Joint Commission journal on quality and patient safety最新文献

{"title":"Examining Patient Safety Events Using the Behaviour Change Wheel: A Cross-Sectional Analysis","authors":"Mari Somerville PhD, MPH (formerly Canadian Institutes of Health Research (CIHR) Health System Impact Fellow, IWK Health, Halifax, Nova Scotia, is Senior Policy Analyst, Nova Scotia Health Authority, and Health Systems Researcher, School of Nursing, Dalhousie University.),&nbsp;Christine Cassidy PhD, RN (is Associate Professor, School of Nursing, Dalhousie University.),&nbsp;Shannon MacPhee MD (is Pediatric Emergency Physician, IWK Health.),&nbsp;Douglas Sinclair MD (is Vice President, Medicine, Quality and Safety, IWK Health.),&nbsp;Jane Palmer MN, RN (is Director, Quality, Patient Safety and Patient Experience, IWK Health.),&nbsp;Daniel Keefe MD (is Associate Professor, Department of Urology, Dalhousie University, and Pediatric Urologist, IWK Health.),&nbsp;Shauna Best RN (is Manager, IWK Health Centre, Halifax, Nova Scotia.),&nbsp;Janet Curran PhD (is Research Chair, Quality and Patient Safety, IWK Health, and Professor, School of Nursing, Dalhousie University. Please address correspondence to Mari Somerville)","doi":"10.1016/j.jcjq.2024.11.001","DOIUrl":"10.1016/j.jcjq.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Precursor-level safety events (PSEs) pose greater patient risk than no-harm events but are not as severe as serious safety events. Despite their potential for harm, the underlying determinants associated with PSEs are poorly understood. This study aimed to use a behavior change framework to understand the underlying determinants of PSEs and whether associated action items aligned with the behavior.</div></div><div><h3>Methods</h3><div>This cross-sectional study took place in a maternal/pediatric hospital. A total of 58 prerecorded PSEs were analyzed using the Behaviour Change Wheel (BCW); a behavioral framework that identifies sources of behavior and proposes intervention types that address said behavior. Researchers and clinicians independently coded each PSE's underlying determinant and action items using the relevant components of the BCW. The types and frequency of underlying behavioral determinants and intervention types for each PSE were documented. A matrix, based on the BCW, reflected how often the underlying behavior aligned with the corresponding action item.</div></div><div><h3>Results</h3><div>Of the 58 PSEs, six behavioral determinants and seven intervention types were identified. Environmental context/resources was the behavioral determinant coded most often (25.4%); education was the most common intervention type (45.8%). Several underlying determinants (24.6%) and action items (8.3%) received no code due to limited information. Based on the BCW matrix, 34.2% of behavioral determinants were addressed with interventions that would target the underlying behavior, while 37.8% did not align, and 28.1% could not be coded due to missing behavioral information.</div></div><div><h3>Conclusion</h3><div>This study identified poor alignment between types of interventions and underlying determinants in more than one third of analyzed PSEs. This included using educational interventions in about 50% of events, despite this type of intervention being ineffective for most of the coded behaviors. Further, alignment of many safety events could not be determined due to limited reported information. This highlights a need to design more systematic, behavior-informed approaches to reporting PSEs and identifying interventions to effectively change behavior.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 2","pages":"Pages 135-143"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Interprofessional Crisis Simulation Training in a Non-Operating Room Anesthesia Setting on Team Coordination: A Mixed Methods Study","authors":"Hedwig Schroeck MD (is Associate Professor of Anesthesiology and Pediatrics, Geisel School of Medicine at Dartmouth College, Dartmouth Hitchcock Medical Center, Lebanon, NH.),&nbsp;Bridget Hatton MPH (formerly with the Dartmouth Institute for Health Policy and Clinical Practice, is DrPH Student, Johns Hopkins Bloomberg School of Public Health.),&nbsp;Pablo Martinez-Camblor PhD (Assistant Professor, Departments of Anesthesiology and Biomedical Data Science, Geisel School of Medicine at Dartmouth College.),&nbsp;Michaela A. Whitty MPH (is Manager, Perioperative Supply Chain, Supply Chain Shared Services, Dartmouth Health, Lebanon, New Hampshire.),&nbsp;Louise Wen MD (is Assistant Professor, Department of Anesthesiology, Geisel School of Medicine at Dartmouth College, and Anesthesiologist, Department