The Joint Commission on Accreditation of Healthcare Organizations made its second leap into the public policy arena last week when it released a detailed position paper urging the nation to create effective community emergency-preparedness programs and establish a way to evaluate and hold the programs accountable.
While the JCAHO said it would not adopt a new role in overseeing or accrediting the proposed programs, it still requires hospitals to be in continuous compliance with specific emergency-management standards mandated by its hospital accreditation program.
The position paper does not describe new requirements beyond ones that were established in January 2001 or suggest that any will be forthcoming in the future, said Charlene Hill, a JCAHO spokeswoman. She said the JCAHO began drafting the communitywide emergency-preparedness recommendations last year to gather perspectives, come up with solutions, and improve accountability.
"It's part of the bigger picture of addressing public policy issues that impact hospitals and providers in terms of their ability to meet our general standards," she said.
Mark Ackermann, senior vice president and chief corporate services officer for Saint Vincent Catholic Medical Centers, New York, which received 450 patients in the first hour of the World Trade Center attacks, said the JCAHO's Jan. 2001 preparedness standards better prepared Saint Vincent to respond to the terrorist attacks. "But still in many parts of the country, preparedness is a thought and not an action," said Ackermann, who has spoken to healthcare and public-safety providers in 38 states about emergency preparedness. "We need to work together."
Prepared by a 28-member panel of federal and state officials, emergency-care providers and public health and hospital officials, the JCAHO's 48-page call to action outlines broad strategies for devising and sustaining communitywide response systems (See chart).
This is not the first time the Oakbrook Terrace, Ill.-based accrediting agency has jumped on a major policy issue. The JCAHO released its first position paper examining the correlation between the nurse-staffing crisis and patient safety in August 2002 (Aug. 12, 2002, p. 20) and is preparing to release another on emergency department overcrowding in the months ahead. Separately, the JCAHO last week announced it is working with the National Committee for Quality Assurance to offer a privacy certification program to help healthcare organizations comply with regulations of the Health Insurance Portability and Accountability Act of 1996. The JCAHO also recently expanded its accreditation services into the growing telemedicine market (March 3, p. 14).
"The JCAHO was ahead of the curve and looking at emergency management in communities well before Sept. 11," said Kristi Koenig, a physician and the principle adviser on emergency management to the U.S. Department of Veterans Affairs, Washington. "With this initiative we can improve safety and quality of healthcare to the public."
Among 41 specific recommendations outlined in the preparedness position paper, the JCAHO advises the federal government to encourage a community-focused approach to emergency preparedness rather than an organization-specific approach.
"The reality is that most terrorist attacks will be local ... and there will be a fundamental need for coordinated response," said JCAHO President Dennis O'Leary in a conference call with reporters last week. Public health agencies and hospitals still are underfunded to deal with terrorist threats, and many communities "are waiting for someone to call the meeting," O'Leary said.
"The key players should not meet one another for the first time during a disaster," he said.