TJC begins advanced certification for hospice
Improving quality of life improves quality of care
The first hospice in the country, The Connecticut Hospice, opened its doors in 1974 and started a movement. Now in a serendipitous turn of events, that hospice was the first one to receive advanced certification under a new program from The Joint Commission.
After the Connecticut Hospice was certified, four other facilities quickly received their certifications, too: Regions Hospital in St. Paul, MN, Strong Memorial Hospital in Rochester, NY, Mt. Sinai Medical Center, New York City; and St. Joseph Mercy Oakland, Pontiac, MI.
Since it's been around so long, some might wonder just why The Connecticut Hospice would feel a need for advanced certification, but Joseph Andrews, MD, chairman of the Connecticut Palliative Group and medical director of The Connecticut Hospice, says that the program is a good external check on the organization's internal quality improvement and self-assessment programs. "The Joint Commission has a long history of rigorous checks, so it can act as a highlighter for us," he says.
The hospice sailed through without a single adverse recommendation, something Andrews is very proud of. "Surveys always find something. This gives us a good sense of our standing, that our methods are correct, and that we can continue to be a good resource for other organizations."
Sandy Klimas, MSN, MPH, senior vice president of clinical services and clinical development at the Bradford facility, said it "seemed right to try" for the certification, simply because they were the first hospice in the nation. "We are a leader, so being the first makes us proud."
Andrews says the surveyor was anxious to see the team in action and so came to watch the daily meeting of the interdisciplinary team that discusses patients. "We just did our usual thing. We did not rehearse or anything," he says. "I've been here five years and it still amazes me how well we know our patients, the interchange of information between us, and the knowledge we all have of where they are clinically, their pain management, what support they have, and any medication interactions they have. If I was watching us for the first time, I would have certified us."
To prepare for the certification survey, they studied the standards and made sure they were following them. It was time-consuming, but not difficult, says Klimas, mostly because the program is so established. She could see a newer program having more difficulty.
Spreading the word
One key to achieving readiness was spreading the word that they were going to attempt this advanced certification. Klimas says they used the leadership team to do that. Then they just made sure they were following all the standards and choosing elements to show off to the surveyor, such as a quality improvement project they did last year on hand-washing that led to 100% compliance. Another project they highlighted involved pain management assessment, she adds.
The ability to get certification is reflective of the entire movement to high-quality end-of-life care, says John Coombs, MD, president and chief operating officer at the Center for Healthcare Governance, part of the American Hospital Association in Chicago. "This way of caring should be used for all patients: teamwork, patient involvement, communication, patient-centeredness. I think over time you'll see many more palliative care programs attempting this certification."
After Connecticut Hospice was certified, Andrews says they had several calls asking about how they prepared. "We have been a bellwether for a long time," he says. "We are in a good position to help others and look forward to doing that."
David Eickemeyer, associate director at The Joint Commission, says that how hard the hospital will have to work to achieve this advanced certification depends on the maturity of the program. The service needs to be available 24 hours a day, seven days a week, but a lot of newer services are only operational from 9 a.m. to 5 p.m. That does not mean you have to be fully staffed all the time, he says, but it does mean you have to have made provisions for those other hours of the week. "You have to be there whenever the need arises."
The Joint Commission wants to see a multidisciplinary team, says Michele Sacco, MS, MPH, The Joint Commission's executive director for health staffing services certification and advanced certification for palliative care. "It can't just be one person," she says.
So far, there are some 20 applications from 11 states waiting for review at The Joint Commission, Sacco says, and Eickemeyer notes that this has taken off faster than any other program the commission has started.
"It is a win-win for the patient and the hospital. It can extend life and quality of life, and it can reduce length of stay in intensive care," Sacco says. "It's all good."
For more information on this topic, contact:
- Joseph Andrews, Jr. MD, Chairman, The Connecticut Palliative Group and Medical Director, Connecticut Hospice, Bradford, CT. Telephone: (203) 315-7602.
- Sandy Klimas, MSN, MPH, Senior Vice President of Clinical Services and Clinical Development, Connecticut Hospice, Bradford, CT. Telephone: (203) 315-7602.
- John Coombs, MD, President and Chief Operating Officer, Center for Healthcare Governance, American Hospital Association, Chicago, IL. Telephone: (312) 278-0868.
- Michele Sacco, MS, Executive Director, Health Care Staffing Services Certification, Advanced Certification for Palliative Care, Joint Commission, Oakbrook Terrace, IL. Telephone: (630) 792-5000.
- David Eickemeyer, Associate Director, The Joint Commission, Oakbrook Terrace, IL. Email: [email protected].
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content