BWH Gets Ready for Next JCAHO Visit
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) will be conducting accreditation surveys on an unannounced basis, according to a new JCAHO policy beginning this year, and BWH is getting ready for this challenge.
BWH completed its most recent triennial survey in March 2004 following an intense, five-day site visit when JCAHO used its tracer method for the first time at BWH, following patients through their care, treatment and services. The survey concluded on a high note, due to the teamwork and dedication by all staff and employees involved in the detailed preparation for the site visit.
The next triennial survey can happen at anytime in 2007. The hospital will have no advance notice and will not find out until 7 a.m. on the day of JCAHO’s arrival. In addition to a triennial survey, the JCAHO may send a surveyor for an unannounced one-day visit at any time between now and the end of this year. The BWH Clinical Compliance Department’s goal is that the hospital is ready whenever JCAHO surveyors arrive.
BWH is counting on the dedication, commitment and readiness of all staff. In addition, the hospital’s Readiness Steering Committee, a newly formed “Ever Ready” Team and an organizational “BWH/JCAHO Are You Ready?” campaign are working to ensure continual readiness.
JCAHO maintains a rigorous and state-of-the-art set of standards that focus on improving the quality and safety of care provided by health care organizations. The hospital’s commitment to safety and quality is evident across the distributed campus. Success depends on each individual doing their job to the best of their ability.
Anyone with questions should call Clinical Compliance at ext. 2-5913 or ext. 2-5810, or check the “Compliance Corner” on www.bwhpikenotes.org