of Anesthesiology and Perioperative Medicine, Dartmouth Hitchcock Medical Center.),&nbsp;Andreas H. Taenzer MD, MS (formerly Professor, Departments of Anesthesiology and Pediatrics, Geisel School of Medicine at Dartmouth College, is Professor, Departments of Anesthesiology and Critical Care Medicine, and Pediatrics, Children's National Hospital, George Washington University School of Medicine & Health Sciences. Please address correspondence to Hedwig Schroeck)","doi":"10.1016/j.jcjq.2024.10.009","DOIUrl":"10.1016/j.jcjq.2024.10.009","url":null,"abstract":"<div><h3>Background</h3><div>Crisis resource management in non-operating room anesthesia (NORA) locations is challenging but can potentially be improved through interprofessional crisis simulation training (ICST). This mixed methods study aimed to evaluate the effect of a one-time training on team coordination in diagnostic and interventional magnetic resonance imaging locations.</div></div><div><h3>Methods</h3><div>Personnel from anesthesia, radiology, and perioperative services (<em>n</em> = 87) underwent ICST over eight months. Team coordination among participants was assessed and compared at baseline, immediately after, and at three months after ICST using a validated instrument—the relational coordination index (RCI)—and a questionnaire on role perceptions and task confidence. Open-ended interviews on a purposive sample of participants were conducted before and after training and analyzed for recurring themes.</div></div><div><h3>Results</h3><div>Response rates for the RCI were 71.3% at baseline, 65.5% immediately after, and 36.8% three months after training. For subjects responding at baseline and at the respective post-training time point, there were no statistically significant differences in composite RCI scores immediately after or at three months after ICST. However, some individual RCI domain scores increased from baseline to three months after training. For instance, mutual respect increased from (mean ± standard deviation) 3.67 ± 0.49 to 4.42 ± 0.67 (<em>p</em> = 0.003) among non-anesthesia personnel rating anesthesia personnel; and shared knowledge rose from 3.58 ± 0.79 to 4.08 ± 0.51 (<em>p</em> = 0.010) among non-anesthesia personnel rating anesthesia personnel. Thematic analysis from 15 interviews revealed increased familiarity with roles and crisis procedures after ICST as well as improved communication.</div></div><div><h3>Conclusion</h3><div>A single interprofessional crisis simulation training in a NORA setting, though it did not change overall relational coordination scores, had positive effects on some aspects of team coordination by improving role clarity, task confidence, trust, and communication.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 2","pages":"Pages 115-125"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of a Cohort Structure on Grantee Experiences Developing Clinical Quality Measures for Diagnostic Excellence","authors":"Abigail T. Evans PhD (is Lead Research Scientist, Battelle Memorial Institute, Columbus, Ohio.),&nbsp;Meridith Eastman PhD, MSPH (is Senior Research Scientist, Battelle Memorial Institute.),&nbsp;Mujahed Khan MBA, RDN, FAND (is Senior Research Scientist, Battelle Memorial Institute.),&nbsp;Jeffrey J. Geppert EdM, JD (is Senior Research Leader, Battelle Memorial Institute.),&nbsp;Lydia Stewart-Artz PhD, MHS (is Lead Research Scientist, Battelle Memorial Institute. Please address correspondence to Abigail T. Evans)","doi":"10.1016/j.jcjq.2024.10.008","DOIUrl":"10.1016/j.jcjq.2024.10.008","url":null,"abstract":"<div><h3>Background</h3><div>Diagnostic errors are harmful and pervasive. The Gordon and Betty Moore Foundation funded the Diagnostic Excellence Initiative (Initiative) to support the development of clinical quality measures needed to inform quality improvement efforts in medical diagnosis. The Initiative leverages a unique cohort structure that combines technical assistance and cohort activities to foster innovation in groups of grantees. This manuscript shares grantee perspectives on their participation in these unique cohorts.</div></div><div><h3>Methods</h3><div>The authors conducted interviews with 16 Initiative grantees to understand how technical assistance and cohort activities affected their measure development process. Interviews were recorded, transcribed, and coded using deductive codes.