Report Of Joint Commission Research Articles

Interprofessional Education: Collaborative Team Work Among Undergraduate Medical Students.

Madam, The last decade has been a global shift towards collaborative learning and practice. A Joint Commission Report noticed that 80% of all medical errors were due to miscommunications during patient handoffs, with 44% occurring in inpatient settings1. Learning Together to Work Together for Health is the essential guide for the working of Interprofessional Education (IPE), the idea presented by WHO and is defined as an experience that “occurs when students from two or more professions learn about, from, and with each other to enable effective collaboration and improve outcomes”2. The core competencies for IPE include collaborative teamwork, communication skills, ethical practice, roles and responsibilities, and conflict resolution2. IPE expects to improve the knowledge, skills, and attitudes towards collaboration to enhance their future clinical practice. Pakistan is a developing country that is strengthening IPE. The Karachi Medical and Dental College launched a training program on research methodology focusing on the principles of IPE to improve primary care delivery2. The Dental Hygiene Program at Aga Khan University is also an example of IPE improving patient healthcare3. These deficiencies can be overcome by vertically and horizontally integrating IPE in the curriculum. The absence of a formal team-based care programme deprives most students from learning about professional roles. This warrants a need to focus on learning approaches that can be used in undergraduate curricula and thereby create and foster a collaborative learning environment. Case-based learning and team-based learning are valuable approaches resulting in experiential learning and reflection. Simulations allow students to practice and improve their communication and collaboration among medical students. E-learning is worthwhile for enlightening their understanding and cognizance of further profession’s duties and authorities, which is unique to the leading competencies of IPE4. The logistics of setting up IPE activities may be more challenging. The leadership confrontation such as lack of management between the faculties and lack of support by organization, curriculum challenges like IPE courses designing, teaching challenges, such as shortage of faculty members training, skills and competence in interprofessional and resistance to transformation i.e. dearth of resources are the main challenges for the institutions5. The institutions should engage in policies in the best strategies to implement interprofessional education. Hierarchical heads and policymakers need to put forth an effort to advance IPE so that different professions can benefit from each other more easily.

Redefining the Valuation Methods of Modern Day Hospital Care

This article discusses the report published last year by the Joint Commission (Improving America's Hospitals) that seeks to showcase the achievements of hospitals identified as Top Performers on Key Quality Measures. The Joint Commission's report also provides a comprehensive analysis on the ways in which those hospitals accredited by the organization fared for all quality measures. This article focuses on specific care measures set forth in the report (heart attack care, pneumonia, and one surgical example), and compares these historical trends with the appropriate Medicare reimbursement data for the same time period. While it comes as no surprise that hospital reimbursements do not share the same trajectory as Joint Commission quality standards, the contradictory manner in which health care regulations reward annual improvement by reducing reimbursements speaks volumes about a system not just in transition, but in a state of confusion. Mindful of the value based purchasing modifications to the Medicare program looming on the horizon, my article suggests that now is an appropriate time to take stock in the collections of data we have amassed as a means to understand and refine the delicate infrastructure of our nation's health care system, with a specific eye toward the ways in which value is assessed and rewarded. As the nation transitions toward a reimbursement policy dictated by performance measures rather than cost, our focus should also be directed toward creating a self-sustaining system that improves the delivery of health care throughout the nation and is fair to both the individuals and institutions that participate therein.

Optimizing Screening for Osteoporosis in Patients With Fragility Hip Fracture

Osteoporosis, the underlying cause of most hip fractures, is underdiagnosed and undertreated. The 2008 Joint Commission report Improving and Measuring Osteoporosis Management showed only an average of 20% of patients with low-impact fracture are ever tested or treated for osteoporosis. We developed an integrated model utilizing hospitalists and orthopaedic surgeons to improve care of osteoporosis in patients with hip fracture. Does our integrated model combining hospitalists and orthopaedic surgeons improve the frequency of evaluation for osteoporosis, screening for secondary causes, and patients' education on osteoporosis? Our Hospitalist-Orthopaedic Surgeon Integrated Model of Care was implemented in September 2009. We compared the rate of evaluation and treatment of osteoporosis in 140 patients admitted with fragility hip fracture at our institution before (70 patients) and after (70 patients) implementation of the care plan. Evaluation of patients for osteoporosis was higher in the postimplementation group compared to the preimplementation group (89% versus 24%). Screening of patients for secondary causes of osteoporosis was also improved in the postimplementation group (89% versus 0%), as was the proportion of patients who received education for osteoporosis management (89% versus 0%). Our model of integrated care by hospitalists and orthopaedic surgeons resulted in improvement in the evaluation for osteoporosis, screening for secondary causes of osteoporosis, and education on osteoporosis management in patients with hip fracture at our institution. This may have important implications for treatment of these patients. Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

