The Joint Commission on Accreditation of Healthcare Organizations said late last week it will begin a pilot project this summer to assess the relationship between adequate staffing and clinical outcomes. Healthcare organizations may be required to use JCAHO-prescribed screening indicators to monitor staffing levels by 2002 to gain accreditation.
"All of us believe that there is a link between staffing and safety," said JCAHO President Dennis O'Leary, M.D. The commission has created a matrix listing more than 20 indicators that will assist with monitoring the relationship between staffing levels and patient-care outcomes, such as patient falls and medication errors.
The accrediting agency's intent is to create a system that will reveal staffing concerns when they occur but not to establish "magic ratios" for staffing, O'Leary said.
The issue of staffing ratios is a hot one. Influential Harvard Professor Lucian Leape, M.D., recently said it is critical that the healthcare industry establish adequate nurse staffing ratios. Leape predicted that nurse-staffing levels would end up being regulated.
California is attempting to implement such regulations under a first-of-its-kind state law passed in October 1999. As of next January, the state's 450 acute-care hospitals will have to comply with mandated nurse-patient ratios, defined on a unit-by-unit basis. Labor organizations and hospitals are conducting a heated debated about what those standards should be (Oct. 16, 2000, p. 3).
The staff screening initiative is another in a series of changes the Oakbrook Terrace, Ill.-based organization is making regarding several hot-button issues in healthcare. New standards on patient restraints and pain management went into effect at the beginning of the month. New patient safety and medical-error standards are scheduled to be part of accreditation for hospitals as of July.