JCAHO Jeopardy. Kelly D. Young, MD, MS Harbor-UCLA Medical Center. JCAHO BASICS. PATIENT SAFETY. WORK- PLACE. DOCUMEN-TATION. POT-POURRI. $100. $100. $100. $100. $100. $200. $200. $200. $200. $200. $300. $300. $300. $300. $300. $400. $400. $400. $400. $400. $500. $500.
Kelly D. Young, MD, MS
Harbor-UCLA Medical Center
What does JCAHO stand for?
Hint: It’s not “Julie Comes And Hangs Out”
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Joint Commission on Accreditation of Healthcare Organizations
AKA “Yes, we can close your hospital and make you seek new residencies”
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That’s why you’re playing this game, right?
What is “tracer methodology”?
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Surveyors analyze a hospital’s systems by following individual patients through their hospitalization, evaluating multiple care units, departments, and services rendered to the patient.
What is HIPAA? Name one way protected health information is kept private in your department.
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stare at the board
What is ORYX?
Bonus $100: name one core measure of ORYX
More next slide
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Name one of the 2009 National Patient Safety Goals
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Check whether to stop old meds
Patient gets yellow copy
List new long-term meds here and write in layperson lingo
Fill out your name, number, date, time, etc.
Name one way you reduce the risk of health-care associated infections in your department
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How do you improve the accuracy of patient identification in your department?
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How are you improving the effectiveness of communication between caregivers?
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Notes feature of Synapse –
Overread by radiologist and we
are notified of any disagreements
Name 3 of the unapproved abbreviations
IU (international unit)
1.0 (no terminal zeros)
.5 (always use a leading zero – “always lead, never follow”))
X3d (for 3 days or for 3 doses)
TIW (three times weekly)
qD or qoD (every day, daily, or every other day)
MS, MSO4, MgSO4 (morphine sulfate or magnesium sulfate)
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Where are the fire extinguishers in the PED?
Where’s the oxygen shutoff valves in case of a fire?
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What color “code” would you call if you had a violent patient? Who would come?
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What do the RACE and PASS mnemonics stand for when there is a fire?
Contain the fire (close doors)
Extinguish the fire when it is safe to do so
Pull the pin
Aim the nozzle at the base of the fire
Squeeze the handle
Sweep the nozzle from side to side
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What should you do in the event of a hazardous material spill?*
* Material more hazardous than cafeteria food, but less hazardous than anthrax
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What are code pink, code white, code orange, code gray, and code triage?
($100 per correct answer)
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How do you document in your procedure note that you confirmed the correct identity of the patient, and the correct site of the procedure?
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Document that a “time out” was done (check box on procedure note area of 253 form)
How would you write the order for 100 mg of Motrin to be given to a 10 kg child PO?*
* Answer is NOT “with a pen”
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Motrin 100 mg = 10 mg/kg PO now
Must put mg/kg
(Date and time order, of course)
What’s wrong with this order?
Motrin 600 mg PO q 6-8 hours prn pain (standard adult dose)
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No range orders allowed
(No range in doses, no range in time intervals)
Which is acceptable?
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What’s the “fifth vital sign” that we document on ALL patients, and where do we document it?
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Pain med w/in 30min
Reassess w/in 30min of IV/IM pain med, w/in 60min of PO
Pain score < 4 at d/c or pain med for home
True of False:
A minor sibling may translate for the parent if the minor is 13 years old or older, clearly fluent in both languages, and the parent and minor consent to using the minor as an interpreter
“El bebe tiene mucho fiebre, hasta ciento siete, y no come nada, nunca, en todo su vida, (esos Cheetos son la primera comida de todo su vida), y tiene fiebre por dos o tres meses, y le duele todo su cuerpo, y tiene ronchas y grippe y tos y nausea y diarrea…”
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So VERY VERY False!
Does Harbor have a mission?
It’s not “To get our residents more sleep and more money.”
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Mission: to provide high quality, cost-effective, patient-centered care through leadership in medical practice, education and research.
What quality performance data are collected in your area, and how are you involved?
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Residents perform peer review of AED and PED charts for pain assessment and management. The data are collated and shared on a quarterly basis, and individual residents also receive a report of how they performed. Also, chart review 8am in the PED.
Dr. X is starting his shift in the PED. He walks down the hall, Starbucks in hand, and waves “hi” to the nurses and clerk. He rounds the corner, going through the propped open door to stand in front of the board. He notes that there are 2 patients with the same initials on the board. He dumps his empty coffee cup in the trash, sets down his trusty Harriet Lane Handbook on the counter, and picks up a chart. Where’s the JCAHO violation?
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Only special fire doors may remain open. Doors may not be propped open (including the 2 doors on either side of the PED board).
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