When the circumstances of a patient's death make the front page, the Joint Commission won't be far behind.
A surveyor from the Joint Commission on Accreditation of Healthcare Organizations visited Ravenswood Hospital Medical Center in Chicago on May 20, four days after a 15-year-old boy bled to death from a gunshot wound outside the hospital's emergency room. Observers charged that hospital personnel refused to treat the boy because he was not on hospital property (See story, above).
The Joint Commission is considering designating the death a "sentinel event," JCAHO spokeswoman Janet McIntyre said. "A sentinel event has a very broad definition. This could probably fall somewhere under the unexpected or unanticipated death (category)," she said.
McIntyre said the situation is complicated by the fact that "we don't have any standards that require a hospital or hospital personnel to go off campus to administer treatment." The standards are written for patients already in the building, she said.
The JCAHO's sentinel event policy, which governs the reporting of patient deaths and other serious preventable accidents, has been a lightning rod of resentment in the hospital industry.
The Joint Commission's habit of showing up just after the headlines hit the papers has irritated some hospitals for years (Dec. 23, 1996, p. 2). Many hospital executives think the JCAHO contributes little after an event occurs.
The Joint Commission expects the hospital to undertake its own root-cause analysis in any case. But whether the agency enters the death as a sentinel event in its database won't be determined until the surveyor makes a recommendation in a week or so. If the JCAHO is dissatisfied with the hospital's response, the facility could be placed on "accreditation watch."