Implementation of JCAH Standards Improves Care

Abstract

If JCAH Standards for Respiratory Care Services were more strictly enforced, many hospitals would be found delinquent, especially in implementation of Standard V, which requires not only a detailed written prescription before services can be rendered but also an indication of diagnosis, therapeutic objectives, the means by which achievement of these objectives should be identified, and the circumstances under which therapy should be stopped. Standard V can be implemented more easily under the forceful guidance of a medical director, who is given authority by Standard II to develop policies governing the use and availability of respiratory care services. Based on the mandate in these standards, the Respiratory Care Department at University Hospital of Jacksonville, Florida, instituted use of a detailed physician order form after several memoranda to the medical staff delineating appropriate use of IPPB therapy. The immediate result was a significant decrease in rate of orders for such therapy. In addition, reduced staff time in administering such therapy increased time spent with critical patients, improved infection control opportunities, and permitted implementation of an equipment-maintenance program.