Standing firm against pressure from several national hospital organizations, the Joint Commission on Accreditation of Healthcare Organizations has reaffirmed its controversial hospital self-reporting policy and will start it as planned April 1.
The Joint Commission's board, however, did agree to convene a special task force to look at protecting healthcare organizations from the legal liabilities of divulging such information to an outside organization.
That response seemed to satisfy some of the industry groups that had reacted with alarm in January to revisions in the Joint Commission's policy on patient-care errors, called sentinel events (Feb. 2, p. 2).
Executives of both the American Hospital Association and the Association of American Medical Colleges professed themselves pleased with the outcome.
But Thomas Scully, president of the Federation of American Health Systems, was less impressed: "I'm not sure why they're not being more flexible." The federation, which represents for-profit hospitals and doesn't have any seats on the Joint Commission's board, also had objected to the self-reporting policy.
Under the policy, which the JCAHO board approved last November, hospitals can voluntarily report sentinel events to the Joint Commission in exchange for leniency from accreditation surveyors. Hospitals must turn themselves in and provide detailed reports of how the incident came about and how such incidents would be prevented. In return, they won't be put on the JCAHO's "accreditation watch" list, which can be made public.
Hospital attorneys feared that documents generated under the policy would be discoverable by malpractice attorneys and lead to a wave of lawsuits against hospitals.
At its Feb. 13 retreat in Aventura, Fla., the Joint Commission's 28-member board discussed the industry's objections. "We are torn between two realities: the reality that we need to deal with the issue of sentinel events, and the reality of the concerns expressed by the AHA and the medical colleges," said John Helfrick, M.D., an oral surgeon at the University of Texas, Houston, who chairs the JCAHO board.
The liability task force will be headed by board member John Leech, a lawyer and one of the AHA's seven representatives. It also will include state hospital association attorneys, and representatives from the American Medical Association, the American College of Physicians and the AHA.
It will prepare state-by-state analyses of existing confidentiality protections for information that might be shared between hospitals and the Joint Commission.
The commissioners' vote to sustain the policy was unanimous, with an abstention.
"In my seven years on the board, this is probably the best opportunity we've had to improve healthcare in the United States in the broadest possible way," Helfrick said.
Although the AHA had raised a ruckus about the new sentinel event policy, the seven AHA commissioners on the board voted in favor of it -- now twice.
Jonathan Lord, M.D., the AHA's chief operating officer, attended the Florida meeting. He said, "The JCAHO's clarifications and the process that will play out over the next three weeks should work to balance the needs of the healthcare field, as well as the public."