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The Joint Commission on Accreditation of Healthcare Organizations has announced the 2007 National Patient Safety Goals and related Requirements for each of its accreditation programs and its Disease-Specific Care certification program. The Goals and Requirements, recently approved by the Joint Commission's Board of Commissioners, apply to the nearly 15,000 Joint Commission-accredited and certified health care organizations and programs.

Major changes in this fifth annual issuance of National Patient Safety Goals include extension of a Requirement that accredited organizations define and communicate the means for patients and their families to report concerns about safety, across all Joint Commission accreditation and certification programs. The Requirement — first applied to the Home Care, Laboratory, Assisted Living, and Disease-Specific Care programs in 2006 — is the central expectation of the Goal: "Encourage patients' active involvement in their own care as a patient safety strategy."

In addition, a new Requirement specifies that behavioral health care organizations, as well as psychiatric hospitals and patients being treated for emotional or behavioral disorders in general acute-care hospitals, identify patients at risk for suicide. This Requirement is part of the Goal: "The organization identifies safety risks inherent in its patient populations." For home care organizations, a corresponding Requirement under this Goal stipulates that these organizations are to identify risks associated with long-term oxygen therapy such as home fires. Finally, new language in one of the two Requirements under the existing medication reconciliation Goal stipulates that a complete list of current medications be provided to the patient on discharge from care. This expectation is applicable to the Ambulatory Care, Assisted Living, Behavioral Health Care, Critical Access Hospital, Disease-Specific Care, Home Care, Hospital, Long Term Care, and Office-Based Surgery programs.

"The 2007 National Patient Safety Goals target critical areas where patient safety can be improved through specific actions in health care organizations," says Dennis S. O'Leary, M.D., president, Joint Commission. "Organizations that truly integrate these requirements into their daily operations will realize major opportunities to improve patient safety."

The development and annual updating of the National Patient Safety Goals and Requirements continue to be overseen by an expert panel that includes widely recognized patient safety experts, as well as nurses, physicians, pharmacists, risk managers and other professionals who have hands-on experience in addressing patient safety issues in a wide variety of health care settings. Each year, the Sentinel Event Advisory Group works with the Joint Commission to undertake a systematic review of the literature and available databases to identify candidate new Goals and Requirements. Following a solicitation of input from practitioners, provider organizations, purchasers, consumer groups, and other parties of interest, the Advisory Group determines the highest priority Goals and Requirements and makes its recommendations to the Joint Commission.

The full text of the 2007 Goals and Requirements is posted on the Joint Commission website. Compliance with the Requirements or alternatives judged by the Advisory Group to be acceptable is a condition of continuing accreditation or certification for Joint Commission-accredited or certified organizations and programs.

The Joint Commission on Accreditation of Healthcare Organizations a;so announced the approval of an infection control standard that requires accredited organizations to offer influenza vaccinations to staff, which includes volunteers, and licensed independent practitioners with close patient contact. The standard will become an accreditation requirement beginning January 1, 2007, for the Critical Access Hospital, Hospital and Long Term Care accreditation programs.

"Preventing the spread of the flu protects patients and saves lives. Encouraging health care workers to be vaccinated can play a vital role in stopping the transmission of this potentially fatal infection," says Robert Wise, M.D., Vice President Division of Standards and Survey Methods, Joint Commission.

The Joint Commission developed the standard in response to recommendations by the Centers for Disease Control and Prevention (CDC) making the reduction of influenza transmission from health care professionals to patients a top priority in the United States. While the CDC has urged annual influenza vaccination for health care workers since 1981, the CDC's "Morbidity and Mortality Weekly Report" published earlier this year calls for stronger steps to increase influenza vaccination of health care workers. Despite the recommendations, the vaccination rates as measured by the CDC remain low.

Studies show that influenza causes 36,000 deaths and over 200,000 hospitalizations on average in the United States annually. Furthermore, health care-associated transmission of influenza has been documented among many patient populations in a variety of clinical settings, and infections have been linked epidemiologically to unvaccinated health care workers. Typically, fewer than 40 percent of health care workers are immunized each year.

The new Joint Commission standard requires organizations to:

• Establish an annual influenza vaccination program that includes at least staff and licensed independent practitioners;
  
  
• Provide access to influenza vaccinations on-site;
  
  
• Educate staff and licensed independent practitioners about flu vaccination; non-vaccine control measures (such as the use of appropriate precautions); and diagnosis, transmission and potential impact of influenza;
  
  
• Annually evaluate vaccination rates and reasons for non-participation in the organization's immunization program; and
  
  
• Implement enhancements to the program to increase participation.