Preach On, Brother!

I have been preaching for years that Press Ganey is nothing more than a tool that validates some administrator’s job (and that is the polite version). I had never heard of Press Ganey until a family member was hospitalized in a facility that was rated “# 1 for patient satisfaction” and no expense was spared advertising this on every floor, unit, lobby, waiting room and dining area of the hospital. This facility even had multiple yard signs posted every 10 feet on the front lawn that screamed the proclamation “WE’RE # 1.” Long story short, this family member barely survived his multi months stay at this hospital but he sure had the nicest, friendlist most accomadating hospital staff to be found in 4 states. And that is my nonstatistical correlation between Press Ganey ratings and patient outcomes. Please, don’t even get me started on JCAHO.

Our ED just installed a ‘white noise’ generator, with speakers mounted all around the nurses station, looking much like claymore mines.It’s so the comments from the nurses, docs (OK, and the medics), and other staff can’t be heard as easily by the patients and families.We’re free to continue our uninhibited commentary, though.

Our ED just installed a ‘white noise’ generator, with speakers mounted all around the nurses station, looking much like claymore mines.It’s so the comments from the nurses, docs (OK, and the medics), and other staff can’t be heard as easily by the patients and families.We’re free to continue our uninhibited commentary, though.

I was at a hospital that has a traffic light at the nurses’ station. There is supposed to be a green light on when the noise level is acceptable. The yellow light comes on to warn them when the noise level is a little higher than acceptable. At 55dB the red light comes on. It is flashing, I think. I don’t remember, but I was not the one who set it off, even though I was standing in front of it and reading the big (JCAHO-stroking) information sticker. There was a brief obnoxious tone to notify the nurses that the noise level had exceeded 55dB.It did have a Big Brother is listening feel to it.

I was at a hospital that has a traffic light at the nurses’ station. There is supposed to be a green light on when the noise level is acceptable. The yellow light comes on to warn them when the noise level is a little higher than acceptable. At 55dB the red light comes on. It is flashing, I think. I don’t remember, but I was not the one who set it off, even though I was standing in front of it and reading the big (JCAHO-stroking) information sticker. There was a brief obnoxious tone to notify the nurses that the noise level had exceeded 55dB.It did have a Big Brother is listening feel to it.

Maybe because I’m schooled in the medical management side (the dark side, if you will) I’ll take some exception to his remarks. I’ll have to read the story in full, and come back here to see if I clarify my statement.

Maybe because I’m schooled in the medical management side (the dark side, if you will) I’ll take some exception to his remarks. I’ll have to read the story in full, and come back here to see if I clarify my statement.

BTW – I don’t think Pennsylvania acknowledges CAAS accreditation. We have our own state system. No ambulance service can function in PA w/o it.

BTW – I don’t think Pennsylvania acknowledges CAAS accreditation. We have our own state system. No ambulance service can function in PA w/o it.

Trekmedic, CAAS is a voluntary accreditation above and beyong state licensing requirements. Louisana has statewide requirements for ambulances, and individual parishes often exceed that.CAAS is simply a merit badge.

Trekmedic, CAAS is a voluntary accreditation above and beyong state licensing requirements. Louisana has statewide requirements for ambulances, and individual parishes often exceed that.CAAS is simply a merit badge.

TrekMedic251,What about JCAHO and the other acronyms suggest anything positive?I was happy with the requirement from JCAHO to rapidly assess and treat pain, but they will probably screw that up and I put it in the blind squirrel category.

TrekMedic251,What about JCAHO and the other acronyms suggest anything positive?I was happy with the requirement from JCAHO to rapidly assess and treat pain, but they will probably screw that up and I put it in the blind squirrel category.

I read a book this week called “The Doctor Game” by Howard A. Olgin, M.D. I thought it was fiction, but as I started reading, I realized that it was a commentary on medicine that is heading for socialism. It was scary and sounded like it was written last week, but was published in 1978. All the games the medical establishment plays are going to ruin our health care, if we allow the talking heads to continue on the present path. Keep fighting AD!

I read a book this week called “The Doctor Game” by Howard A. Olgin, M.D. I thought it was fiction, but as I started reading, I realized that it was a commentary on medicine that is heading for socialism. It was scary and sounded like it was written last week, but was published in 1978. All the games the medical establishment plays are going to ruin our health care, if we allow the talking heads to continue on the present path. Keep fighting AD!

Had an in-service this am to go over our new CS 300 balloon pump. The subject of JCAHO regs came up again, re: 90-minute door-to-table for STEMI patients. I have to say, JCAHO has a point, as it backs up what the AHA preaches every time I re-up my ACLS – Time is muscle.BTW – I did read the entire post. I agree with some points, disagree with others. I can be reached at dafossil-at-hotmail-dot-com if anyone else wants to debate.Thanx for the topic, AD.

Had an in-service this am to go over our new CS 300 balloon pump. The subject of JCAHO regs came up again, re: 90-minute door-to-table for STEMI patients. I have to say, JCAHO has a point, as it backs up what the AHA preaches every time I re-up my ACLS – Time is muscle.BTW – I did read the entire post. I agree with some points, disagree with others. I can be reached at dafossil-at-hotmail-dot-com if anyone else wants to debate.Thanx for the topic, AD.

If the AHA is already stating that door to balloon should be less than 90 minutes, why do we need JCAHO to tell us the same thing.But, while they are focusing on the 90 minute time, why are they doing so much to delay care in hospitals?A little bit of consistency might not be a bad thing. How do all of the obstacles to care improve the care of the MI patient? They don’t.JCAHO should be trying to HELP hospitals to decrease the time from arrival to balloon. Instead JCAHO seems to be creating as many obstacles as they can. It is as if they are a bunch of sadists pointing and laughing at the poor schmucks in the hospital trying to deliver good care to the patient.This is supposed to be about the patient – not worship of the arbitrary and irresponsible gods of JCAHO.

