There have been dire need to improve the quality of healthcare services provided to the patients, a lot of enough effort limited to policies, infrastructural improvement and upgrade and staff empowerment have been effected to trigger patient safety, quality medical care and reduce the cost of medication. Different approaches have been affected in the healthcare system to realign the health sector towards the objective of the provision of quality services; of the all the approaches, the joint commission have had significant effects of the general operations in the healthcare system since its inception.
History of the Joint Commission
The Joint Commission has been in existence for more than half a century, it was founded in 1951 as an independent not-for-profit organization whose functions as standards-setting and accrediting body in health care included evaluating health care organizations and inspiring them to succeed in providing safe and effective care of the highest quality and value. While the organization officially started its operation in the early 1950s, it traces its origin and development much earlier in the twentieth century. Its development was a culmination of the long desire and need to have a fully independent functional body that could oversee safety in the health institution. The first foundation of what will be the Joint Commission started in 1910 when Ernest Codman, M.D proposed an end result system of hospital standardization leading the American College of Surgeons, a body whose objective included the consideration of the end result system. In 1926 the first standards manual is printed, consisting of 18 pages (jointcommission.org) was written giving more pronounced steps towards the formation of the organization.
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While it began as a voluntary organization, the Joint Commission on Accreditation of Healthcare system (JCAH) widened its province of operation and started charging for the services. The Social Security Amendments of 1965 passed by the Congress in which it asserted “a provision that hospitals accredited by JCAH are “deemed” to be in compliance with most of the Medicare Conditions of Participation for hospitals”(jointcommission.org) reinforced the position of the organization, and since then, its impact to the health care, in general, has been immense.
Purpose of Joint Commission
The purpose of the Joint Commission ranges across varies components of the healthcare sectors such as Medicare, integrity, patient care and state compliance. In terms of patient care, the organization focuses in an extensive investigation that covers a myriad of activities such as nursing care, medication management and safety standards as well as patient privacy. Generally, the Joint Commission as an accreditation agency has its purpose aligned in accordance with the need to provide improved health care. Joint Commission sets its mission as “o 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.” Such missions are achieved through the accreditation and survey programs that intend to improve the delivery services, ethical working environment s and compliance with the set code of conducts and rules by all stakeholders in the industry. There exist various initiatives set forth to ensure that there is implementation, they includes an unannounced or random survey and data-based intra-cycle monitoring.
Another purpose for the existence of the joint Commission has been to evaluating organization standards; under this orientation, the organization deploys various strategies such as on-site survey that is aimed at maximum collection of data and patient –concerned and focuses of evaluating the actual care administered to the patient. Under this goal, the organization not evaluates the performance of the institutions but also provide teaching and training on the best way to achieve the best health practices. The purpose of the organization also border around the advancing safety and quality, the progress towards this goal has been made through numerous measure not limited to the establishment of reports of patients of patient safety concerns and improve the quality and safety of the accredited members.
Data Repositories
Data is a critical aspect of the healthcare sector, its collections, management and utilization define quite a lot in relation to the provision of better healthcare. Usually data as a tool for assessing the viability of a given project and a measure of the implementation plan. The Joint Commission being aware of the tough mandate they have and also in line with the purpose and the objective of the organization, they manage a data repository that enables that measure their actions towards the goal set. Therefore, the Joint Commission operates the electronic clinical quality measure (eCQM) database. Under this database, the organizations put it as mandatory for the critical access hospitals and small hospitals must report on a total of 6 measures applicable to the services provided and patient populations served by the hospital. The eCQM variety of activities such as (ED-1) Median Time from ED Arrival to ED Departure for Admitted ED Patients, (ED-2) Admit Decision Time to ED Departure Time for Admitted Patients, (VTE-6) Incidence of Potentially Preventable VTE among other essentials.
Joint Commissions Tool for measuring performance
The healthcare sector requires proper and efficient strategies for assessing the performance of the projects implemented, as result of this need, the Joint Commission stipulates various tools for measuring performance based on the situations and circumstances at hand. Most of the tools are aligned towards the aspects of quality.
