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Joint Commission Conference Call - curious

Posted: Jul 31, 2013

Does anyone remember the post about the Joint Commission Conference Call that was supposed to take place on July 23? I am wondering if this call took place and what the result was. I don't see anything on the poster's facebook page, but I am not savvy with facebook. I'd be curious to know the outcome, if any. http://forum.mtstars.com/489327.html

I found this - anon

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It took a bit, since her page is rather busy... needed to scroll a lot.

Anyway, here's her update. I have not watched it yet.

Thanks for the reminder!

http://www.youtube.com/watch?v=o11asGi2zuc

Interesting, but did not really - say much.

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continuing to engage in conversation still does not help MT too much. Seeing as how even some of the higher ups in any commission, not just the Joint Commission, do not even know what it is that we do, I think that would be a good place to start. Educate lay people about our job description. How we do that, is beyond me, but I am sure someone can creatively initiate a means.

by using social media. Post things on Facebook and Twitter pages - the only way

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x

thanks for sharing that - sm

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The impression I gleaned from her original post was that she did not understand the role of the Joint Commission. Her video confirms my impression.

If her background is in quality assurance, she would have done well to perform a little due diligence with respect to the scope and nature of the Joint Commission's role. They are an accrediting body - not an advocacy group.

Transcriptionists and MTSOs are not accredited by the Joint Commission. The fact that the JC is oblivious to the role of MTs and other medical support staff is neither illuminating nor surprising.

I don't know what this woman is thinking, but if I were her, I'd opt for the Fiji Dive Shop idea.

trust me, we tried to tell her what Joint Comm. was and did but - she was not listening. sm

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Hope the commission realizes one does not reflect all,

[X] Bozo

I remember - sm

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I had specifically asked her on what basis she secured the conference call, but she declined to explain. In my opinion, if someone is seeking supporters, they should provide these details. You can't start a movement without information, after all.

true. but JComm was not the place to go in the first place - might as well have asked the local butcher for

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support. She had no clue, which made me think she never worked in-house for a hospital in her life, or she would have known they weren't going to do anything. I hate when people don't know what they're doing and then proceed to represent others. thanks...loads.

yeah. I know. - I agree.

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My take on this - sm

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I think she got the conference call by making them think she was going to reveal some sort of horrible quality-of-healthcare problem affecting hospitals nationwide.

She appears to have completely confused the 3 JC representatives. She seems to see the confusion as them not knowing what MTs are, but from her description of their responses I think they just couldn't figure out what she was complaining about and why she thought they had anything to do with it. You can see it in one's comment to her that they needed to move the conversation along. That is an indication that she was rambling and they weren't going to listen further.

At least they were spared the sight of that messy bed in the background. LOL!

MY take on this... - MT

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Joint Commission Vision

All people always experience the safest, highest quality, best-value health care across all settings.

I think her main goal was to let the joint commission know that these hospitals, clinics, and other health facilities that are supposed to be Joint Commission accredited are not providing the "safest, highest quality, or best-value healthcare." These facilities are paying half-ass wages, but expect the world from MTs when it is unrealistic. I believe her point was to let them know that the hospitals are sacrificing patient care for the almighty dollar. By letting the Joint Commission know what is going on in our field, it might be something that they will consider when deciding to accredit a health facility...how well they actually manage their patient records, whether they keep them in the US for confidentiality purposes, whether their speech recognition program is working properly or being proofed, etc. These facilities can't provide quality care if the medical records are wrong and could cause fatalities!

That is just silly - sm

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The notion that what gets typed into a record can cause fatalities is not supported by evidence. Joint Commission already reviews records. If there was a problem, they would have seen it already.

MTs overestimate the importance of their role in this. The physician who signs the report is responsible. The reports MTs transcribe are NOT used to administer drugs, do tests, or perform surgery.

Not entirely true... - MT

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I'm sure you recall the recent case with Precyse.

Also, just viewing the records is not enough, as the information can appear correct when reading it. Listening to reports while reading along may reveal major errors.

Medical documentation plays a critical role in patient care. I think she was smart to go to Joint Commission. If there is any entity that can scare the living hell out of facilities in a matter of minutes, it's them.

