Monday, April 8, 2013

Compliance News:  The Power of Tracers 

by David Stymiest, PE, CHFM, CHSP, FASHE 

The Joint Commission (TJC) discussed the use of a sample hazardous material and waste management environment of care (EOC) tracer in its March 2013 issue of EC News.  The article provided specific examples for conducting the tracer to explore issues related to orientation and training, physical environment, and quality improvement priority focus areas.   

EC News articles also discussed the use of non-patient tracers in June 2011 (sterilizer maintenance) September 2012 (fire safety) and November 2012 (utilities systems).  An earlier Joint Commission International publication also discussed the uses and benefits of a similar tracer methodology approach called System Tracers.  In the writer’s opinion, tracers of this nature have been proven to be extremely powerful in assessing not only compliance with individual TJC Standards and Elements of Performance but also in determining where opportunities for improving the EOC management processes exist within an organization.  As TJC also stated in its November 2012 issue, “Performing mock tracers can help your organization evaluate the effectiveness of its policies, engage staff in looking for opportunities to improve processes, and identify compliance issues that need attention.”

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Compliance News:  Risk Icons Considered as TJC FSA Replaces PPR

by David Stymiest, PE, CHFM, CHSP, FASHE


Users of The Joint Commission’s (TJC’s) 2012 "Update 2" and 2013 accreditation manuals found a new RISK ICON "R" in selected elements of performance. According to TJC in its September 26, 2012 Joint Commission Online edition, This new icon is related to TJC’s "Replacement of the Periodic Performance Review (PPR) with the Focused Standards Assessment (FSA)" and the "new risk icons denote elements of performance (EPs) assessed through the FSA process, applicable to all except the long term care program." A more comprehensive discussion occurred in TJC’s October 2012 Perspectives.

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Compliance News:  EOC Risk Assessments

by David Stymiest, PE, CHFM, CHSP, FASHE 
  
In its March 2013 issues of both Perspectives and EC News The Joint Commission (TJC) continued to promote the use of risk assessments to evaluate whether to accept, mitigate or avoid environmental risks when there not definitive right or wrong answers. The articles by Joint Commission engineering director George Mills reiterated previous TJC guidance on 7-step risk assessments.
  
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