The Joint Commission is revising its Emergency Management (EM) requirements for accredited ambulatory health care and office-based surgery programs. The EM chapter requirements will be released in July 2024, and we are seeking input from the field on the new requirements.
The primary goal of the revisions is to streamline the chapter to be more cohesive and concise, which has resulted in a complete rewrite and restructure of the EM chapter. The new and revised EM standards will help these organizations develop and improve their actions and responses to emergencies or disasters. The chapter continues to address preparedness, mitigation, response, and recovery. Additional focus has been placed on areas such as leadership roles and responsibilities, use of the hazard’s vulnerability analysis, as well as providing EM-related education and training to staff.
Comment now on the proposed requirements:
Feedback will be accepted until July 28.
There is still time to comment on The Joint Commission’s proposed new Infection Control (IC) chapter requirements. The proposed requirements are intended to replace the current IC chapter requirements for hospitals and critical access hospitals.
The primary goal of the revision project is to align the IC standards and elements of performance (EPs) more closely with the Centers for Medicare & Medicaid Services' Conditions of Participation and to streamline the chapter to be more cohesive and concise.
Comment now on the proposed requirements. Feedback will be accepted until July 5.
Asymptomatic severe hypertension, also known as hypertensive urgency, is severely elevated blood pressure (BP) that is frequently encountered in the hospital. Management with one-time doses of intravenous (IV) antihypertensives may increase adverse events such as acute kidney injury, myocardial injury, or low blood pressure. Despite this, single-dose treatment remains common in emergency department (ED) and inpatient settings.
A new study in the June/July 2023 issue of The Joint Commission Journal on Quality and Patient Safety details a quality initiative launched at New York City Health + Hospitals, the largest safety net hospital system in the United States, to reduce unnecessary IV antihypertensive use. The initiative involved two changes to electronic orders for IV hydralazine and IV labetalol across 11 hospitals from November 2021 to October 2022:
- A nonintrusive nudge in the order instructions and an additional advisory statement with the appropriate indications and recommended assessment of alternate etiologies as a potential treatment alternative.
- A mandatory requirement to document the indication for IV antihypertensive use.
- Of the indications selected for IV antihypertensive orders, 60.7% were for hypertensive emergency, 15.3% were for patients who were strictly nothing by mouth (NPO), 21.2% were for other, and 2.8% were for more than one indication.
Findings showed for ED-only encounters, IV hydralazine orders had a 49.5% reduction, IV labetalol orders had a 30.1% reduction, and aggregate IV hydralazine and IV labetalol orders had a 38.7% reduction. For inpatient encounters, IV hydralazine had a 22% reduction, IV labetalol orders had a 6.3% reduction, and aggregate IV hydralazine and IV labetalol orders had a 13.4% reduction.
“We found that two small prompts in our electronic health record had a dramatic impact on reducing IV antihypertensive orders,” says Mona Krouss, MD, assistant vice president of Value and Patient Safety at NYC Health + Hospitals and lead author of the study. “By reducing unnecessary antihypertensive IV use, this low effort intervention likely had an impact on decreasing adverse events."
Also featured in the June/July issue:
- In Situ Simulation as a Quality Improvement Tool to Identify and Mitigate Latent Safety Threats for Emergency Department SARS-CoV-2 Airway Management: A Multi-Institutional Initiative (Montefiore Medical Center and NYC Health + Hospitals, New York)
- Reducing Inappropriate Simultaneous Ordering of Heparin Antibody and Serotonin Release Assays (NYC Health + Hospitals, New York)
- Home Health Agency Patient Experience Measures and their Relationship to Joint Commission Accreditation (The Joint Commission, Oakbrook Terrace, Ill.)
- Reducing Sharps Injuries in the Operating Rooms of an Academic Tertiary Care Center (Massachusetts General Hospital, Boston)
- Social Determinants of Health Screening and Management: Lessons at a Large, Urban Academic Health System (New York-Presbyterian, New York)
- Standardized Electronic Order Entry to Improve Enteral Nutrition Prescribing in the Critically Ill (research letter)
- Bringing Environmental Sustainability into the Quality Agenda: Time to Act on Reducing Health Care Pollution and Waste (commentary)
- No Time to Waste: A Call for Papers on Making Health Care Environmentally Sustainable (call for papers)
Access the Journal.
Quality in Senior Living — Learn more about The Joint Commission’s new Memory Care Certification option for ALCs this Alzheimer’s and Brain Awareness Month: This month, Alzheimer’s and Brain Awareness Month, provides the perfect opportunity to spread the word about and discuss Alzheimer’s disease and other dementias, as well as highlight The Joint Commission’s Memory Care Certification for Assisted Living Communities (ALCs) that launches on July 1, writes Gina Zimmermann, Executive Director, Nursing Care Center and Assisted Living Community Services, The Joint Commission.