Joint Commission’s 2009 patient safety goals

---have just been rolled out (H/T to Wachter’s World). Here’s my take on a few of the hospital goals. (I’m not sure which ones are changed from 2008 but these are some I found interesting).

Redundancy: For identifying the correct patient and the correct surgical site. Bar coding is part of this redundancy. It doesn’t replace people.

Infection control: Lots of organizational structure and documentation requirements found here. Expect more paper shuffling and longer committee reports. Buried somewhere in all this verbiage are the actual best practice recommendations for prevention of central line and surgical infections. Facility associated infections that result in unexpected death or permanent loss of function are to be handled as sentinel events.

Medication reconciliation: At discharge the medication instructions must be both written and verbal (you can’t just hand the patient a piece of paper!). What about in the ER? Say the patient comes in with a laceration. Do you have to do complete med rec? No. It’s not required provided the patient is cognitively intact, not admitted and no changes are made in long term medications. If the patient has changes made in long term medication, is admitted, or is confused a complete medication reconciliation process, to include documentation of name, dose and route, is required.

Fall prevention: I was underwhelmed by this section. More paper work, committee reports and raised awareness won’t do it. They’ve taken away restraints and Vail beds. If you want to make patient falls a never event, hire a sitter for every elderly patient. (What hospital can afford that?). Otherwise they’re gonna fall.