Healthcare Facility Compliance 14 items
The Joint Commission Hospital Accreditation & National Patient Safety Goals Readiness
Continuous-readiness checklist for a Joint Commission hospital accreditation survey, including the current National Patient Safety Goals and tracer methodology focus areas.
The Joint Commission CAMHTJC National Patient Safety Goals
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National Patient Safety Goals - Identification & Communication
- Are at least two patient identifiers used before care, treatment, and services? *
- Are critical test and diagnostic results reported to the responsible provider on a timely, defined basis? *
National Patient Safety Goals - Medication Safety
- Are all medications, containers, and solutions labeled on and off the sterile field? *
- Is extra care taken with patients on anticoagulant therapy (education, monitoring, protocols)? *
- Is an accurate medication reconciliation performed and communicated at transitions of care? *
National Patient Safety Goals - Infection & Harm Prevention
- Does the organization comply with current CDC or WHO hand hygiene guidelines? *
- Is a suicide risk assessment conducted for patients being treated for behavioral health conditions? *
- Are alarm systems managed so clinically significant alarm signals are not missed? *
Universal Protocol (Surgical/Invasive)
- Is a pre-procedure verification process conducted to confirm the correct patient, procedure, and site? *
- Is the procedure site marked by a licensed practitioner accountable for the procedure? *
- Is a time-out performed immediately before starting the invasive procedure? *
Tracer & Survey Logistics Readiness
- Are staff able to describe the organization's process for reporting safety events and sentinel events? *
- Is the Statement of Conditions (SOC) and Basic Building Information current and accessible? *
- Are ORYX/measurement performance data available for review during the survey? *
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