Accreditation Newsletters

Ambulatory Quality and Compliance Insider Briefings on The Joint Commission

Briefings on The Joint Commission will help you with all of your accreditation and survey preparation needs. Every month, BOJ takes a look at problematic standards, identifies best practices, and clarifies the latest updates and changes from The Joint Commission, CMS, and other regulatory and accreditation organizations. BOJ also offers bonus content, tools, sample policies, and more online.

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Briefings on The Joint Commission

Issue 12, December 1, 2005 - VIEW THE FULL ISSUE

• Policy not the only answer to range order problems

  Get all staff on the same page when it comes to range orders and make sure they know how to...

• Three tips for successful reconciliation training

  Editor's note: The following is an excerpt from the book Medication Reconciliation: Practical...

• Validation survey may precede status change

  The JCAHO may conduct validation surveys to justify changing a hospital's accreditation status from...

Issue 11, November 1, 2005 - VIEW THE FULL ISSUE

• Safety culture becomes part of proposed leadership standards

  After proposing to regulate a culture of safety in the National Patient Safety Goals earlier this...

• JCAHO to check emergency plans

  Surveyors will scrutinize emergency management and preparedness plans for hospitals with more than...

• Certification opens new opportunities for hospitals

  With an increased public focus on healthcare quality and state legislatures considering laws...

• Experts answer frequently asked goals questions

  Della Lin, MD, chief executive director of continuing medical education at Queen's Medical Center...

• PPR can help prepare hospitals for real deal

  Although the length of a PPR survey may mimic a real JCAHO inspection, organizations might find...

Issue 10, October 1, 2005 - VIEW THE FULL ISSUE

• Katrina's lessons for hospitals

  Soon after one of the deadliest hurricanes in American history made landfall southeast of New...

• JCAHO IDs potential goals

  Assessing a culture of safety by using technology such as bar coding to identify patients and...

• Four tips to meet JCAHO hand-off goal

  A JCAHO National Patient Safety Goal for 2006 will require hospitals to look beyond the obvious to...

Issue 9, September 1, 2005 - VIEW THE FULL ISSUE

• Tracers, PPR approach give one hospital perfect JCAHO survey

  Intensive mock tracers and a focused PPR helped one New Jersey hospital come away from its July...

• Get in line with JCAHO abuse-prevention rules

  Statistics have shown that an estimated 1 million to 2 million people age 65 or older in the United...

• Use JCAHO survey prep methods to meet CMS requirements, survive CMS survey

  Preparing for a JCAHO survey should help get your facility ready for a CMS inspection, but the...

Issue 8, August 1, 2005 - VIEW THE FULL ISSUE

• 'Disaster plan' helps staff prep for unannounced survey

  Having a strategy similar to a disaster plan will help your organization prepare for an unannounced...

• Hospitals get satisfaction through patient surveys

  Keep your hospital's patient satisfaction survey concise and to the point. This strategy will help...

• Experts provide 10 CMS survey prep tips

  Editor's note: The following Q&A is adapted from the June 21 audioconference, "CMS Survey: Insider...

Issue 7, July 1, 2005 - VIEW THE FULL ISSUE

• JCAHO announces 2006 NPSGs

  Learning objectives: After reading this article, you will be able to 1. identify the JCAHO's...

• PPR options 2 and 3 becoming a 'real' survey

  Learning objectives: After reading this article, you will be able to 1. describe the periodic...

• Involve physicians in H&P form development

  Learning objectives: After reading this article, you will be able to 1. explain the importance...

Issue 6, June 1, 2005 - VIEW THE FULL ISSUE

• JCAHO releases a slew of new FAQs

  History & physical changes nearly go unnoticed If you caught spring fever, you may have missed...

• Protect against imposter surveyors

  Recent mainstream media news stories and a bulletin from the U.S. Department of Homeland Security...

• Track JCAHO compliance with a dashboard

  Dashboards that track JCAHO standards are powerful tools for survey coordinators who want to...

Issue 5, May 1, 2005 - VIEW THE FULL ISSUE

• Eight tips for advance directives

  Eight tips for advance directives The death of Terri Schiavo in Florida on March 31 renewed the...

• Stroke care saves money, empowers staff at one facility

  Stroke care saves money, empowers staff at one facility Editor's note: This is the second in a...

• Preanesthesia assessment tool impresses surveyors

  Preanesthesia assessment tool impresses surveyors One hospital's preanesthesia assessment tool...

• Tips to comply with operative procedures

  Tips to comply with operative procedures Hospitals have difficulty complying with PC.13.20, the...

Issue 4, April 1, 2005 - VIEW THE FULL ISSUE

• Hospital learns informed staff are essential to system tracers

  That advice comes from Debra Hudmon, BSN, quality improvement and patient safety coordinator at...

• JCAHO stroke center certification meets emerging standard

  Editor's note: This is the first in a two-part series about JCAHO primary stroke center...

• Six steps for submitting a clarification to JCAHO

  Hospitals continue to struggle with writing clarifications of how they comply with a standard...

Issue 3, March 1, 2005 - VIEW THE FULL ISSUE

• Three strikes and you're out

  Surveyors will now score two National Patient Safety Goal (NPSG) requirements that no longer...

• What to expect when LSC surveyors arrive at your facility

  If a Life Safety Code® (LSC) specialist is part of your facility's survey team, you can expect a...

• JCAHO may add eight new Patient Safety Goals

  Prevention of surgical fires and patient harm due to emotional and behavioral crises are among the...

• Use dashboards to give your facility's data meaning

  When you're driving a car, which is more meaningful to you: How fast the wheels are turning or how...

• Case study: Hospital chooses PPR option one

  Choosing option one for the periodic performance review (PPR) wasn't nearly as hard as submitting...

Issue 2, February 1, 2005 - VIEW THE FULL ISSUE

• LSC engineer to scrutinize your hospital's EC issues

  The addition of a Life Safety Code® (LSC) engineer on JCAHO survey teams this year means survey...

• Surveyors trace patients while hospital traces surveyors

  One of the greatest anxieties for survey coordinators on survey day is not knowing where surveyors...

• Latest Sentinel Event Alert focuses on PCA danger

  Editor's note: This story is adapted from a fax express sent to BOJ subscribers December 20 after...

• Q&A

  Ask the experts: Answers to your questions about patient falls risk assessment and...

• The staff have spoken: Staff education is a hit

  A $1 million prize wasn't at stake, but staff education achieved through "Survivor" games may mean...

Issue 1, January 1, 2005 - VIEW THE FULL ISSUE

• Learn how a model hospital maximized throughput

  The JCAHO's new patient flow standard, LD.3.15, takes effect this month, and JCAHO president Dennis...

• Survey focuses on nursing shortage, staffing effectiveness, and credentialing

  If a candidate for a nursing position walked in the front door to apply, could he or she get an...