Patient Safety - Reality Check

JCAHO

pronounced Jayco
http://www.jointcommission.org/

They say that their mission is: "To continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value." Unfortunately the board of directors of JCAHO usually has been dominated by representatives of the American Medical Association and the American Hospital Association, which raises concerns about conflicts of interest and the extent to which it can have a perspective that is objective and honest enough to do what must be done to improve safety and quality.

In fairness, where would they find executives with experience that didn't have a conflict of interest, like people with experience managing patient advocacy organizations? We don't have appropriate career paths to produce those people yet since no one is in that business yet.

Their initials stand for The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), but generally they are referred to as The Joint Commission.

They set standards for healthcare organizations and issue accreditation to organizations that meet those standards. JCAHO conducts periodic on-site surveys to verify that "an accredited organization substantially complies with Joint Commission standards and continuously makes efforts to improve the care and services it provides."

The Joint Commission evaluates and accredits more than 19,000 healthcare organizations and programs in the United States. Operating since 1951, it is an independent, not-for-profit organization and is the nation’s predominant standards-setting and accrediting body in healthcare.

However, according to The Massachusettes Nurses Association News at
http://www.massnurses.org/news/2004/10/JCAHOhtm.htm,
critics say that it is more lapdog than watchdog. In that article, Karen Higgins, RN says, "The hospitals are given notice of pending surveys, and they spend months preparing to get ready. Staffing always improves around the time of a JCAHO visit, and it goes right back to normal (usually bad) immediately after."

Based on a survey of 500 hospitals inspected by JCAHO between 2000 and 2002, the report found that the organization failed to identify 167 of the 241 deficiencies state inspectors later found at the facilities, or 69 percent of the total.

During the entire tenure of JCAHO there have been regular revelations about the amount of unnecessary death and injury in medicine with no overall improvement in those numbers and almost no changes in the way medicine is practiced.

Perhaps things would be worse without them, but when were such watchdogs ever able to do a better job of protecting people than the people could do for themselves when they they were able to get the right information to work with, which they cannot get from medicine. Patients are going to have to establish the means to get it themselves.