No subject

Nelson Toussaint ntoussaint at TAMARAC.COM
Sat Dec 22 02:12:45 UTC 2018



December 21, 2018

8:45 PM



Earlier this year a concerted effort was put forth to engage TJC -
specifically Dr. Andy Bland, Medical Director - in discussions about things
they could do to help Improve the Diagnosis element.  After many
discussions, I found him a proponent of moving forward with some diagnostic
process improvements "that would result in actual clinician actions".  We
put together a very noteworthy Team focused on Diagnosis, including some
members of SIDM.  The goal was to engage key TCJ management with Diagnosis
Experts and result in deployable improvements.  Unfortunately, this got a
little bit off-track in timing; however TJC issued a call for feedback
(closed Dec. 15) on an initiative to require all Test Results to be
communicated amongst those involved with tests and diagnostic results for
all patient care.  Mark Graber provided that data in a Nov. 27 message to
the Listserve.


"The Joint Commission's National Patient Safety Goal 02.03.01 requires
healthcare organizations to: "Report critical results of tests and
diagnostic procedures on a timely basis". Because this NPSG is focused on
critical results alone, TJC is now seeking input on how to ensure
appropriate follow-up of all diagnostic test results and consults. This
would include results that may not be critical but could lead to a different
diagnosis or a change in management plans."


This represents a foot-in-the-door, but hopefully leads to additional
improvements.  I expect this activity to include an Expert Team (SIDM
members and others) to assist them in this new development.  Stay tuned!


   Nelson Toussaint




 <mailto:ntoussaint at> ntoussaint at


From: Ruth Ryan [mailto:ruth at RYAN-GRAHAM.COM]
Sent: Friday, December 21, 2018 11:04 AM
Subject: [IMPROVEDX] Joint Commission Safety Goals and Accreditation, do
they relate to quality of care>?


Hello All,


The Joint Commission or TJC has been much in the news of late, e.g., Wall
Street Journal (Hospital Watchdog Gives Seal of Approval, Even After
Problems Emerge 9.6.17), AMA News (Trump administration weighing possible
financial conflicts in hospital accreditation process, 12.19.18), and now
this article by Ashish Jha:

Accreditation, Quality, and Making Hospital Care Better. The JAMA Forum
December 18, 2018 Ashish K. Jha, MD, MPH.

JAMA. 2018;320(23):2410-2411. doi:10.1001/jama.2018.18810.

referring to this new study:

Lam MB, Jha, A et al. Association between patient outcomes and accreditation
in US hospitals: Association between patient outcomes and accreditation in
US hospitals: observational study

Jha concludes from this recent comparative study that accreditation by TJC,
the states or any other body is not associated with improved outcomes or
patient experience. 


He states, "The problem, it seems, is that accrediting organizations are not
focusing on what actually matters to patients. The criticism that these
organizations spend enormous amounts of energy requiring hospitals to focus
on things like signs in the hallway or how documentation is done appears to
have some merit. We need to reexamine the standards required for
accreditation to ensure that they are promoting what's actually important:
the health, safety, and optimal experience of patients."


Diagnosis is largely unaddressed by the patient safety goals and measures of
either TJC  or CMS.  How can we who are advocates of improving diagnosis
participate in this discussion of changing the quality measures used by
accrediting bodies?




Ruth Ryan RN, MSW, CPHRM

Telephone (504) 256-8797

Email  <mailto:ruth at> ruth at

Save the Date: Diagnostic Error in Medicine Conference, November 10-13,
2019, Washington, D.C.

Save the Date: Australasian Diagnostic Error in Medicine Conference, April
28-30, 2019, Melbourne, Australia




Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine

To unsubscribe from the IMPROVEDX list, click the following link:<br>
<a href="" target="_blank"></a>

HTML Version:
URL: <../attachments/20181221/782bcbfa/attachment.html>

More information about the Test mailing list