The New Standards BoosterPak High-Level Disinfection (HLD) and Sterilization aim at ensuring that “ practices are carried out following regulatory standards and evidence-based guidelines for HLD and sterilization in order to minimize the potential risk of infection transmission to patients ” (jointcommision.org). This tool is fundamental as it provide mechanisms for addressing the consistency in the interpretation of data. This tool encompassed various aspects such as High-Level Disinfection (HLD) and Sterilization which aims at practices are carried out following regulatory standards and evidence-based guidelines. Similarly, other components of this tool entail Home-oxygen safety, credentialing & Privileging in Non-Hospital Settings and use of Restraint and Seclusion for Organizations Using Joint Commission Accreditation for Deemed Status.
Joint Commission initiatives for healthcare
The dynamics of the health care system calls for the need to have robust measures to help in the push for the changes and implement the objectives of the Joint Commission. The continuity of the organization has been enabled by the various initiatives put in place.
First, the Agency for Healthcare Research and Quality (AHRQ) and quality initiative is an approach envisaged by the Joint Commission “the development, adaptation, and implementation of innovative concepts, strategies, methodologies, and practices in quality and patient safety” (Baker & Berman, 2017). Under this initiative, various agencies have been formulated to help foresee the development of research plans, conducting, supporting and disseminating research. This initiative is fundamental to the organization in that it helps the health sectors and the stakeholders with a proper knowledge of the decision-making purposes. Through its research initiative, it aims at bringing all players into the process in order to reduce chances of resistance or criticism of the process.
Next, The Joint Commission’s ORYX initiative is one that aims at integrating the performance measurement into the accreditation process. Through this initiative, the organization intention remains to vet the institutions on their capability to operate with the realm of guidelines set by the body. The accreditation process involves checking on the staffing process, plant and internal procedures and the influence on the patient care.
Impact of Joint Commission on the healthcare system
The Joint Commission has made a tremendous impact on the general healthcare system; first, the accreditation programme has helped the health institutions to develop a multi-disciplinary assessment of healthcare functions and relook at the various strategies for improving quality. Over the years, the accreditation programme has attracted many institutions, this is because, more recent and developed programmes are now characterized by using optimum standards of performance in terms of process and outcome. The accreditation process requires organizations to continuously work to improve safety, which reduces opportunities for errors and enhances risk management efforts ( Wrzesniewski , 2005).
The Joint Commission as also fostered the standardization processes where it health institutions are subjected to the guidelines that are oriented towards improvement of quality and safety of patients. For instance, the “ALPHA programme aims to make standards-based assessment systems more reliable, valid and compatible within and between countries” (Shaw, 2005). This has enabled the comparison of services provided also allows for the monitoring of the progress within the institution and against various healthcare sector.
In conclusion, the Joint Commission has over the years established the need for the best practices and standards that are designed to orient the health sector towards achieving best performance in terms of quality of services provided and the best safety measures for the patients. While it may be argued that such par excellence goals are yet to be met, it should be appreciated that there exist a lot of dynamics that pose a challenge or hinder the practicality of some of the objectives.
References
Baker, D. W., & Berman, S. (2017). Continuity and Change at The Joint Commission Journal on Quality and Patient Safety. The Joint Commission Journal on Quality and Patient Safety, 43 (1), 1-2. doi:10.1016/j.jcjq.2016.11.002
Shaw, C. (2005). WORLD hospitals and health services | 13 The external assessment of health services. World Hospitals and Health Services,40 (1).Retrieved February 8, 2018.
The Joint Commission: Over a century of quality and safety. (n.d.). Retrieved February 08, 2018, from https://www.jointcommission.org/facts_about_the_joint_commission/
Wrzesniewski, C. (2017). Quality and Safety through Compliance with The Joint Commission Requirements Carolyn E. Wrzesniewski. California Journal of Health-System Pharmacy, 61-69. Retrieved February 10, 2018.
