The Joint Commission accredits and certifies more than 15,000 health care organizations and programs in the United States including clinics, home health agencies, behavioral health centers, hospitals, and long term care facilities.
Hospitals and other health care facilities base their bylaws, policies and procedures on Joint Commission standards. The interpretation of these standards by medical staff directors and other administrators has a direct impact on physician assistant practice.
The Comprehensive Accreditation Manual for Hospitals (CAMH) contains:
- Standards—statements that define the performance expectations and/or structures or processes that must be in place for a health care facility to provide safe, quality care, treatment, and services.
- Rationales—background, justification, or additional information about a standard.
- Elements of Performance (EPs)—detail the specific performance expectations and are scored to determine a health care facility’s compliance with a standard.
Hospital standards of most concern to PAs
- Countersigning/Authentication/Document
The Joint Commission standards do not require physician co-signatures on orders issued by physician assistants. - History and Physical Examinations (H&P)
PAs may perform admission and pre-surgery H&Ps if permitted by law, the medical staff bylaws, and the organization to do so. - Hospital Credentialing and Privileging
Physician assistants may be credentialed and privileged through the medical staff or equivalent process with criteria set forth in the Medical Staff chapter of the CAMH. - Licensed independent practitioners (LIP)
The Joint Commission definition of physician assistant includes language that recognizes the physician’s delegatory authority.
- Restraint and Seclusion
The Joint Commission (TJC) restraint and seclusion standards have been totally overhauled to align the language of its hospital standards and elements of performance (EPs) more closely with the Medicare and Medicaid Conditions of Participation (CoPs). - Procedure Site Marking
Yes, PAs can mark the site of the procedure. - The Joint Commission Field Reviews
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Frequently the Joint Commission will post proposed new standards or changes to existing standards on their Web site. This is an opportunity for PAs, supervising physicians, and supportive administrators to offer comments on how proposed standards will impact their place of employment or practice.
