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September 2008
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Joint Commission
Send your questions for the Joint Commission to e-news@nahq.org.
Question: How will The Joint Commission monitor progress toward a culture of safety and the occurrence of disruptive behavior in the workplace among healthcare providers?
Joint Commission: Beginning in January 2009, during the onsite survey, The Joint Commission will evaluate each organization’s culture of safety under Leadership standard LD.03.01.01. (The 2009 standards have been renumbered as part of the Standards Improvement Initiative. During development, this standard was number LD.3.10.) Disruptive and inappropriate behaviors will be addressed in two of its elements of performance:
EP 4: The hospital has a code of conduct that defines acceptable and disruptive and inappropriate behaviors.
EP 5: Leaders create and implement a process for managing disruptive and inappropriate behaviors.
The prepublication version of the Leadership standards is available on The Joint Commission Web site. Also, in July, The Joint Commission issued a Sentinel Event Alert that addresses behaviors that undermine a culture of safety. The Alert includes 11 specific suggested actions to help put an end to intimidating and disruptive behaviors among physicians, nurses, pharmacists, therapists, support staff, and administrators. The entire Alert is available on The Joint Commission Web site.
New AHRQ Tool Helps Hospitals Evaluate Disaster Drills
Hospitals can now identify the most important strengths and weaknesses in their disaster response plans using a new tool from the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality.
Ensuring that hospitals are prepared to respond appropriately during any type of disaster situation—manmade or natural—is a priority for HHS. Beginning in September, hospitals participating in the Hospital Preparedness Program, administered through HHS, will be required to provide executive summaries of the results of disaster drills they conduct. AHRQ’s new Tool for Evaluating Core Elements of Hospital Disaster Drills can help hospitals meet this requirement.
Hospital disaster response drills are real-time tests of a facility’s readiness to respond to a sudden demand for services resulting from a community-wide disaster. Routine evaluation of these drills can help a hospital make sure it is ready to meet community needs and provide high-quality care during a disaster event.
“This tool is a critical first step in helping hospitals evaluate their disaster plans to find out what works and what doesn’t,” said AHRQ Director Carolyn M. Clancy, MD. “That knowledge can help hospitals make important changes to their response plans now before a disaster strikes.”
The tool is a series of evidence-based modules that provide standardized checklists to document observations during a disaster drill. Using the observations, hospitals can identify areas for improvement, make appropriate changes, and set benchmarks to track those changes over time.
The individual modules assess the adequacy of response by different functional “zones” set up within a hospital during a disaster: command center, decontamination, triage, and treatment. A pre-drill module is also included, and a debrief module helps capture feedback from all participants, including observations that occur across multiple functional zones.
The new evidence-based tool is an abridged version of a more comprehensive evidence report developed by AHRQ’s Johns Hopkins University Evidence-based Practice Center in Baltimore. The new version singles out only the most critical elements that all hospitals should evaluate during disaster drills.
AHRQ’s Evidence-based Practice Centers are part of an important federal effort to compare alternative treatments for significant health conditions and make the findings public. AHRQ’s role in national emergency preparedness efforts is to conduct and support research and to develop tools and resources that communities can use to improve public health preparedness.
Click here for Tool for Evaluating Core Elements of Hospital Disaster Drills. Single, free copies can be ordered by e-mailing ahrqpubs@ahrq.hhs.gov or by calling 800/358-9295. For more information about the Hospital Preparedness Program, visit www.hhs.gov/aspr/opeo/hpp.
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