JCAHO stopped by Kadie’s hospital this week. JCAHO is to hospitals what the Gestapo was to your average law abiding German and the KGB to your every day Russian. Not in a moral sense, of course, but in the sense that they inspire fear in the hearts of every hospital employee. They appear at random and quiz the employees on policies and procedures. Their job is to find mistakes. A negative word from them can result in an employee being written up at best, or even terminated if negligence is detected. (To get some idea of the sense of dread their name evokes, Googling the phrase "JCAHO sucks" reveals over 15,000 hits).
[Ed. note: I do fully understand the necessity of an accrediting agency. One of the reasons that we have educational and medical systems that are the envy of the world is because of the strict and rigorous processes of ongoing certification.]
In short, they are scary. This week they arrived on Kadie’s floor and began snooping around. They asked opened a chart at random and asked the nursing supervisor to show them an example of how the staff evaluates a patient’s pain. Now as I understand it (and Kadie rolls her eyes and shakes her head slowly whenever I speak of medical things) when a patient requests pain medication, the nurse must evaluate their current pain level, give the medication, and then a few hours later follow up and evaluate the pain condition again. But as busy as nurses are, at times they do not follow up and evaluate the patient’s condition again. The average nurse assumes that if the patient is still in pain after taking the meds, then they will let the nurse know.
So the JCAHO agent was checking the charts to make sure that the nurse had correctly followed procedure. Well, you can see where this was going. They pulled one of Kadie’s patients and checked her chart. The nursing supervisor said that she was holding her breath as they looked.
Of course, Kadie had perfectly followed proper procedure. Her supervisor expressed relief that they had pulled Kadie's chart. I was surprised by none of this. She is a remarkable nurse and is gifted for that occupation.
Regrettably, she also never reads this blog, so I will score no brownie points with her. I simply want to brag on my fine spouse.
1 comment:
It's been 10 years since I left the world of hospital work; I don't miss JCAHO (pronounced: "jay-coe"). It's not that I dreaded them; the hospital programs I managed always did fine.
It's that they were small-minded and rigidly bureaucratic in their outlook.
One hospital I worked at had a small, concrete duck pond on the grounds. JCAHO insisted we have a policy for rescuing drowning patients (even thought the pond was 12 inches deep at it's deepest).
My suggested policy was that a staff member, upon seeing a patient floundering in the pond, should walk over to the patient and whisper in their ear, "Stand up".
Needless to say, this simple and common-sense approach did not pass muster. Many hours later - at a cost I don't like to think about - we came up with a policy that was erudite and obfuscatory: just what JCAHO wanted.
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