It’s true—most of the time, we don’t go about our day with an expectation that an adverse event will occur. But unfortunately, sometimes there are emergency situations, whether or not we are prepared for them. And sometimes in health care, people make mistakes that result in patient harm, despite having the best intentions when caring for someone. This is why it is so important that at UTMB, we devote ourselves every day to promoting patient safety, environmental safety, proper patient identification, medication safety, infection control and effective communication, whatever our role may be.
For some time now, the Health System has been on high alert, busily preparing for our Joint Commission re-accreditation survey. However, the preparations and safety measures on which we are currently so acutely focused are things we should always be doing to ensure the safety of our patients and staff. Whether it is focusing on prevention, communication, processes, documentation, or ensuring pathways are clear in case of emergency, we must always be alert. Our re-accreditation survey window, which extends through the next two months, has been a great opportunity to reinvigorate our current efforts to ensure we are providing the safest possible care for our patients, families and one another.
Just as achieving high reliability in health care is a daily endeavor, our successful completion of the survey will require the cooperation and support of every provider and staff member. After the survey, our competitors, affiliates, managed care and insurance companies, referring physicians and, most importantly, our patients and their families will be able to read the details of our performance. I believe the results they see will truly reflect that every UTMB faculty member, clinician and employee at every level is committed to providing excellent patient care!
Why is a good accreditation survey so important? The Joint Commission accreditation survey is a nationwide seal of approval indicating that UTMB meets high quality and safety performance standards. It says we deliver the best care to all of our patients in a safe environment. Therefore, we must remain committed to zero patient harm, a culture of safety, and continual process improvement. Never ignore or tolerate unsafe conditions, behaviors and practices, and when or if we see something that could be unsafe or cause harm, we must communicate clearly and close the loop on conversations with our team. If needed, escalate issues. It’s simply the right thing to do for our patients.
Our success on the survey will require everyone’s familiarity with Joint Commission requirements in their particular area, and I have full confidence in our teams that we will be fully prepared for the survey. Please review the materials provided on UTMB’s Joint Commission website, including readiness checklists and the preparedness handbook. If you are a manager or supervisor, review employee readiness tips with your team when you have your weekly relay meetings, especially handbook sections “How to Participate in the TJC Survey” and “Other Helpful Hints for the Survey” on pages 12-13.
Spanish novelist, poet and playwright Miguel de Cervantes once said, “To be prepared is half the victory.” Perhaps the other half is to remain vigilant!
If you have questions about Joint Commission standards, please contact Janet DuBois, Associate Director of Accreditation. For more information on Joint Commission Accreditation preparedness in your area, please visit http://intranet.utmb.edu/qhs/TheJointCommission
Thank you for your dedication to delivering excellent care and service to our patients and families!