Putting the 1996 Joint Commission on the Accreditation of Health Care Organizations (JCAHO) Standards into Clinical Practice:: Applications for Cross-training and Automation

Abstract

LEARNING OUTCOME: To comply with the 1996 JCAHO standards using computerization and cross-training.Prior to automation, the department maintained three separate areas within Clinical Services: a hostess program, the diet office, and the clinical staff. From April 1994 to August 1995, an automated diet office system was developed and fully implemented, which streamlined the technical aspects of both the diet office and the hostess program. Hence, these areas were combined and existing support personnel were cross-trained as nutrition care assistants (NCAs). Their expanded roles included: delivering meals and snacks, completing meal rounds, calculating calorie counts, assisting patients with menu selections, entering such selections into the computer system, and screening all hospitalized patients within 24 hours of admission. The NCAs completed screens by assigning points for high risk indicators, which, in turn, triggered the clinical pathway appropriately for the professional staff. There were several positive outcomes: 1) it improved patient service and satisfaction, 2) it created a departmental reduction in full-time equivalents (FTEs), 3) it improved working relations between production and clinical services, and 4) it adequately satisfied the 1996 JCAHO standards for nutrition assessment. With the current, tenuous health care environment, clinical nutrition managers must investigate methods to streamline processes and standardize procedures, while impacting the bottom line and improving patient care.