The hospital industry seems to have accepted that "random unannounced surveys" by the Joint Commission on Accreditation of Healthcare Organizations will now be truly unannounced. There have been few complaints about the new policy, hospital association sources said.
On July 31, the Joint Commission altered its policy regarding midterm surveys. Hospitals had been given 24 or 48 hours' notice that surveyors were coming, but now they will be given no advance warning.
The move angered the American Hospital Association, which argued that the Joint Commission had ignored its own field-testing process, a requirement for making such policy changes.
Since the change was announced, however, the AHA has not received many complaints, said Richard Wade, senior adviser for communications. "We knew that (the Joint Commission was) going to do that. Our members were disappointed there wasn't some small window of time (for notification) there."
To address hospital concerns and work out procedural kinks, the Oakbrook, Ill.-based Joint Commission formed a liaison group of state hospital associations earlier this year. Leading the group was Gary Carter, president and chief executive officer of the New Jersey Hospital Association. He said the group was not consulted about the policy change. "There are some who think it should have been," he said. Carter said he has not heard anything about the issue from his own members.
Cathy Barry-Ipema, spokeswoman for the Joint Commission, said the organization has received "very few comments. The only one who's really given us comments is the AHA."
The agency did receive a letter from an accreditation liaison at a hospital, who welcomed the new policy and agreed with the criticisms in a hospital oversight report HHS' inspector general's office recently issued (Aug. 9, p. 2).
Barry-Ipema said only 5% of accredited organizations are selected for the midterm surveys per year. The organizations that had never been surveyed thought the surveys were previously unannounced, she said.
Dorel Harms, vice president of professional services at the California Healthcare Association in Sacramento, said she has received few calls about the issue. "The amount of notice they received before was minimal. If someone is out of town, it's not going to make any difference (in scheduling the survey)," she said. Staff availability might be an issue for smaller hospitals. If the medical staff coordinator is the only person who knows where everything is, "it's the luck of the draw if this person is there."
Craig Jones, president of the Oklahoma Hospital Association, said his members are increasingly annoyed by the deteriorating relationship between hospitals and the Joint Commission.
In recent years, he said, hospitals were optimistic about the increasing dialogue between clinicians and Joint Commission staff. "But in response to the inspector general's report or public concern, the pendulum is swinging the other way. The (Joint Commission is) taking on a more regulatory attitude. It's losing perspective on who is its customer."
Jones said some hospitals may decide to give up JCAHO accreditation and opt for a state inspection, which would be cheaper and easier.