Agree. SM, you're totally wrong. Medical error does - kill people, and we do insert errors. nm

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x

Apparently you haven't been an MT long enough to know that the record you type IS used for thes - MT

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The reports that MTs type are most certainly used to administer drugs, do tests, or perform surgery. How do you think most physicians communicate with each other? Through their records!! When you go to see a specialist, they want your records. Why would they want your records if they aren't going to use them? If you go see a surgeon and all the medical records say that your left leg is to be amputated, that is probably the leg he is going to amputate. If the specialist sees the doctor is prescribing you so many milligrams of a medication, he is going to refill the medication based on those records. He isn't going to call and bother the physician who prescribed them to verify his wishes...he is going to go by the records. Your reply is a good indication of how you completely misunderstand the importance of what your job really is!

No, you misunderstand what doctors do - and how they do it

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No surgeon amputates a left leg because a report said "left." They evaluate the patient and determine the necessity for surgery themselves.

Physicians do not renew medication prescribed by others based on a report. They assess the need for it and the appropriate amount themselves. The amount is validated by the pharmacist. While medication errors are a major problem in healthcare, the errors are not coming from medical reports. The recent Precyse case was due to hospital procedural error, not to the error in the report-they were not to have used the report in the first place.

There are parts of the medical record that MTs never see, so you may be unaware that medication orders are written in the "orders" section. Staff go by that, not what is in typed reports. Lab results are in their own section. Staff go by that, not what is in typed reports mentioning them.

When doctors use VR on their own, or type their own reports, they are largely unconcerned about the majority of errors. Everyone just reads right around them. It is still possible to get the meaning from the report.

The whole idea that an MT's work needs to be 99.9% correct and the concept of major and minor errors, and that this somehow affects patient care is something AHDI cooked up to promote MT. While it is good for work to be accurate, patient care is not suffering.

It is a combination... - MT

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What is used is a combination of what is in the report and what is in the computer, to break it down simply. Errors are on the rise, that is why many facilities are now pulling in information from the computer side of the record into the dictated side. If you have ever worked on an account like this, you would understand. There are codes to enter into your transcription that insert vital signs, labs, medications, allergies, and history once it arrives at the facility. The point of that is to reduce errors.

You might not know this, as well, but thousands of people view each medical record. It is not only used by physicians for decision-making purposes, it is also used for statistical and billing purposes. One mistake in the transcribed report carries on to many other areas, and it affects patient care and reimbursement, costing added time, risk, and funds to correct. You obviously haven't studied health information management.

The purpose of all the recent changes is to streamline this process, making it more efficient, less costly, and more accurate. There is no reason why MTs shouldn't be involved in this process. We are at the forefront of the medical record. There is also no reason why a facility should not have their record process included in their accrediting and hospital rating (think: breaches and identity theft, too.)

How do you think wrong limbs and organs manage to get amputated/removed? - (sm)

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The medical report is one link in the communication chain that can certainly lead to major errors, up to and including fatalities, as the Precyse lawsuit so amply demonstrated. Healthcare procedural errors are rampant, and we have no idea how often the medical report may actually be relied on rather than the MAR, etc., that should be used instead.

Surgery mix-ups surprisingly common

"The errors in the database -- some of which originated with other doctors or support staff, rather than surgeons -- were caused by a range of slipups, including mixing up patient medical records, X-rays, and biopsy samples. All of the mistakes could be traced back to some form of miscommunication."

http://www.cnn.com/2010/HEALTH/10/18/health.surgery.mixups.common/index.html

None of those are due to transcribed errors - sm

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Mixed up records, biopsies, and lab reports, and surgeons forgetting are not MT errors.

Because you only see transcribed reports, and because you are told your reports are critically important, it seems logical to you that those reports are the cause.

That is not the case. Mixed up biopsy specimens? How exactly did THAT happen? Not in one of your reports. Entire mixed up records? Nope. Relying on a nurse's memory? Nope. Wrong patient? Absolutely not.

Most of your typing hasn't included any of these things at the time of the error. The reports have not been dictated yet.

