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Dec 14

The Joint Commission Explains Patient Identification Requirement Changes

Published: December 14 2009

Response to comments from Dennis Ernst of the Center for Phlebotomy Education

Recently Dark Daily alerted clinical laboratory readers to a decision by The Joint Commission to change their particular requirements for patient identification. Included was the opinion of Dennis Ernst, MT(ASCP), long time Director of the Center for Phlebotomy Education, that The Joint Commission’s decision to change patient id requirements was a step backwards in patient safety. (See Dark Everyday, “Joint Commission Changes Requirement for Patient ID during Blood Draws” ).

In particular, Ernst has been troubled that the new patient id protocols no longer require a healthcare employee to have the patient state his or her title before blood is drawn. This individual contacted The Joint Commission to inquire about this change. He related to Dark Daily that officials at TJC had informed him that, in their surveys of clients, there was a feeling that this specific requirement was “burdensome and unnecessary. ”

Denis Ernst

Denis Ernst

In response to publication of Ernst’s comments in that Dark Daily e-briefing, we obtained a letter on the matter in the Joint Commission. That letter can be viewed here. That spurred us to make contact with The Joint Commission to get additional comment on how and why these types of changes were made to the requirements for patient identification.

“First of all, we certainly support the middle for Phlebotomy Education’s position that active patient involvement is the best exercise when collecting a specimen, ” stated Megan Sawchuk, Associate Movie director in Standards Interpretation at of the Joint Commission. “It is good exercise to ask a patient to state his or her name in an active way. ”

“And The Joint Commission does not think asking a patient for their name is ‘burdensome and unnecessary’, ” she continued. “It was actually the second part of the requirement that was difficult for our accredited institutions to implement. Specifically, a healthcare worker collecting a specimen or even administering medications was required to obtain another individual to identify the patient once the patient was unable to respond or even identify themselves. This step was in addition to confirming two identifiers on the patient’s armband or using a barcode program. ”

“This scenario can happen frequently in a hospital establishing, ” she explained. “It has been this added identification requirement that caused concerns among our accredited organizations and generated comments that—not only would this step prove ‘burdensome and unnecessary’ in practice—but that the healthcare organization can find itself open to error if its healthcare employee is dependent on a third party to confirm the identify of the patient from who a specimen is about to be collected. ”

Sawchuk stated that The Joint Commission’s decision to drop EP 1—the title of the rule outlining patient identification requirements—was an attempt to cut down on the subjectivity of the identification process in situations where patients are not fully coherent.

“Further, each standard released by The Joint Commission must be objective and concrete, ” she carried on. “As an example, it is less than ideal to write a requirement that says, ‘Use active patient involvement when possible. ’ The term ‘when possible’ is vague, which makes it difficult to impose on survey. Because the organization establishes their own policies about what is considered ‘when possible’, it can become very subjective. ”

Sawchuk does not think this particular change to patient id rules will have a detrimental effect on individual safety. “It is my opinion that EP 1, as it was composed, didn’t add anything beyond exactly what organizations already do today with proactive communication, ” she commented. “If anything, the change in the goal may actually serve to encourage more dialog about how to improve active patient communication. ”

Sawchuk added that the feedback through Ernst and his group was appreciated by The Joint Commission and further input would be welcome. “The Joint Fee values the Center’s input and would welcome their participation in strengthening the requirements for patient id when specimens are collected, ” noted Sawchuk. “We like to function collaboratively with organizations affected by changes to our standards. Working together helps insure we come up with the best possible solutions for patients along with reasonable expectations for the organizations. ”

Related Information:

The Joint Commission’s New Patient Identification Requirements

HealtDataManagement. com: Positive Patient ID: Pub Coding Success at the Bedside

Phlebotomist Rewarded For Proactive Patient Communication

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