ED Accreditation Update: ED overcrowding survey process may be revamped

ED Accreditation Update

ED overcrowding survey process may be revamped

The Joint Commission is keenly aware that much still needs to be done to address ED overcrowding; in fact, the agency is considering a redesign of its survey process to more accurately measure ED performance in terms of overcrowding, according to a leading Joint Commission official.

These insights were provided in response to a question posed at a March 20, 2007, press conference unveiling The Joint Commission's new report titled Improving America's Hospitals: A Report on Quality and Safety. (The report can be accessed at www.jointcommissionreport.org.)

Following the initial presentations, Arthur Kellerman, MD, MPH, professor and chairman of the Department of Emergency Medicine at the Emory School of Medicine, Atlanta, noted that a table on page 8 of the report showed achievement rates of 90% or greater for several areas of ED performance, including overcrowding, and asserted that these figures did not correspond to reality. He asked the panel whether The Joint Commission had any plans to help facilitate the prompt movement of patients through the ED.

'Not persuaded we are there yet'

Dennis S. O'Leary, MD, president of The Joint Commission, said, "We had a recent public policy round table during which we noted the very high rate of compliance, but I'm not persuaded we are there yet." O'Leary said he had a hard time believing 90% of hospitals are doing an excellent job of compliance. "It may be more an issue of how we execute on-site surveys," he said.

O' Leary noted that most surveys are conducted during the day, while most overcrowding occurs at night. Accordingly, he noted, "We need new ways of assessing compliance with [Joint Commission] standards. We are talking about survey process redesign, to get our arms around that issue."