In any event, spelling and punctuation are not going to cause those errors and you would be powerless to correct the rest because YOU DO NOT KNOW what should have been dictated.

Root cause analysis to determine the underlying cause of this type of error does not usually find a typed error. If it had been finding them, something would have been done about it long before now.

You believe you are the critical link in the chain, but you are not.

Never said I was "the" critical link but that we're "one" link in the chain - (sm)

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Nor did I imply that MT error was a "usual" cause. Those were some examples in that article of possible places in the database chain where miscommunication can occur, which obviously includes errors within medical records, which, once again, the Precyse situation obviously demonstrates.

I actually used to attribute less importance to our part in the picture too, thinking the same as you apparently do, that other *proper* channels are always being used for info and double-checking, until I worked directly in a healthcare setting for a while and saw what really goes on.

I don't understand your motivation for denigrating the importance of medical record accuracy, except perhaps to possibly try to let MTs off the hook for the potential impact of our errors. No, spelling and punctuation aren't likely going to affect anybody's healthcare outcome, but the wrong allergy, med or dosage certainly could (and has).

http://mttoolsonline.com/2012/12/17/the-value-of-quality-healthcare-documentation/

The link is an MT opinion - sm

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Again, in the link you cited, MTs are the ones saying their accuracy is life-or-death.

That simply is not the case. MTs type what they hear. That is what verbatim means. Physicians dictate errors. THEY CREATE THE ERRORS. You cannot control that. There is no way you can know what he should have said. You cannot know and it was never made your job to know. Your job does not even require the education to be able to know.

That is why the whole AHDI campaign to inflate MT jobs fell flat. That is why everyone switched to VR . . . they saw MTs as a rote typist function. VR can do that function at far less cost. Facilities and physicians who use it directly don't hire editors.

The physician is responsible. He is supposed to validate the information in the report regardless of how it got typed. He has to do that for your reports, as well.

This whole "we need to resurrect our jobs by claiming that people will die without us" is invalid.

Wrong yet again... - MT

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An individual who is not trained at all will not know what they are hearing. That is what you are not understanding. Have you ever listened to dictation before? Many of these physicians do not even speak English as their first language. Do you really believe that the MT is not required to understand the dictation at all? This is laughable, really, what you are saying. And, once again, you are harping on about the fact that physicians are solely responsible. Tell that to Precyse! Your argument is not substantiated by facts. A facility's medical documentation should be included in their accreditation and rating.

You hit the nail on the head...nm - MT

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nm

not so much - sm

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the post made some points about the decline of MT and the associated degradation of quality control. That said, the joint commission has nothing to do with this. N-o-t-h-I-n-g. They are an accrediting body - NOT an oversight committee. They do not review records.

Yes, they do lol... nm - MT

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nm

to clarify - sm

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I realize they review a sampling of medical records as part of the accreditation process. However, TJC is not involved in ongoing oversight.

Their accreditation is based on documentation criteria such as completeness and timeliness.

You and I both know there is no way for someone to determine the accuracy of transcribed data without the voice file.

you are right. the only thing they do is make sure hte records - are up to date completed. nm

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nm

Sorry, not so, and that is why... - MT

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the Joint Commission created the "Do not use" abbreviation list. So now all they do is make sure the records are up to date? Some of you on here are so out of the loop. It's embarrassing, actually.

Here you go.... - MT

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In 2001, The Joint Commission issued a Sentinel Event Alert on the subject of medical abbreviations, and just one year later, its Board of Commissioners approved a ****National Patient Safety Goal**** requiring accredited organizations to develop and implement a list of abbreviations not to use. In 2004, The Joint Commission created its â��do not useâ�� list of abbreviations as part of the requirements for meeting that goal. In 2010, NPSG.02.02.01 was integrated into the Information Management standards as elements of performance 2 and 3 under IM.02.02.01.

Do you notice that Patient Safety Goal portion? It is part of our job to implement this list because it's part of the MEDICAL RECORD. This has nothing to do with keeping records UP TO DATE.

yes, they enact information management standards - and other criteria

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And as long as these standards are met, it is not within the purview of the TJC to regulate who is transcribing the record, where they live, or what they are being paid.

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