JCAHO saftey goals

[Guest guest]

I have a question on what is the current practice for hospital based

outpatient clinics dealing with the JCAHO National Patient Safety

Goal 8: " Accurately and completely reconcile medications across the

continuum of care " and 8A " there is a process for comparing the

patient's current medications with those ordered for the patient

while under the care of the organization "

We are being advised that we need to do the following:

1) Develop a complete and accurate list of all medications the

patient is currently taking. (We are currently doing this at intake,

but it is provided by the patient and we are only able to assume that

this is complete and accurate.)

2) Compare the list of the patient's current medications with the

medications being used in treatment and reconcile any discrepancies.

(The typical medications that would be used are either dexamethasone

or hydrocortisone. Are we to contact our pharmacy dept. each time

with the list of meds to see if there are any interactions with their

other medications?)

3) Update the list upon each visit. (This is asked at each visit

and appropriately documented.)

4) Communicate the list to the next provider of care if

appropriate. (When would you think that this may be applicable for

our environment?)

5) Upon discharge from therapy, provide the patient a list of all

medications. (I am not sure this would really apply to rehab since

the only list that we have is one that was provided to us by the

patient in the first place.)

How are others addressing this particular goal?

Thanks

Tim , PT

CDH Physical Therapy

Bloomingdale, IL

[Guest guest]

Our hospital was just reviewed by JCAHO in May. I was concerned about this

very thing because I had heard talk that some clinics were doing away with

having dexamethasone or hydrocortisone in their clinics and were requiring

patients to obtain it as a prescription from their pharmacies. We asked

the physician reviewer when he was here and his response was as follows:

As long as the patient is using the medication under the PTs guidance in

the clinic and isn't leaving the clinic with the medication to

self-administer later, we are being compliant with this goal.

(paraphrased)

We have the patients list their current medications at the start of

treatment, we obtain a signed prescription from the doctor to use the dex

or hydorcortisone, our pharmacy supplies us with the dex or

hydrocortisone, and we do not use the IontoPatch so the patient is in the

clinic for the entire treatment.

I hope this helps.

Suzanne LeBlanc, PT, MPT

Director, Rehabilitation Services

Willamette Falls Hospital

Oregon City, OR

x6870

" tptuw91 "

Sent by: PTManager

06/13/2007 01:34 PM

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PTManager

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Subject

JCAHO saftey goals

I have a question on what is the current practice for hospital based

outpatient clinics dealing with the JCAHO National Patient Safety

Goal 8: " Accurately and completely reconcile medications across the

continuum of care " and 8A " there is a process for comparing the

patient's current medications with those ordered for the patient

while under the care of the organization "

We are being advised that we need to do the following:

1) Develop a complete and accurate list of all medications the

patient is currently taking. (We are currently doing this at intake,

but it is provided by the patient and we are only able to assume that

this is complete and accurate.)

2) Compare the list of the patient's current medications with the

medications being used in treatment and reconcile any discrepancies.

(The typical medications that would be used are either dexamethasone

or hydrocortisone. Are we to contact our pharmacy dept. each time

with the list of meds to see if there are any interactions with their

other medications?)

3) Update the list upon each visit. (This is asked at each visit

and appropriately documented.)

4) Communicate the list to the next provider of care if

appropriate. (When would you think that this may be applicable for

our environment?)

5) Upon discharge from therapy, provide the patient a list of all

medications. (I am not sure this would really apply to rehab since

the only list that we have is one that was provided to us by the

patient in the first place.)

How are others addressing this particular goal?

Thanks

Tim , PT

CDH Physical Therapy

Bloomingdale, IL

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[Guest guest]

We are currently working on this as well. I have received some feedback from

this group in the past so you may want to look at the archives if you have not

already. We take a medication inventory on evaluation and are building into our

policy known allergies and interactions for all medications we may use in OP.

The big one for us is barium sulfate suspension since we do VFSS on site. We

communicate to the referring physician the medications in way of the evaluation

- if we do ionto or phono it is stated in the POC which medication we will use

with the procedure. We are still looking into the need to update the medication

list each visit for topical dex and hydrocortisone applications. There are no

known drug interactions for topical dex or hydrocortisone according to our

pharmacist. I would be interested in hearing more about what you come up with

as well!

McBride, PTA, BS

Southwest Regional Rehab Center

tptuw91 wrote:

I have a question on what is the current practice for hospital based

outpatient clinics dealing with the JCAHO National Patient Safety

Goal 8: " Accurately and completely reconcile medications across the

continuum of care " and 8A " there is a process for comparing the

patient's current medications with those ordered for the patient

while under the care of the organization "

We are being advised that we need to do the following:

1) Develop a complete and accurate list of all medications the

patient is currently taking. (We are currently doing this at intake,

but it is provided by the patient and we are only able to assume that

this is complete and accurate.)

2) Compare the list of the patient's current medications with the

medications being used in treatment and reconcile any discrepancies.

(The typical medications that would be used are either dexamethasone

or hydrocortisone. Are we to contact our pharmacy dept. each time

with the list of meds to see if there are any interactions with their

other medications?)

3) Update the list upon each visit. (This is asked at each visit

and appropriately documented.)

4) Communicate the list to the next provider of care if

appropriate. (When would you think that this may be applicable for

our environment?)

5) Upon discharge from therapy, provide the patient a list of all

medications. (I am not sure this would really apply to rehab since

the only list that we have is one that was provided to us by the

patient in the first place.)

How are others addressing this particular goal?

Thanks

Tim , PT

CDH Physical Therapy

Bloomingdale, IL

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