Biomedical Engineering Reference
In-Depth Information
22 Hospital Large-Scale Drills
GARRETT HAVICAN
for the Federal “Center for Medicaid and Medicare
Services (CMS)” which administers the Medicare
program and works with the States to administer
the Medicaid and Child Health programs as well as
the “Health Information Portability and Account-
ability Act (HIPAA)” [2].
Hospitals are extremely reliant upon Medicare
and Medicaid reimbursement programs as most of
them report that CMS reimbursement accounts for
more than half of its overall annual revenue. There-
fore, JCAHO compliance and subsequent accredi-
tation is a requirement for the hospital to maintain
operations and stay in business. Accredited Hospi-
tals spend countless hours and funds complying
with JCAHO standards, preparing for JCAHO
visits and identifying process improvement initia-
tives and strategies to maintain the high standard
that JCAHO requires.
One of the most challenging processes required
of the acute care hospital under JCAHO is
the development and implementation of Emer-
gency Management standards. These standards
are required under a specific section in the
JCAHO Accreditation Manual dedicated to main-
taining a safe and efficient environment, known as
the “Environment of Care” standards. The envi-
ronment of care section identifies seven areas,
including Emergency Management, Life Safety,
Hazardous Materials and Waste, Security Manage-
ment, Safety Management, Medical Equipment,
and Utility Systems Management. These areas
focus on the safety of the patients, the staff and
the infrastructure and collaborate with the other
standards to assure a safe and efficient healthcare
operation.
Under the Emergency Management section, the
standard requires the hospitals to initially conduct
22.1 Introduction
The acute care hospital is in business to treat sick
and injured citizens within its municipality and its
contiguous communities. The hospital is a repos-
itory of clinicians from many disciplines and a
consortium of ancillary and diagnostic staff all
acting synergistically to achieve the common goal
of adding value to precious human life.
As the practice of medicine evolves due to
research, new pharmaceutical treatment regimens
and technological advances in the field of medicine,
the acute care hospital has successfully met
these ever-changing needs. Hospitals have proven
they are resilient and that they respond to the
aforementioned changes appropriately and without
undue stress. Many hospital administrators have
developed the philosophy of “anticipate, act and
adapt” to the substantive changes incurred by the
modern day acute care hospital. This adage is all too
similar to one of the United States Military mottos,
which is to “improvise, adapt and overcome.”
Due to the fact that the paradigm is constantly
changing in the acute care hospital, it has been
challenged with the implementation of certain
requirements developed by the Joint Commis-
sion on Accreditation of Healthcare Organiza-
tions (JCAHO). JCAHO, the primary accrediting
body for Acute Care Hospital is a private non-
profit organization whose mission is to “Contin-
uously improve the safety and quality of care
provided to the public through the provision
of health care accreditation and related services
that support performance improvement in health
care organizations” [1].
As the oldest and most recognized accrediting
agency, JCAHO also acts as a “Clearing House”
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