In Phase II of its Elements of Performance (EP) review project, the Joint Commission is deleting 51 EPs to which health care facilities no longer will have to adhere beginning January 2017. The organization says reasons for the deletions mainly fall into the following categories:
- Similar to, implicit in, or duplicative of other existing EPs.
- Address issues that have been covered by standards for many years and are now a routine part of operations or clinical care processes, so they no longer need to be addressed in standards. Some no longer address contemporary quality and safety concerns, and how they are managed can be left to the discretion of the organization.
- EPs adequately addressed by law and regulation or other external requirements, so separate Joint Commission requirements are not needed.
The deletions include seven from its Environment of Care chapter, such as EC.02.04.01, which stipulates how to manage medical equipment risk, or EC.02.05.01, which addresses managing risk associated with hospital utility systems.
The Joint Commission also is deleting IC.01.05.01 within its Infection Prevention and Control chapter. The EP concerns methods hospitals use to report infection surveillance and control information to external organizations. The Joint Commission has deemed the standard duplicative of IC.02.01.01.
The organization says that the deletions are part of a multiphase project to streamline its hospital accreditation standards.
The Centers for Medicare & Medicaid Services (CMS) issued a final rule to make major changes to improve long-term care facilities. Approximately 1.5 million residents in the more than 15,000 long-term care facilities participate in the Medicare and Medicaid programs. CMS says the final rule is targeted at reducing unnecessary hospital readmissions and infections, improving the quality of care, and strengthening safety measures for residents in these facilities. The new rule does touch on aspects of the physical environment.
The documents states that CMS is "requiring facilities that are constructed, reconstructed or newly certified after the effective date of this regulation to accommodate no more than two residents in a bedroom. We are also requiring facilities that are constructed, or newly certified after the effective date of this regulation to have a bathroom equipped with at least a commode and sink in each room."
Other requirements touch on infection control, quality of care, quality of life, physician services, behavioral services, food and nutrition, etc.
CMS estimates that the total projected cost of this final rule will be about $831 million in the first year and $736 million per year in subsequent years. The average cost per facility is estimated to be about $62,900 in the first year and $55,000 per year in subsequent years.
The Medical Device Innovation Consortium (MDIC), a nonprofit organization, has been awarded $3 million from the Food and Drug Administration to develop a national evaluation system for medical devices, called the National Evaluation System for Health Technology (NEST).
The initial phase of the project will involve piloting methods for tracking medical device data and patient-reported outcomes through the use of real-world evidence. The hope is that the use of real-world evidence will shift premarket data collection into the postmarket by leveraging the electronic health information generated in both clinical settings and patients’ homes.
“There is great potential in using real-world data to foster innovations in medical device technology that will lead to optimized outcomes for patients and improved quality of life,” says Mike Minogue, MDIC board chairman, who also serves as president, CEO and chairman of the medical device implant manufacturer Abiomed. “In addition, real-world evidence will help measure the cost-effectiveness of these new technologies,”
President Obama yesterday signed legislation funding federal programs through Dec. 9 and providing $1.1 billion in emergency funding for the Department of Health and Human Services and other agencies to combat Zika. The measure passed the House and Senate Wednesday. The compromise package to fund Zika response includes $400 million in offsets through rescissions to accounts, including Affordable Care Act funds to set up exchanges in territories and unused Ebola funds.
The Joint Commission has updated its policy regarding notification of changes within accredited organizations. Effective Oct. 1, organizations will need to provide written notification to the Joint Commission when the change is initially contemplated — that is, when leadership within the organization has approved moving forward with the proposed change and identified a time frame for implementing that change.
Historically, the policy required organizations to notify the Joint Commission within 30 days after a significant change occurred. However, because certain changes may result in the need for on-site survey activity, the policy now requires advanced notice of a potential change to allow organizations and the Joint Commission to evaluate whether there is any impact from an accreditation standpoint, including the need and timing for any on-site survey activity. Once the change officially has occurred, the organization should update its electronic application for accreditation within 30 days.