The controversy over the Joint Commission's new hospital self-reporting policy could come to a head this week.
The Joint Commission on Accreditation of Healthcare Organizations' 28-member board is meeting this Friday in Aventura, Fla. A discussion of its new "sentinel events" policy is on the board's agenda.
Under the policy, which takes effect April 1, hospitals that self-report serious patient incidents to the JCAHO will receive leniency in the subsequent review process.
Although hospital industry representatives on the JCAHO's board approved the policy, hospitals in the field are criticizing it out of fear the new terms will create a sea of paperwork that malpractice attorneys could use against the hospitals.
The American Hospital Association is urging the JCAHO to suspend the policy until legal questions surrounding the confidentiality of records submitted to the JCAHO can be settled.
Charles Mowll, a JCAHO executive vice president, said the agency will respond to the AHA request and other suggestions about the policy, after it discusses the issues at its board meeting.
What action the Oakbrook Terrace, Ill.-based JCAHO will take is unclear.
"I wouldn't want to speculate on that," Mowll said. The JCAHO already has proposed some revisions to the policy to address industry concerns, he said.
One of those revisions includes keeping secret the name of the patient or caregivers involved in the sentinel event (Feb. 2, p. 2).
A sentinel event leads, or could lead, to the death or serious injury of a patient.
But the JCAHO's revisions aren't enough for the AHA. "They address some of our concerns, but it still leaves a lot of questions about the confidentiality issue," said Richard Wade, the AHA's senior vice president for communications.
Mowll said the JCAHO is working out the confidentiality issue state by state. For example, he said, JCAHO officials met with state hospital association attorneys and risk managers at the AHA's annual membership meeting in Washington last week. However, he said, the JCAHO didn't meet with AHA leadership at last week's meeting.
Mowll said resolving the confidentiality issue includes reviewing what is required by each state's peer review statutes and modifying the language in contracts between the JCAHO and the organizations it accredits. Modifications would include spelling out that the JCAHO isn't a third party, so therefore correspondence it has with hospitals over sentinel events would be confidential.
Thomas Scully, president of the Federation of American Health Systems, which represents for-profit hospitals, said the proposed revisions and discussions about ways to preserve confidentiality "certainly sound like a step in the right direction." The federation was first to express concerns about the self-reporting policy creating liability problems for hospitals.
Under the policy, the JCAHO promises not to put a hospital on accreditation watch if it self-reports a sentinel event within five days. Within 30 days, it also must analyze the event to the JCAHO's satisfaction and look at ways to avoid it in the future.