JNP Urges Prevention Focus for 2010

It has been well documented that it takes some time for research knowledge to diffuse and affect clinical practice. For many years we have heard about the need for clinicians to help obese patients lose weight. This topic is now on the national policy agenda—including that of First Lady Michelle Obama as she focuses on prevention of childhood obesity. Almost everywhere we look there is information to help clinicians assist patients in losing weight. Another policy initiative of a few years ago that seems to be maturing and beginning to show change is that of disease prevention. JNP is very interested in supporting prevention initiatives and is actively focusing journal content on disease prevention this year. We hope this emphasis will inspire NPs nationwide to recommit themselves to this important clinical task. This special issue of JNP includes information that focuses on prevention for the pediatric population. Progress in disease prevention in the inpatient arena is highlighted by the recent release of the American Hospital Association's “Improving America's Hospitals: The Joint Commission's Report on Quality and Safety 2009.” The report summarizes objective statistics documenting quality of care in 31 core areas and how the statistics relate to common medical conditions and procedures. The report also shows that there was “continual improvement between 2002 and 2008 on 12 quality measures reflecting the best evidence-based treatments for heart attack, heart failure, and pneumonia—practices demonstrated by scientific evidence to lead to the best outcomes. The magnitude of national improvement on these measures ranged from 4.9% to 58.8%.” Hospital performance also improved in 13 other measures. Pneumococcal vaccination and smoking cessation advice measures show the greatest rates of improvement for this period. Among the areas evaluated, there are 8 measures of care relating to heart attack, 4 to heart failure, 9 to pneumonia, 8 to surgical care, and 2 to children's asthma care. The report is based on data from more than 3,000 Joint Commission– accredited hospitals. A summary of the report highlights some of the findings: •Hospital performance on two individual measures of quality relating to inpatient care for childhood asthma show that 99.8% of the time “relievers” were provided to childhood asthma inpatients and 99.1% of the time systematic corticosteroids were provided to childhood asthma inpatients.•Hospitals provided an evidence-based treatment for heart attack 96.7% of the time in 2008, up from 86.9% in 2002.•The overall heart failure care result improved to 91.6%, up from 59.7% in 2002.•The overall 2008 pneumonia care result is 92.9%, up from 72.3% in 2002. Areas indicating a need for improvement showed that only 52.4% of hospitals provided fibrinolytic therapy to heart attack patients within 30 minutes of arrival and that only 60.3% of hospitals provided antibiotics to intensive care unit pneumonia patients within 24 hours of arrival. The report documents that variability is still present in the level of quality of patient care delivered. Results of quality, safety, and patient satisfaction for specific hospitals can be found at www.qualitycheck.org. For a complete copy of the report, visit www.jointcommission.org.

USA - New Joint Commission report portrays patient safety and health care quality performance of nation's hospitals

USA - New Joint Commission report portrays patient safety and health care quality performance of nation's hospitals

The Joint Commission report on children: a reaction.

The Joint Commission report on children: a reaction.

THE CLINICIAN AND THE JOINT COMMISSION REPORT: A Dialogue

THE CLINICIAN AND THE JOINT COMMISSION REPORT: A Dialogue

A Time to Act: Final Report of Joint Commission on Correctional Manpower and Training.Perspectives on Correctional Manpower and Training: Staff Report of Joint Commission on Correctional Manpower and Training.Manpower and Training in Correctional Institutions: Staff Report of Joint Commission on Correctional Manpower and Training. John J. Galvin , Loren KarackiDeveloping Correctional Administrators: Research Report of Joint Commission on Correctional Manpower

<i>A Time to Act: Final Report of Joint Commission on Correctional Manpower and Training</i>.<i>Perspectives on Correctional Manpower and Training: Staff Report of Joint Commission on Correctional Manpower and Training</i>.<i>Manpower and Training in Correctional Institutions: Staff Report of Joint Commission on Correctional Manpower and Training</i>. John J. Galvin , Loren Karacki<i>Developing Correctional Administrators: Research Report of Joint Commission on Correctional Manpower

Financing, organization and control: the problem of implementing comprehensive community mental health services.

IT has been said that we have now come full circle on the issue of providing care for mentally ill persons. The argument here runs that, prior to the nineteenth century, the care of mentally ill persons was the responsibility of the community. In the early nineteenth century, the work of liberal reformers in this area, such as Dorothea L. Dix, resulted in a shifting of responsibility from the community to the state and the advent of that venerable institutionthe state mental hospital. In fact, we have every reason to believe that the early state hospitals, proceeding in enlightened climate to do what has been referred to as therapy, were quite effective. Over a relatively brief period, the community got out of the business of caring for its mentally ill and, probably with some relief, referred these persons to the state hospital. There they received, at least during the first part of the nineteenth century, what appeared to be adequate care. The state hospital, however, rapidly declined as an effective treatment modality, and by the end of the nineteenth century was essentially a custodial warehouse for all kinds of undesirable, impoverished individuals. The reasons for its decline are complex, but certainly some of the factors had to do with the size of these institutions. They continued to grow as they absorbed the ever-increasing number of patients who flowed into them from the community and with the change in climate in professional thought. A more scientific attitude eventually displaced the earlier commitment to moral therapy.' The poor conditions in our state hospitals have been very well documented, and this topic received perhaps its most comprehensive exposition in the Joint Commission Report published in 1961.2 Thus, by the mid-twentieth century, we found ourselves in the rather interesting position of having the federal government spearhead a movement to return the locus of care and the central responsibility for mentally ill persons to the community. Not only did we come full circle; one could embellish the story further by indicating that state mental hospitals in many respects are currently returning to a philosophy of moral treatment. The full circle parable, however, is quite deceptive. One can never really

REHABILITATIVE POTENTIAL IN "CHRONIC" MENTAL PATIENTS.

