The pivotal role of accreditation leaders is undeniable in ensuring patient outcomes and institutional integrity. Tasked with navigating the maze of regulations and standards, these leaders are fundamental in ensuring healthcare institutions comply with and surpass benchmarks in quality care.
Healthcare workers are no strangers to burnout and suicide as many suffer from emotional exhaustion and mental and physical stress due to the demanding nature of their job, including long working hours, high-stress environments, and death in extreme cases.
Determining how your facility addresses requests for information about how it complies with CMS’ Quality Assessment and Performance Improvement (QAPI) Conditions of Participation (CoP) while protecting sensitive patient safety details is a task for leadership and the hospital attorney...
This is Part 2 of our coverage of revisions to U.S. Pharmacopeia (USP) <797> requirements for compounding sterile medication, which were discussed by Robert Campbell, PharmD, BCSCP, The Joint Commission’s (TJC) director of Medication Management, during the accreditor’s...
The clinical director of The Joint Commission’s (TJC) Standards Interpretation Group is warning hospitals that one of the greatest risks for noncompliance under revisions to U.S. Pharmacopeia (USP) <797> requirements for compounding sterile medication will be under drugs in the category 3...
What is meant by the phrase “supporting situational awareness”? It’s simple: Healthcare leaders must understand the critical link between situational awareness and clinical decision-making.
Safety concerns and potential for erroneous errors have made the Waived Testing (WT) chapter a common area of focus for surveyors during patient tracers. Surveyors will observe staff while performing waived testing and ask them questions about training and competency. Therefore, you will want...
As the result of a CMS directive, unannounced surveys for organizations started in 2006. If you are undergoing a deemed status survey, your visit will be unannounced except in certain circumstances, such as for durable medical equipment or small-office practices. Organizations new to...
To assist organizations in improving their credentialing and privileging processes, the Accreditation Association for Ambulatory Health Care (AAAHC) has released an updated version of its Credentialing and Privileging Toolkit.
According to a press release from AAAHC, the toolkit...
