On June 2, 2006, The Joint Commission’s Board of Commissioners approved the 2007 National Patient Safety Goals. The Goals and related requirements are below. New Goals and requirements are indicated in italics. Gaps in the numbering indicate a Goal has been “retired,” usually because the requirements were integrated into the standards.
| Goal 1 |
Improve the accuracy of patient identification. |
| 1A |
Use at least two patient identifiers when providing care, treatment or services. |
| Goal 2 |
Improve the effectiveness of communication among caregivers. |
| 2A |
For verbal or telephone orders or for telephonic reporting of critical test results, verify the complete order or test result by having the person receiving the information record and "read-back" the complete order or test result. |
| 2B |
Standardize a list of abbreviations, acronyms, symbols, and dose designations that are not to be used throughout the organization. |
| 2C |
Measure, assess and, if appropriate, take action to improve the timeliness of reporting, and the timeliness of receipt by the responsible licensed caregiver, of critical test results and values. |
| 2E |
Implement a standardized approach to “hand off” communications, including an opportunity to ask and respond to questions. |
| Goal 3 |
Improve the safety of using medications. |
| 3B |
Standardize and limit the number of drug concentrations used by the organization. |
| 3C |
Identify and, at a minimum, annually review a list of look-alike/sound-alike drugs used by the organization, and take action to prevent errors involving the interchange of these drugs. |
| 3D |
Label all medications, medication containers (for example, syringes, medicine cups, basins), or other solutions on and off the sterile field. |
| Goal 7 |
Reduce the risk of health care-associated infections. |
| 7A |
Comply with current Centers for Disease Control and Prevention (CDC) hand hygiene guidelines. |
| 7B |
Manage as sentinel events all identified cases of unanticipated death or major permanent loss of function associated with a health care-associated infection. |
| Goal 8 |
Accurately and completely reconcile medications across the continuum of care. |
| 8A |
There is a process for comparing the patient’s current medications with those ordered for the patient while under the care of the organization. |
| 8B |
A complete list of the patient’s medications is communicated to the next provider of service when a patient is referred or transferred to another setting, service, practitioner or level of care within or outside the organization. The complete list of medications is also provided to the patient on discharge from the facility. |
| Goal 9 |
Reduce the risk of patient harm resulting from falls. |
| 9B |
Implement a fall reduction program including an evaluation of the effectiveness of the program. |
| Goal 13 |
Encourage patients’ active involvement in their own care as a patient safety strategy. |
| 13A |
Define and communicate the means for patients and their families to report concerns about safety and encourage them to do so. |
| Goal 15 |
The organization identifies safety risks inherent in its patient population. |
| 15A |
The organization identifies patients at risk for suicide. [Hospital (applicable to psychiatric hospitals and patients being treated for emotional or behavioral disorders in general hospitals)] |
The goals and requirements for each accreditation program are available on The Joint Commission. As of January 1, 2007, all Joint Commission accredited health care organizations and the Disease-Specific Care certified programs will be surveyed for implementation of applicable 2007 goals and requirements—or acceptable alternatives (see below)—as appropriate to the services the organization or program provides. Compliance with applicable requirements (or an acceptable alternative) will be scored at the associated implementation expectation(s) for that requirement in the NPSGs chapter of each standards manual.
Derivation of the goals
The development and annual updating of the NPSGs and requirements is overseen by an expert panel of widely recognized patient safety experts, as well as nurses, physicians, pharmacists, risk managers, and other professionals who have hands-on experience in addressing patient safety issues in a wide variety of health care settings. Each year, the Sentinel Event Advisory Group works with Joint Commission staff to undertake a systematic review of the literature and available databases to identify potential new goals and requirements. Following a solicitation of input from practitioners, provider organizations, purchasers, consumer groups, and other parties of interest, the advisory group determines the highest priority goals and requirements and makes its recommendations to The Joint Commission. In order to maintain the focus of accredited organizations on the most critical patient safety issues, the Sentinel Event Advisory Group may, as part of its annual review, recommend the retirement of selected requirements from the NPSGs. In such cases, they will usually continue as accreditation requirements under the relevant standards.
The Sentinel Event Advisory Group was formed in February 2002 and the Board of Commissioners approved the first NPSGs in July 2002; they became effective in January 2003. Program-specific goals were developed for all accreditation programs in 2004 for implementation in 2005. The Joint Commission established the NPSGs to help accredited organizations address specific areas of concern in regards to patient safety. The Sentinel Event Advisory Group is charged with conducting a thorough review of all Sentinel Event Alert (The Joint Commission’s widely read patient safety advisory) recommendations and other sources of patient safety recommendations, and identifying those that are candidates for the annual NPSGs. The Group also advises The Joint Commission as to the evidence for and face validity of these recommendations, as well as their practicality and cost of implementation. The Advisory Group’s recommendations for annual NPSGs and associated requirements are forwarded to The Joint Commission’s Board of Commissioners for approval prior to the year in which they are to be implemented.