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The Joint Commission Announces 2008 National Patient Safety Goals for Ambulatory Care and Office-Based Surgery

By admin | July 2, 2007

OAKBROOK TERRACE, IL – July 2, 2007 The Joint Commission today announced the 2008 National Patient Safety Goals and related Requirements that will apply specifically to accredited ambulatory care facilities and offices in which surgery is performed.

The major change in this sixth annual issuance of Ambulatory Care and Office-Based Surgery National Patient Safety Goals, which were recently approved by the Joint Commission’s Board of Commissioners, is a new Requirement to take specific actions to reduce the risks of patient harm associated with the use of anticoagulant therapy. This Requirement addresses a widely-acknowledged patient safety problem and becomes a key element of the Goal: “Improve the safety of using medications.” In order to assure smooth implementation, this new Requirement has a one-year phase-in period that includes defined milestones. Full implementation is targeted for January 2009.

In addition, the Requirement that addresses hand hygiene has been expanded to permit use of the World Health Organization (WHO) Hand Hygiene Guidelines as an alternative to the Centers for Disease Control and Prevention (CDC) guidelines. Finally, the Requirement to limit and standardize drug concentrations that is part of the Goal to improve the safety of using medication will be retired as a National Patient Safety Goal, but organization compliance will continue to be evaluated as part of the Medication Management standards.

“The 2008 National Patient Safety Goals seek to focus the efforts of health care organizations on the priority areas where the opportunities for improving patient safety are greatest,” say Dennis S. O’Leary, M.D., president, The Joint Commission. “Consistently putting these Requirements into action will benefit millions of patients.”

The development and annual updating of the National Patient Safety Goals and Requirements continue to be overseen by an expert panel that includes widely recognized patient safety experts, as well as nurses, physicians, pharmacists, risk managers and other professionals who have hands-on experience in addressing patient safety issues in ambulatory care and other health care settings. Each year, this Sentinel Event Advisory Group works with The Joint Commission to undertake a systematic review of the literature and available databases to identify candidate new Goals and Requirements.

Following a solicitation of input from practitioners, provider organizations, purchasers, consumer groups, and other parties of interest, the Advisory Group determines the highest priority Goals and Requirements and makes its recommendations to The Joint Commission.

The 2008 Ambulatory Care and Office-Based Surgery National Patient Safety Goals are:

Improve the accuracy of patient identification.
* Use at least two patient identifiers when providing care, treatment or services.

Improve the effectiveness of communication among caregivers.
* For verbal or telephone orders or for telephonic reporting of critical test results, verify the complete order or test result by having the person receiving the information record and “read-back” the complete order or test result.
* Standardize a list of abbreviations, acronyms, symbols and dose designations that are not to be used throughout the organization.
* Measure and assess, and if appropriate, take action to improve the timeliness of reporting, and the timeliness of receipt by the responsible licensed caregiver, of critical test results and values.
* Implement a standardized approach to “hand off” communications, including an opportunity to ask and respond to questions.

Improve the safety of using medications.
* Identify and, at a minimum, annually review a list of look-alike/sound-alike drugs used by the organization, and take action to prevent errors involving the interchange of these drugs.
* Label all medications, medication containers (for example, syringes, medicine cups, basins), or other solutions on and off the sterile field.
* Reduce the likelihood of patient harm associated with the use of anticoagulation therapy.

Reduce the risk of health care-associated infections.
* Comply with current World Health Organization (WHO) Hand Hygiene Guidelines or Centers for Disease Control and Prevention (CDC) hand hygiene guidelines.
* Manage as sentinel events all identified cases of unanticipated death or major permanent loss of function associated with a health care-associated infection.

Accurately and completely reconcile medications across the continuum of care.
* There is a process for comparing the patient’s current medications with those ordered for the patient while under the care of the organization.
* A complete list of the patient’s medications is communicated to the next provider of service when a patient is referred or transferred to another setting, service, practitioner or level of care within or outside the organization. The complete list of medications is also provided to the patient on discharge from the facility.

Reduce the risk of surgical fires.
* Educate staff, including operating licensed independent practitioners and anesthesia providers, on how to control heat sources and manage fuels with enough time for patient preparation, and establish guidelines to minimize oxygen concentration under drapes.

Encourage patients’ active involvement in their own care as a patient safety strategy.
* Define and communicate the means for patients and their families to report concerns about safety and encourage them to do so.

CLICK HERE to view the 2008 National Patient Safety Goals.

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