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
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.
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
Foster said JCAHO's
alert will educate hospital administrators who may not have known that such
infections should be reported to JCAHO.
"Unhealthy Hospitals," January 22, 2003