Sunday, September 04, 2011

OMG. It's supposed to be 80 here tomorrow.

And the low?

In the fifties.

I might just live long enough to go to California with Pens The Lotion Slut and see Beloved Sister.

In the meantime, the Universe reminded me that there's something worse than having a chunk gone out of your head: Joint Commission survey prep.

For those of you who are lucky enough never to have heard of the Joint Commission (the Joint Commission on Accreditation of Healthcare Organizations, aka "TJC," aka "JCAHO," aka "Our Benevolent Overlords"), it's a not-for-profit organization that sends out "Surveyors" every so often to your local hospital to determine whether or not people are charting, washing their hands, sterilizing instruments and changing lightbulbs--all the stuff that goes into running a hospital.

Surveys are usually unannounced. You can be sure that the middle manglement of every hospital in every city across this great land is on speed-dial to every other hospital the minute TJC shows up, to warn everybody that The Beast Is In The House. You don't want to be caught unprepared, without liners in your trashcans or with mops in the corners of the utility closets.

Accreditation is bullshit. When a survey's expected, the management of a hospital decrees that every chart will be audited for errors and omissions. Every bit of equipment that normally languishes in the hallways between uses gets taken away and stored somewhere. Things that are normally unlocked, like syringe drawers and storage room doors, are locked by the housekeeping staff, who usually have the only keys. Nurses are subject to surprise searches to be sure nobody's carrying meds in their pockets. Floors get polished and bathrooms get cleaned.

And then, once TJC has either not come or has come and gone, things go back to their usual comfortable, vaguely disorganized state. About the only thing that Joint Commission accreditation tells you is whether or not the management of a facility can handle having a bag of rabid weasels thrown into their midst unexpectedly, because that's what it looks like.

Prep is horrible. Everybody who shows more intelligence than your average turnip is handed a stack of charts to audit--in other words, you go back from day one of a patient's stay and look at everything everybody has written--and correct. Correction means hunting down the folks who made an error and sitting on them until they fix the error (or omission). Given that we move patients between Sunnydale and Holy Kamole all the time, chart prep means hours and hours of soul-destroying fiddly work, followed by the opportunity to have doctors and nurses from two hospitals and all the associated clinics pissed off at you, the auditor.

My job this week was auditing, along with precepting a new experienced nurse for the unit. Thankfully the nurse was sharp and with-it, or else I would've leapt out the window by nine ack emma. Chart audits are the worst thing I can think of to do at work.

But we're prepared! For the survey! And it'll be great!

Never mind that another hospital in Bigton got surveyed a couple of years ago and won accolades from the JC folks, only to return to having potato chips show up in supposedly-sterilized surgical kits. I'll bet their trash bin liners looked fantastic.

14 comments:

jimbo26 said...

What we in the UK call a Quango : get paid a lot of money to do nothing .

Brad said...

Potato Chips can be sterile.

danielle said...

Yeah we just went thru ours....they showed up a month and a half later than expected...you did forget the other part of the clincher - the hospital PAYS for this stress...actually pays TJC and, at least in our case, pays a consultant to come out and pre-survey you - meanwhile picking out the most stupid things in the world to comment on. This year the survey wasnt bad at all - TJC messed up and actually hired human beings to do it.

messymimi said...

Good luck, and glad the weather is giving you a break from straight heat.

Sara said...

At the nursing home I work at, our "window" for state survey is open from now until January, so all the administration has their panties in a bunch making sure everything is just so.

The funniest part is all the people that come out of the woodwork when the surveyors are here to make sure everything looks and goes right.

bandagedboater said...

That's one advantage to working night shift - we don't need to deal with the Weasels and JCAHO very often. They'd rather sleep! We don't see management very often either. I love night shift!

Michelle in Colorado Springs said...

The thing that gets me is when They decide that some thing needs to be done differently and the hospital needs to drop everything and change the way it has been done for years.

MamaPontius said...

We have had TJC and CMS...it's been a great year!

terri c said...

OY!!!! We have 'em where I work too and people sure panic. I just try to hide.

Anonymous said...

Girl, we deserve a medal for surviving this Summer. I'm in Dallas. Don't know about you but I feel like I've lost three months of my life to staying in the cool house with all the drapes and blinds closed. I'm surprised I haven't grown vampire fangs.

woolywoman said...

Yup. Pack of weasels. I just wish they would keep the hospital as clean all the time as they do on Joint days. It always looks as shiny as if our mothers-in-law were coming to visit. Then, POOF no more overtime for housekeeping.

JA-RN said...

one place I worked rented tractor trailers to keep all the extra stuff until the Joint left!

shonyB said...

No extra time granted until surveyors are gone. Sometimes 3 months of no extra time off.

This year it's a double whammy. One down, one to go. You guessed it no time off during those "windows". After that it is limited time during holiday season.

It is amazing who works here. I've challenged people I see on the homes only to be told "I'm Bigshot and you should know who I am". Nope been here 7 years you don't come to the homes. Now here you are chatting it up with the peeps who live here. *sigh*

Rosanna said...

Sara's very good comment----(i.e., at 10:02 AM, Above)----about "the people that come out of the woodwork when the surveyors are here to make sure everything looks and goes right," reminded me SO MUCH OF the Accreditation Review, (every 3 years), for our #2 large Ambulatory Clinics. Normally, certain Administrative/Managerial Staff members often didn't professionally-acknowledge EVEN THE PRESENCE OF certain longtime, very dedicated employees, (e.g., in passing in the hallways and/or at meetings); YET when the Surveyor(s) were "IN the building"............ then (SUDDENLY) there were Administrative/Managerial............ *Smiles*-For-All!!

F.a.k.e.r.o.n.i. *deluxe*............

A second rather conspicuously-noticeable Accreditation time "superficiality" was that, (in our routine Nursing Rotations to different Clinic areas), the nurses who probably would've been, say, really good socially/"decoratively" at Home-Builders Convention booths............ received the most "visible" Clinic Assignments............ while those of us who simply answered questions factually/completely/straight-ahead............ were somewhat "exiled" in our assignments............ *seemingly* to the FAR North 40 (acres), on top of the most DISTANT Mesa, (haha)!!

All things considered, I think it's better TO BE Accredited than NOT TO BE Accredited; but I'm not quite sure whether or not I ever............ *fully* understood the phrase "The Games People Play"............ UNTIL I, (in my nursing career), really helped-out-with that............ *first* Healthcare Accreditation!!