The Joint Commission recently announced a surprising result from its 2017 surveys of accredited hospitals. A whopping 72% of surveyed hospitals and critical access hospitals were noncompliant with The Joint Commissions accreditation standards for high-level disinfection and sterilization.
The Joint Commission is the oldest and largest of the independent accrediting organizations for hospitals. They have a unique perspective of being able to identify nationwide problems in healthcare because they continuously conduct on-site inspections and surveys of accredited hospitals.
When The Joint Commission issues or modifies standards, hospital administrators take note and act fast to make sure that their facilities and health care providers comply with them. While not common, if a hospital loses accreditation by The Joint Commission, it risks becoming ineligible for Medicare and Medicaid reimbursement.
I know that hospitals take The Joint Commission’s standards and accreditation seriously because I am a former hospital administrator.
I started my post-graduate educational work in medical school and was fortunate to have a full scholarship through the U.S. Army’s Health Professions Scholarship Program. When I decided to change my career path from medicine to health law, I had an obligation to serve on active duty as an officer in the U.S. Army. My principal assignment was as a hospital administrator at the General Leonard Wood Army Community Hospital, at Fort Leonard Wood, Missouri. One of my responsibilities in that role was to be the hospital’s JCAHO (The Joint Commission) compliance officer.
The Joint Commission standard IC.02.02.01 requires hospitals to reduce the risk of infections associated with medical equipment, devices, and supplies. According to its analysis, the most vulnerable locations for lapses in sterilization or high-level disinfection of equipment are ambulatory care sites, which would include surgery centers and office-based surgery facilities.
Data from The Joint Commission’s on-site surveys of accredited hospitals shows an alarming increase in noncompliance on the standards, from around 20% in 2009 to around 60% in 2016.
The reasons for having a standard on reducing infections related to medical equipment should be easy for hospital administrators and healthcare providers to understand, because they are readily apparent to patients. Improperly sterilized medical equipment poses risks including patient contamination and causing an infection outbreak.
As a Houston, Texas medical malpractice attorney, I have handled many cases where contaminated equipment played a significant role in patient injuries. The medical literature reflects that poor hospital equipment sterilization practices can lead to outbreaks of infections like Pseudomonas aeuruginosa, E. coli, methicillin resistant Staphylococcus aureus, Salmonella, and Clostridium sordelli.
In my experience, hospitals and outpatient surgery facilities that have infection control problems often have poorly-trained staff and inadequate supervision. To address these deficiencies, The Joint Commission recommends that hospitals and ambulatory surgery centers implement:
· Competency and training for staff members on infection and sterilization practices.
· Follow manufacturer’s instructions for use on instruments, equipment, and supplies used for disinfection and sterilization. In 2018 guidance, The Joint Commission announced that it would mark hospitals as noncompliant for not following manufacturer instructions.
· Ensuring that Healthcare provider staff has access and knowledge to guidelines specific to disinfection and sterilization.
· Hospital or facility leadership should implement a quality monitoring program, including documentation for disinfection and sterilization logs.
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Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. A member of the board of directors of the Houston Bar Association, he was honored, in 2017, by H Texas as one of Houston’s top lawyers. In May 2018, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.
