep. Pete Stark (D-CA) and Sen. Charles Grassley (R-IA) responded by introducing legislation July 20 that would accomplish this goal.

This is not the first time that the JCAHO has come under fire. A 1999 investigation by the Health and Human Services Office of the Inspector General concluded that JCAHO accreditation surveys failed to identify patterns of deficient care.

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