CE spotlight: Florida hospital system weathers survey surprises

Nurse Leader Insider, June 22, 2009

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One survey. Five hospitals. More than 40 ambulatory and outpatient locations. When Joint Commission surveyors arrived at Lee Memorial Health Systems in Fort Myers, FL, in November 2008, the result was a weeklong survey on an epic scale. But the health system was ready, having mirrored its survey readiness plan on an unusual but appropriate model: an emergency management plan. Each surveyor was assigned a chaperone and a scribe.

"Everyone was educated in their roles for survey," says Chris Crawford, RN, MHA, LHRM, system director of standards and quality at Lee Memorial. "We had a command center set up, and if the surveyor had a need, the scribe could call the command center to ensure that whatever documentation the surveyor was looking for was made available to them."

The scribe also kept the command center aware of the surveyor's location, next destination, and his or her findings and concerns. At the end of each day, the health system held a debriefing session and discussed possible requirements for improvement officials believed were imminent.

The Joint Commission (formerly JCAHO) sent eight surveyors to survey the five hospitals and their combined 1,400 beds, plus 44 related outpatient and ambulatory sites.

"Our plan got blown up the first day," says Crawford. Lee Memorial had initially anticipated that the surveyors would break up and go to different hospitals, with one surveyor to each hospital, two surveyors to the outpatient and ambulatory sites, and a Life Safety Code® surveyor.

Editor's note: This excerpt was adapted from the new CE article, "Florida hospital system weathers survey surprises" featured in The Reading Room on HCPro's online resource center,

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