ISMP Alert Clarified
Standards of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) state that “pharmacy services are available when the pharmacy is closed or otherwise unavailable.” The intent of this standard is that a hospital must have a safe means of providing pharmacy services when the on-site pharmacy is closed or not available.

The Institute for Safe Medication Practices (ISMP) in its May 30 issue of ISMP Medication Safety Alert, stated that the JCAHO is banning open access to pharmacies after hours, which has led to confusion. To clarify the interpretation of its standard, the JCAHO said it does not intend to ban open access to pharmacies and has posted frequently asked questions on its Web site. 

The questions and answers indicate that total after-hours open access to an entire pharmacy is not acceptable as a “system” but may be acceptable in emergency situations on a limited basis, with precautionary measures taken to assure safety, such as accurate labeling and staff training.

The JCAHO identifies acceptable alternatives to open access, such as use of an outside pharmacy, night cabinet, automated dispensing machine, providing access to a limited section of the pharmacy, and use of on-call pharmacist services. The questions and answers are available online at www.jcaho.org/standard/faq/pharm_faq.html.

JCAHO Offers Online Survey Application

Beginning September 2001, most organizations due for JCAHO survey in March 2002 will have the option of applying for survey on JCAHO’s Web site, www.jcaho.org.  When an organization is due for survey, JCAHO will provide it with a password to access the online application which is customized in a secure, password-protected environment that allows review, update and printable features.

Pre-populated information from an organization’s last application for survey allows the organization to simply update, remove or add to the demographics or other data.  The application prompts for required information, cutting down on future calls from JCAHO account representatives.

When it’s time for the actual survey, surveyors will have access to the application to familiarize themselves with an organization’s size and services.  In the future, the profile from an online application will also be used to generate customized standards specific to an organization.

JCAHO Core Measures

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) will implement its national core measure sets beginning July 1, 2002. 

To prepare for the implementation, accredited hospitals serving patient populations with acute myocardial infarction (AMI), heart failure (HF), community-acquired pneumonia (CAP), and pregnancy and related conditions (PR), must choose core measure sets by June 30, 2002. 

The JCAHO has established the following core measure set selection criteria to assist hospitals in making the decisions:

• Hospitals may select two core measure sets related to their services and discontinue collection and submission of non-core ORYX measures. 

• Hospitals may identify only one core measure set related to their services but will need to continue collection and submission of data for four non-core ORYX indicators.

• Hospitals not able to identify core measure sets related to their services will continue collection and submission of data for six non-core ORYX indicators until applicable core measure sets are developed.

Coding Advice Available Online
The AHA's Central Office, a source for coding advice and information, is now even more accessible with the re-launch of its Web site http://www.AHACentralOffice.org.

The Web site will serve as a Coding Resource Center for hospital providers. Health information management professionals will have access to free coding advice and extensive information on the ICD-9-CM and HCPCS classification systems. It also features free downloadable samples of Coding Clinic on ICD-9-CM, Coding Clinic on HCPCS and Coding Clinic on CD-ROM by 3M.

Other features include news alerts and product news features, an AHA Central Office product section and on-line quizzing for continuing education credits. The products and quizzes are available on a fee basis.

The AHA Central Office is comprised of two services, the Central Office on ICD-9-CM and the Central Office on HCPCS. The Central Office on ICD-9-CM was established in 1963 through a memorandum of understanding between AHA and the National Center for Health Statistics (NCHS). It serves as a clearinghouse for ICD-9-CM issues; works with NCHS and the Centers for Medicare & Medicaid Services to maintain integrity of the classification system; and recommends future revisions and developments for ICD. It also develops educational programs and materials on ICD-9-CM.

The Central Office on HCPCS, which started earlier this year, seeks to provide consistent outpatient coding advice and education for hospital outpatient providers.

"AHACentralOffice.org provides user-friendly, unbiased coding information for health information management professionals," said Jim TeWinkle, director of coding product development at AHA's Health Forum.

Health Care Providers Receive Bad Safety Record
Health care providers accounted for about 3,400 of the 14,000 employers with the worst employee safety records in 1999, according to new data from the Occupational Safety and Health Administration (OSHA).  The agency sent letters to 1,000 of those 14,000 employers with the highest rates of injury and illness, saying it would target them for inspection through the end of the year.

Providers can seek advice on improving their safety from outside consultants, their insurance carriers, or their state workers’ compensation agency, OSHA said.  The agency also funds safety and health consultation services for small businesses in each state.