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JCAHO Criticicised

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), an influential hospital regulatory group, plans to step up efforts to reduce fatal infections contracted by hospitalized patients after being criticized for not doing its job.

Last year, the Chicago Tribune alleged that, "tens of thousands of such deaths go unreported," and that JCAHO sometimes fails in its duty to ensure hospital quality and safety.

The federal Centers for Disease Control and Prevention estimates that two million patients annually develop often preventable infections while hospitalized and that about 90,000 die.

JCAHO attributes the problem, in part, to hospitals not adequately reporting infection-linked deaths to the agency. In response to the Tribune's articles, the agency

checked its 7-year-old database on patient safety reporting and found that it included only ten such reports involving 53 patients, according to JCAHO president Dr. Dennis O'Leary. Calling the number of received reports on the number of patient deaths from infections acquired in the health care setting "a disproportionately low volume,"  O'Leary points out it's, "possibly because many health care organizations do not view these events as 'errors'" under JCAHO's definition.

Dr. O'Leary urges health care organizations to share this information with JCAHO, since increased reporting will provide useful information on factors that lead to hospital-acquired infections and will help JCAHO develop prevention strategies.

Better hand-washing practices by doctors and nurses will certainly help, and in a bulletin sent recently to the nation's nearly 17,000 JCAHO-accredited health care facilities, the agency urged compliance with new CDC hand-washing guidelines.

The infection-control guidelines, issued last October, urge doctors to use alcohol-based products after treating each patient to help reduce the spread of infections.

JCAHO also has convened an expert panel of doctors, nurses and other health care professionals to recommend ways the agency can "bring our standards up to state-of-the-art," to reduce hospital-acquired infections, and "Making adherence to the new hand-washing guidelines a requirement for accreditation may be among the recommendations," according to O'Leary.

The 20-member panel will meet in February and has been asked to come up with recommendations by summer so JCAHO can introduce new infection standards by early next year.

The CDC's recommended hand-washing practices already are "fairly widespread and becoming more so" at hospitals nationwide, said Nancy Foster, senior associate director of policy at the American Hospital Association.

She called fighting hospital-acquired infections "a never-ending battle…" complicated by competing forces of increasingly sick and vulnerable patients and increasingly drug-resistant germs.

Foster said JCAHO's alert will educate hospital administrators who may not have known that such infections should be reported to JCAHO.

Source: Chicago Tribune investigation: "Unhealthy Hospitals," January 22, 2003

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