The Joint Commission

The Joint Commission 2011 National Patient Safety Goals set forth clear guidelines for how health care organizations can improve the quality of care. As the following table illustrates, MEDITECH's Health Care Information System (HCIS) provides many tools to help organizations increase patient safety and meet The Joint Commission's goals.

The Joint Commission Goal The Joint Commission Goal Description MEDITECH Tools
Goal #1:
Improve the accuracy of patient identification
Use at least two patient identifiers when providing care, treatment, or services.

Eliminate transfusion errors related to patient misidentification.

MEDITECH's HCIS ensures positive patient identification. Caregivers can use medical numbers, health insurance numbers, account numbers saved within the MEDITECH system, and swipe technology to identify their patients prior to taking blood samples, administering medications, or blood products.

MEDITECH's HCIS helps to ensure safe medication administration through the Five Rights of medication management: Right Patient, Right Medication, Right Dosage, Right Route, and Right Time. To ensure that the right patient gets the right medication, MEDITECH's system offers a variety of patient identifiers, including the ability to scan bar codes on patient wristbands and medications to correctly identify the patient and the appropriate medication. Caregivers utilize bar code scanning technology prior to administering medications to confirm patient identity and medication information against data readily available via MEDITECH's on-line Medication Administration Record.

MEDITECH's system offers a variety of patient identifiers, including the ability to scan bar codes.

Goal #2:
Improve the effectiveness of communication among caregivers
Report critical results of tests and diagnostic procedures on a timely basis.
MEDITECH provides physician desktops and nursing status boards as a global view of the caregiver's patients and serves as a central point from which to process all aspects of the patient's care.

MEDITECH's fully-integrated system facilitates comprehensive, enterprise-wide communication throughout a health care organization. MEDITECH's table-driven system can assist in meeting The Joint Commission's list of do not use abbreviations, acronyms, and symbols throughout your organization. Relevant clinical data displays provide real-time patient information that is readily available when managing medication therapies, both at the point of order entry and during medication administration. Whether ordering or administering medications, clinicians have the right information, which provides critical decision support. Capabilities from throughout the MEDITECH HCIS are integrated to ensure a coordinated and safe ordering process. Pharmacists, nurses, laboratory and radiology technicians, and the rest of the care team are all included in the physician-initiated process. Physicians can also sign any verbal orders and view results from wherever they may be.

Goal #3:
Improve the safety of using medications
Label all medications, medication containers (e.g. syringes, medicine cups, basins), and other solutions on and off the sterile field in perioperative and other procedural settings.

Reduce the likelihood of patient harm associated with the use of anticoagulation therapy. Note: This requirement applies only to hospitals that provide anticoagulant therapy and/or long-term anticoagulation prophylaxis where the clinical expectation is that the patient's laboratory values for coagulation will remain outside normal values.

In order to limit and standardize drug concentrations, the MEDITECH system helps control and manage inventory, analyze supply usage, and manage maintenance equipment throughout your health care organization. To help pharmacists comply with government regulations, organizations can track inventory more closely by identifying stock medications at all stock locations and record the use of controlled substances. Pharmacists can also create robust reports including Controlled Drug Dispensed Report, Controlled Medication Log, and Daily Controlled Drug Inventory Report.

MEDITECH can also support users in providing the capability of printing labels in supporting applications.

Goal #7:
Reduce the risk of health care-associated infections
Comply with either the current Centers for Disease Control and Prevention (
CDC) hand hygiene guidelines or the current World Health Organization (WHO) hand hygiene guidelines.

Implement evidence-based practices to prevent health care-associated infections due to multidrug-resistant organisms (MDRO) in acute care hospitals. Note: This requirement applies to, but is not limited to, epidemiologically important organisms such as methicillin-resistant staphylococcus aureus (MRSA), clostridium difficile (CDI), vancomycin-resistant enterococci (VRE), and multidrug- resistant gram-negative bacteria.

Implement evidence-based practices to prevent central line-associated bloodstream infections. Note: This requirement covers short- and long-term central venous catheters and peripherally inserted central catheter (PICC) lines.

Implement evidence-based practices for preventing surgical site infections (SSI).

* These requirements have a one year phase in period that includes defined expectations for planning and development milestones at 3, 6, and 9 months in 2009. Implement by January 1, 2010.

The infection control functionality of MEDITECH's Laboratory Information System helps providers to effectively and efficiently identify health care-associated infections. An organization's infection control group can easily track patient infections by automatically flagging organisms by markers or through other customer-defined screens. Staff has the ability to generate reports based on patient, location, physician, site of the infection and type of organism – whether sensitive or resistant to certain antibiotics. Depending on the outcome of the reports, the infection control group can automatically receive alerts, which will assist them in tracking nonsocomial infections. Clinicians can also pull data from throughout the MEDITECH HCIS and store it in a secure database for robust reporting and benchmarking by authorized users. Organizations can thereby track and report on a variety of issues such as patient and visitor incidents, adverse drug events, employee health and safety, blood utilization, and infections with complete confidentiality. Staff has the ability to effectively analyze their efforts and devise strategies for improving outcomes and regulatory compliance.
Goal #8: Accurately and completely reconcile medications across the continuum of care
A process exists for comparing the patient's current medications with those ordered for the patient while under the care of the hospital.

When a patient is referred to or transferred from one hospital to another, the complete and reconciled list of medications is communicated to the next provider of service, and the communication is documented. Alternatively, when a patient leaves the hospital's care to go directly to his or her home, the complete and reconciled list of medications is provided to the patient's known primary care provider, the original referring provider, or a known next provider of service.

When a patient leaves the hospital's care, a completed and reconciled list of the patient's medications is provided directly to the patient and, as needed, the family, and the list is explained to the patient and/or family.

In settings where medications are used minimally, or prescribed for a short duration, modified medication reconciliation processes are performed. Note: This requirement does not apply to hospitals that do not administer medications.

MEDITECH's integrated and dynamic order management features provide users with the ability to capture and update medication information from a variety of settings.

Whether at an associated physician practice, or in an ambulatory setting such as a clinic or the emergency department, medications that the patient currently takes at home are captured or updated, creating a profile list of medications for clinicians to view throughout the health care enterprise. Any medications written for the patient during the current visit are added to the medication profile. In addition, when the patient is discharged from the facility, medications from the inpatient stay can be converted to outpatient prescriptions.

The comprehensive medication profile list can be viewed throughout the enterprise, for patients who are transferring within the organization. Conversely, a list of the patient's active prescriptions can be generated and made available when the patient transfers outside the network.

Goal #15:
The organization identifies safety risks inherent in its patient population.
Identify patients at risk for suicide. Note: This requirement applies only to psychiatric hospitals and patients being treated for emotional or behavioral disorders in general hospitals.
MEDITECH's clinical applications offer assessments that can be used to identify any patient that may be at risk, with the additional ability to track and trend those outcomes.
Universal Protocol UP.01.01.01
Conduct a preprocedure verification process.

Mark the procedure site.

A time-out is performed before the procedure.

MEDITECH's Operating Room Management solution offers a Multidisciplined Surgical Profile, which includes:
• Ability to view the patient's electronic enterprise medical record and nursing assessments from pre-testing to recovery
• Routines for identifying and maintaining patient allergies and risks for all past and future care
• Reports for capturing outcome data used in risk management and quality assurance
• Document and track implant and explants.

The Multidisciplined Operating Room Management Documentation allows users to document the entire peri-operative episode. The system automatically captures who entered the information and the time of documentation. The information entered becomes part of the patient's surgical profile, as well as part of the statistical database of operating room events.

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