Joint Commission Online- March 29, 2023
Joint Commission Online is The Joint Commission's weekly newsletter and is posted every Wednesday.
March 29, 2023
The COVID-19 pandemic has unfairly and disproportionately impacted the health of communities of color and other marginalized groups, shining a light on America’s inequitable healthcare system and public health services. This was evident in increased Black maternal mortality rates, limited access and timeliness of care, and inadequate preventative health programs.
Joint Commission President and CEO Jonathan B. Perlin, MD, PhD, MSHA, MACP, FACMI, penned a commentary in Population Health Management — cowritten with Alonzo L. Plough, PhD, MPH, MA, Chief Science Officer and Vice President of Research-Evaluation-Learning at the Robert Wood Johnson Foundation — that discusses the need for health systems to use new data collection methods as a way to advance healthcare equity.
“It is time for transformational change in our health care systems to advance long overdue health equity for millions of Americans who are regularly denied equal access to quality health care services,” Drs. Perlin and Plough wrote. “The challenge is that you cannot fix what you do not accurately measure. And today, standard data gathering practices among health systems and hospitals are not only siloed and disconnected, but they also rarely capture broader population level data — including vital race, gender, and social determinants of health (SDOH), like education and access to healthy food and stable housing — needed to address structural racism and the health disparities affecting well-being. The lack of data connectivity between America's health care systems, community health providers, and public health departments has only served to widen America's health equity gap.”
Read the commentary.
March 29, 2023
A new issue of Quick Safety focuses on utilizing validated tools for suicide risk screening.
Suicide risk screening is intended to identify individuals who may be at risk of suicide. Brief validated screening tools are an effective way to identify individuals at risk for suicide who may require both further assessment and steps to protect them from attempting suicide. But while there are numerous types of suicide screening tools available, any tool that is not used appropriately may hinder the intended results.
Read Quick Safety.
March 29, 2023
With an already distressed healthcare workforce demonstrating high levels of burnout, depression and suicide, access to behavioral healthcare, particularly after experiencing an adverse event, is critical. Unfortunately, clinicians identify multiple barriers to seeking behavioral support.
A new study in the April 2023 issue of The Joint Commission Journal on Quality and Patient Safety introduces CHaMP (Center for Healthy Minds and Practice), a program designed to improve crisis response, build a peer support program, and remove barriers to accessing mental healthcare by establishing an on-campus behavioral health support center.
Researchers at the University of Florida College of Medicine implemented CHaMP using Kotter’s 8-step Model of Change:
- Step 1: Create a sense of urgency by demonstrating that clinicians need behavioral support.
- Step 2: Build a guiding coalition by appointing a multidisciplinary well-being task force.
- Step 3: Develop a strategic change vision by implementing a crisis response plan, peer support program and work-life center.
- Step 4: Communicate the vision and recruit a volunteer army by gaining leadership approval and financial support.
- Step 5: Remove barriers by decreasing startup costs, ensuring convenient accessibility to work-life center and assuring confidentiality.
- Step 6: Generate short-term wins with the work-life center grand opening, sharing employee coaching and counseling experiences, and reporting statistics showing rapid adoption of services.
- Step 7: Build on the change by using employee surveys to improve the service model and establishing long-term financial sustainability with metrics tying behavioral health services to employee retention and engagement as well as reduced medical errors, improved team functioning and morale, and decreased burnout and absenteeism.
- Step 8: Incorporate change into the culture by appointing a director of work-life center to the executive management board, providing bidirectional communication between leadership and employees.
Within the first months of establishing the program, the support team responded to multiple activations of the crisis response plan and provided counseling services to 631 employees. The crisis response plan included an internal communication list, scripts for communicating with media, family and public safety officers, and an internal support team of trained counselors. During the COVID-19 pandemic, CHaMP played a central role in the support of all employees. The study found that including key stakeholders in the organizational diagnosis and treatment process was key and that a collaborative approach, filtered through Kotter’s Model, is a powerful tool for designing positive, lasting interventions to address system and individual factors that affect clinician and employee well-being and resilience.
Also featured in the April issue:
- The Gap Between Daily Hospital Bed Supply and Demand: Design, Implementation, and Impact of Data-Driven Pre-Noon Discharge Targets (Massachusetts General Hospital, Boston)
- Addressing the ED Crowding Crisis: Is Discharge by Noon Really the Answer? (editorial)
- Hospital Capacity Command Centers: A Benchmarking Survey on an Emerging Mechanism to Manage Patient Flow (survey of 38 leaders at U.S. health systems)
- An Approach to Evaluating Multisector Partnerships to Support Evidence-Based Quality Improvement in Primary Care (Healthy Hearts for Michigan Cooperative, a statewide cooperative)
- An Infrastructure to Provide Safer, Higher-Quality, and More Equitable Telehealth (UTHealth Houston)
- A System to Improve Compliance with Electrocardiography Electrode Expiration Tracking (Icahn School of Medicine at Mount Sinai, New York City)
- Medication Rounds: A Tool for Promoting Medication Safety for Children with Medical Complexity (Children’s Hospital of Philadelphia)
- Now Is the Time to Routinely Ask Patients About Safety (commentary)
Access the Journal.
March 29, 2023
The Joint Commission has approved 81 new requirements for behavioral healthcare and human services organizations that select the Certified Community Behavioral Health Clinic (CCBHC) service on their electronic application (E-App). The new requirements go into effect on July 1.
CCBHCs provide coordinated, comprehensive access to a variety of behavioral health and primary physical health services in accordance with the Substance Abuse and Mental Health Services Administration (SAMHSA) criteria. CCBHCs are required to serve anyone who requests care for mental health or substance use, regardless of their ability to pay, place of residence, or age.
Organizations that select the CCBHC service on their application will have their compliance with these new standards assessed during the organization’s accreditation survey like other programs and services. New, however, is that the CCBHC designation will be shown on their Quality Report, and CCBHC is now a searchable service category within Quality Check®.
These new requirements align with the current SAMHSA criteria for CCBHCs. Accredited organizations that meet Joint Commission CCBHC requirements will be better prepared to meet the national expectations for a CCBHC program and better able to validate the quality and safety of the care, treatment, and services provided by the CCBHC.
“The Joint Commission now provides state authorities and payors with a new way to confirm that CCBHCs are truly meeting all SAMHSA requirements,” said Melinda Lehman, Executive Director, Behavioral Healthcare and Human Services, The Joint Commission. “And now with Joint Commission Accreditation, there will be — for the first time — validation of the quality and safety of the programs and services being provided to the individuals these clinics serve.”
Recently, SAMHSA published updates to its CCBHC requirements. The Joint Commission will update its CCBHC requirements in return to match SAMHSA’s July 1, 2024 effective date.
March 29, 2023
Dateline @ TJC — Revised EP for Licensed Practitioner Evaluations Will Improve Quality, Save Time and Reduce Costs: The Joint Commission recently extended the timeframe for licensed practitioner evaluations from two years to three years to align with standard practice and to help streamline and enhance quality-assessment processes, writes Diane Meldi, MBA, CPCS, CPMSM, FMSP, and Molly Ford, MPP.