Introduction THE JOINT Commission report in Action for Mental Health stimulated a great deal of interest in the size and functions of public mental hospitals. One of the most tangible, and talked about, recommendations of the report was that all existing state hospitals of more than one thousand beds be gradually and progressively converted into centers for the longterm and combined care of chronic diseases including mental illness. 1 If mental hospitals are indeed to become centers for the care of chronic diseases, then some reduction of the size of the present mental hospital population is implied. Reduction of the number of patients chronically hospitalized for mental illness is currently being approached in several ways: by providing services to avoid the necessity of hospitalization, by preventing chronicity through early and active treatment programs, and by releasing more patients who have been hospitalized for

Statement on report of Joint Commission on Mental Illness and Health.

Statement on report of Joint Commission on Mental Illness and Health.

Psychiatric training for future responsibilities.

The developmental trends of psychiatric practice have, over the past year or so, become an increasing concern for both psychiatrists and community. The British Mental Health Bill, the U.S.A. Joint Commission Report on Mental Health, the Mental Health Services report of the Canadian Mental Health Association and the various psychiatric briefs to the Royal Commission on Health Services, have all given expression to changing need, new patterns of action, and increasing responsibilities in the field of mental disorder. Although many conditions and circumstances will determine the effect of the new thinking and new arrangements, the essential ingredient vitalising the whole is the psychiatrist. Psychiatrists, from a logistic point of view, must be available to the Canadian scene in sufficient numbers and in appropriate distribution. The problems of the university graduate divisions to increase numbers are by no means simple. To raise the ratio of psychiatrists to population from the present 1 in 25,000 to 1 in 15,000 over a decade requires the tripling of present programmes. The creating of well-distributed posts for the increased numbers is an urgent issue at the community level of health organization. Although psychiatry may be thought of as a body of knowledge the applications of that knowledge are various. The heterogeneous nature of psychiatry is more apparent than real: the variegated appearance is due to the differing modes of application of psychiatric knowledge. The educational or training problem is to develop a fundamental body of knowledge in the graduate student and from that base to bring about a concentration of studies in one or other area of application. To allow the graduate students incorporation of a fundamental body of knowledge, the educational matrix must include, in near equal degree, both biological and behavioural ingredients. In each, both structural and functional aspects will require consideration, thus providing an emphasis on relations with both organic medicine and social medicine. Concentration studies, limited to techniques of psychotherapy, will be outmoded. The expansion of learning theory and sociological theory will modify both interrelationship therapy and group therapy. Maturation and development will be better understood in terms of biological and adaptive mechanisms capable of control. As these expansions come about neglected areas—juvenile delinquency, mental retardation, alcoholism etc.—will more definitely be allocated to psychiatry. The embryo psychiatrist, involved in a scene where basic knowledge is growing and focussed studies are clearing, will of necessity become more identified with technical competence in smaller areas. His interest in and sympathy for that kind of research, which first delimits problems before attempting to solve them, will be enhanced. The educational and training programmes will reveal those men who are, not only curious, but also willing and able, to discipline a ranging curiosity in the interest of research discovery. Greater numerical strength, more appropriate distribution, wider ranging basic studies, more focussed concentrations, more specific research endeavours are each and severally the objectives of the developing training programmes. Movement in respect to these objectives will be the greater the more ideas are interchanged across the barriers of provincial boundaries, the cleavage of bilingualism, the entrenchments of status, and the defences of sectarian departments. One of the more important functions of our national Psychiatric Association is to facilitate such interchanges.

THE JOINT COMMISSION REPORT ON MENTAL ILLNESS AND HEALTH: IMPLICATIONS FOR NURSING ADMINISTRATION

Back to table of contents Previous article Next article ArticleNo AccessTHE JOINT COMMISSION REPORT ON MENTAL ILLNESS AND HEALTH: IMPLICATIONS FOR NURSING ADMINISTRATIONANNIE LAURIE CRAWFORDANNIE LAURIE CRAWFORDSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.119.6.550AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail PDFThis content is only available as a PDF. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byPSYCHIATRIC NURSINGMARY F. LISTON1 April 2006 | American Journal of Psychiatry, Vol. 120, No. 7 Volume 119Issue 6 December 1962Pages 550-554 Metrics PDF download History Published online 1 April 2006 Published in print 1 December 1962