Another example of TJCs efforts to improve patient care is found in the

Another example of tjcs efforts to improve patient

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Another example of TJC’s efforts to improve patient care is found in the “Provision of Care, Treatment, and Services” (PC) chapter of the Comprehensive Accreditation Manual for Hospitals: The Official Handbook. 409 Under “Performance of Initial Assessments/History and Physical” is this Element of Performance (EP): “Based on the patient’s condition, information gathered in the initial assessment includes the following: . . . physical, psychological and social assessment.” This performance expectation strengthens the NPSG regarding patients at risk for suicide. Most assuredly, inpatient suicide prevention is a vital part of NPSG 15.01.01. In large measure, this goal stems from the fact that inpatient suicide is the second most frequent sentinel event (wrong-site surgery is first) reported to TJC. 410 TJC has made available education and other resource materials to help prevent inpatient suicide. One of the most comprehensive is Reducing the Risk of Suicide , published in 2005. This book summarizes much of this material and lists the key TJC standards. 282 Excerpts from these standards that most apply to continuity of care ap- pear at the beginning of Table 4. None of these are directive in the sense that explicit, measurable requirements are incorporated, although organizations are expected to have and use measurement tools. For example, the timing of the first post-discharge outpatient appointment is never specified. Reducing the Risk of Suicide discusses the literature and gives experts’ opinions about the impor- tance of an appointment soon after discharge, for example, but these opinions do not influence the standards in any noticeable way. Most recently, TJC has issued performance measures that may be in conflict with the goal of reducing inpatient suicide and, by so doing, TJC may have missed an opportunity to improve best practice expectations for psychiatric inpatient units. In late 2003, The Joint Commission was approached by the National Association of Psychiatric Health Systems (NAPHS), the National As- sociation of State Mental Health Program Directors (NASMHPD) and the NASMHPD Research Institute (NRI) to work together to develop and to implement a set of core performance measures for hospital-based, inpatient psychiatric services. This significant initiative has now reached frui- tion with the release of the National Hospital Inpatient Quality Measures-Hospital Based Inpatient Psychiatric Services Core Measure Set (HBIPS). 411 As of October, 2008, these core measures ap- plied. These measures are designed to make possible comparisons across health care organizations and to motivate quality improvement initiatives.
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Continuity of Care for Suicide Prevention and Research 94 The most likely times for inpatient suicide are soon after admission and just before or after dis- charge.
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