Friday, August 14, 2009


A couple of days ago, I participated in a Joint Commission Mock Survey. The Joint Commission (TJC) accredits and certifies more than 16,000 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards. Simply put, TJC reviews a healthcare facility’s compliance with a set of rules that ensure patient’s health and safety:

Typically a TJC review involves pulling at least 12 months of continuous data to check on compliance. Several Joint commission requirements align with CMS (Center for Medicare and Medicaid Services) Conditions of Participation. CMS is the U.S. federal agency which administers Medicare, Medicaid, and the Children's Health Insurance Program.

As part of the initial discussion, we learned of the various levels around the Environment of Care, Life Safety and Emergency Management Standards:

Level 1: an immediate threat to health and safety

Level 2: a situational or decisional rule

Level 3: direct impact requirement

Level 4: indirect impact requirement

The presenter spoke about Level 1, 2, and 3 being like picking up $100, $50, and $20 bills, respectively. Level 4 were the pennies. Not that the pennies are not important, but they just become a lower priority to ensure that you pick up the larger bills. While we all know that little things count, we also know that the big things can shut us down. In this case, the Level 1 immediately would stop the Joint Commission survey with a preliminary denial.

The key seemed to be, how do we stay focused on the most critical things first? Earlier this week I spoke about things patients value most.

My neighbor shared a funny story with me:

A man showed up to work one day with no clothes on. His boss was outraged, of course, and demanded the man explain himself.

“I was so busy this morning!” the employee said. “I had to shower, get the kids ready, put on coffee and a million other things! I had every intention of getting dressed, but just did not have the time to put on my clothes!”

In our busy, hectic days, how do we stay focused on the “non-negotiables” – things which must happen? Do you have a daily plan to ensure you handle the highest risks and priorities?

I look forward to hearing about the “non-negotiables” in your business or personal life.

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