If the AHA is already stating that door to balloon should be less than 90 minutes, why do we need JCAHO to tell us the same thing.But, while they are focusing on the 90 minute time, why are they doing so much to delay care in hospitals?A little bit of consistency might not be a bad thing. How do all of the obstacles to care improve the care of the MI patient? They don’t.JCAHO should be trying to HELP hospitals to decrease the time from arrival to balloon. Instead JCAHO seems to be creating as many obstacles as they can. It is as if they are a bunch of sadists pointing and laughing at the poor schmucks in the hospital trying to deliver good care to the patient.This is supposed to be about the patient – not worship of the arbitrary and irresponsible gods of JCAHO.

We were the first “government” EMS agency to get the full 5-year CAAS Accreditation. Being hospital-based, we also have the specter of JCAHO ever-present.We never renewed it. Our newer management (back then) realized that while going through the process once was beneficial (from an admin. point of view), there was little benefit overall, and if they wanted some independent evaluation of the workplace, ISO9001 (or whatever they’re at now) would be just as effective, and cheaper.Now we just deal with JCAHO…woo hoo.

We were the first “government” EMS agency to get the full 5-year CAAS Accreditation. Being hospital-based, we also have the specter of JCAHO ever-present.We never renewed it. Our newer management (back then) realized that while going through the process once was beneficial (from an admin. point of view), there was little benefit overall, and if they wanted some independent evaluation of the workplace, ISO9001 (or whatever they’re at now) would be just as effective, and cheaper.Now we just deal with JCAHO…woo hoo.

I’ll take the opposing side for shits and grins. I’ve been in patient care for 25+ yearts. I’ve been at the bedside, I’ve been in management; I’ve also assisted hospitals with accreditation by JCAHO, CAP, CLIA, OSHA, etc. before someone responds that I can’t find my ass with 2 hands and directions…So here’s my input on JCAHO… truly the bottom line is this: (1) JCAHO accreditation is voluntary. The hospital CEO signs a “contract” that basically says “we want people to suffer… let’s go with JCAHO.” (2) There is absolutely NOTHING new in the standards. The primary reason that they exist is because, across the board, health-care workers are non-compliant in conisistently applying the care that is proven to affect better patient outcomes and therefore “evidenced-based”. For example, why is there a National Patient Safety Goal on hand-washing under the Infection Control standards? Because we as a whole are non-compliant– even though if asked, the vast majority of us would state that hand-washing is crucial in preventing infection. Do you wear gloves every time, all the time when providing patient care? No slip ups… ever? Probably not. What about medication administration? How do you identify the patient in the field? Is is consistent with the policy that is mandated by the regulatory agency (which, simply suggests that the employee is required to abide by their facility policy on patient identification). For those who have been in this game for years, NONE of this is new, different or exciting. Healthcare facilities simply make the standards more difficult than they really need to be… seems like the more convoluted the better for some.It’s not a matter of JCAHO “making us,” sitting around a table and thinking of new things to do (“I know! Let’s make ‘em do this!!”) to justify our existence– it’s really a matter of us not holding ourselves and our peers accountable in providing excellent patient care. Lastly, as a compliance person I will say this–new paint is nice but it is not going to deter the surveyor from looking at the provision of care. However, I do agree with the person who was referencing Press Ganey and inferred that just because people are nice doesn’t mean that they can take care of people appropriately. It’s the provision of the care that is provided and the methodology/processes used to safeguard and protect the patient (First do no harm… remember?).By the way, I’ve left this anonymous because I don’t have an ID to “choose an identity” from and didn’t want yet another ID/PW to remember.

I’ll take the opposing side for shits and grins. I’ve been in patient care for 25+ yearts. I’ve been at the bedside, I’ve been in management; I’ve also assisted hospitals with accreditation by JCAHO, CAP, CLIA, OSHA, etc. before someone responds that I can’t find my ass with 2 hands and directions…So here’s my input on JCAHO… truly the bottom line is this: (1) JCAHO accreditation is voluntary. The hospital CEO signs a “contract” that basically says “we want people to suffer… let’s go with JCAHO.” (2) There is absolutely NOTHING new in the standards. The primary reason that they exist is because, across the board, health-care workers are non-compliant in conisistently applying the care that is proven to affect better patient outcomes and therefore “evidenced-based”. For example, why is there a National Patient Safety Goal on hand-washing under the Infection Control standards? Because we as a whole are non-compliant– even though if asked, the vast majority of us would state that hand-washing is crucial in preventing infection. Do you wear gloves every time, all the time when providing patient care? No slip ups… ever? Probably not. What about medication administration? How do you identify the patient in the field? Is is consistent with the policy that is mandated by the regulatory agency (which, simply suggests that the employee is required to abide by their facility policy on patient identification). For those who have been in this game for years, NONE of this is new, different or exciting. Healthcare facilities simply make the standards more difficult than they really need to be… seems like the more convoluted the better for some.It’s not a matter of JCAHO “making us,” sitting around a table and thinking of new things to do (“I know! Let’s make ‘em do this!!”) to justify our existence– it’s really a matter of us not holding ourselves and our peers accountable in providing excellent patient care. Lastly, as a compliance person I will say this–new paint is nice but it is not going to deter the surveyor from looking at the provision of care. However, I do agree with the person who was referencing Press Ganey and inferred that just because people are nice doesn’t mean that they can take care of people appropriately. It’s the provision of the care that is provided and the methodology/processes used to safeguard and protect the patient (First do no harm… remember?).By the way, I’ve left this anonymous because I don’t have an ID to “choose an identity” from and didn’t want yet another ID/PW to remember.