Friday, February 25, 2005

JCAHO BS

You know, I'm old enough (and that's not very old) to remember when hospitals didn't have interference certification by JCAHO. We just went about our business.

JCAHO initially offered services as a voluntary certification to demonstrate that the examined hospital followed it's own guidelines. This became a competitive edge. A hospital could advertise itself as JCAHO certified. Now it has become required by insurance companies.

The first time I had to experience JCAHO was as the chairman of the medical records committee at a Navy hospital. We didn't have to deal with insurance companies, but I suppose the brass wanted the merit badge. That was back when JCAHO didn't tell you how to do business, but merely evaluated whether you followed your own guidelines. Of course, now JCAHO dictates.

The reviewer for medical records was a surgeon. One of the rules we had in place was that an operative report had to be in the chart "within a day" of the operation. We received a "major" violation for one chart where an emergency c-section was done at 2345 and the op-note was dictated at 0030. No joke. It wasn't the same day. Fortunately, we were able to appeal our way out of that one (with his supervisor, the surgeon never relented.) But wouldn't you think a surgeon would understand that getting the op-note dictated in less than an hour after an emergency c-section was pretty good?

Now I find out that JCAHO wants to get into the business of certifying staffing organizations, such as the ER company I work for. How fast can we run away from this one?