</div></div><div><h3>Results</h3><div>Grantees reported technical assistance and cohort activities provided as part of the Initiative effectively supported them in developing clinical quality measures. Technical assistance, including one-on-one technical support and work plans, helped meet project milestones and address implementation challenges. Grantees valued cohort activities, including office hours and in-person meetings, because they gave grantees the opportunity to connect with other measure developers and gain new perspectives on their work. Further, grantees reported learning about the measure development process and indicated participation in an Initiative cohort had positive effects on their careers.</div></div><div><h3>Conclusion</h3><div>Grantees believed the combination of technical assistance and cohort activities provided by the Initiative supported their ability to develop diagnostic quality measures. This suggests collaborative learning activities like those provided to grantees could effectively support other complex problems in health care.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 2","pages":"Pages 108-114"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing and Sustaining Clinical Outcomes in 88 US Hospitals Post-Pandemic: A Quality Improvement Initiative","authors":"Mohamad G. Fakih MD, MPH (is Chief Quality Officer, Ascension, Professor, Department of Internal Medicine, Wayne State University School of Medicine.),&nbsp;Florian Daragjati PharmD, BCPS (is Senior Director of Quality, Ascension.),&nbsp;Lisa K. Sturm MPH, CIC, FAPIC (is Senior Director, Infection Prevention, Ascension.),&nbsp;Collin Miller MS (is Manager, Data Analytics, Ascension Data Science Institute, Ascension.),&nbsp;Betsy McKenzie MBA (is Senior Director of Quality, Ascension.),&nbsp;Kelly Randall PhD, MSW (is Vice President of Patient Safety and Regulatory, Ascension.),&nbsp;Frederick A. Masoudi MD, MPSH, MACC, FAHA (is Chief Science Officer and Vice President of Research and Analytics, Ascension, and Professor, Department of Internal Medicine, Dell Medical School, University of Texas.),&nbsp;Jamie Moxham MSPH (is Director of Analytics, Ascension.),&nbsp;Subhangi Ghosh PhD, MS (is Senior Data Analyst, Ascension Data Science Institute, Ascension.),&nbsp;Jyothi Karthik Raja MS (is Senior Vice President, Chief Analytics and AI Officer, Ascension Data Science Institute, Ascension.),&nbsp;Allison Bollinger MD (is Vice President, Acute Clinical Care, Ascension.),&nbsp;Stacy Garrett-Ray MD, MPH, MBA (is Senior Vice President–Chief Community Officer, Ascension, and Adjunct Assistant Professor, Department of Epidemiology and Public Health, University of Maryland School of Medicine.),&nbsp;Maureen Chadwick PhD, RN, MSN, NE-BC3 (is Senior Vice President, Nursing, and Chief Nursing Officer, Ascension.),&nbsp;Thomas Aloia MD, MHCM, FACS, FACHE (is Senior Vice President, System Chief Medical Officer, Ascension.),&nbsp;Richard Fogel MD (is Executive Vice President, Chief Clinical Officer, Ascension. Please address correspondence to Mohamad Fakih)","doi":"10.1016/j.jcjq.2024.11.010","DOIUrl":"10.1016/j.jcjq.2024.11.010","url":null,"abstract":"<div><h3>Background</h3><div>Optimizing outcomes of hospitalized patients anchors on standardizing processes in medical management, interventions to reduce the risk of decompensation, and prompt intervention when a patient decompensates.</div></div><div><h3>Methods</h3><div>A quality improvement initiative (optimized sepsis and respiratory compromise management, reducing health care–associated infection and medication risk, swift management of the deteriorating patient, feedback on performance, and accountability) was implemented in a multistate health system. The primary outcome was risk-adjusted in-hospital mortality. Secondary outcomes included health care–associated infections, patient-days with hypoglycemic and severe hyperglycemic episodes, and hospital onset (HO) acute kidney injury (AKI).</div></div><div><h3>Results</h3><div>A total of 2,015,408 patients were admitted to 88 hospitals over the 36-month study period. Overall mortality improved from the baseline observed/expected (O/E) of 0.97 in 2021 to 0.74 in 2023 (-23.4%; 4,186 fewer deaths, <em>p</em> &lt; 0.001). Controlling for baseline (2021) mortality O/E ratios, the mean mortality O/E ratio for 2023 was 0.74 for system and 0.84 for peers, representing a difference of -0.10 (<em>p</em> &lt; 0.001, 95% confidence interval [CI] 0.12 – -0.07], with 1,807 fewer deaths). The standardized infection ratio declined for central line–associated blood stream infections by 24.8% (0.58; 88 fewer events), catheter-associated urinary tract infections by 30.6% (0.44; 98 fewer events), HO methicillin-resistant <em>Staphylococcus aureus</em> bacteremia by 29.0% (0.72; 67 fewer events), and HO <em>Clostridioides difficile</em> infection by 35.1% (0.36; 311 fewer events) in 2023 compared to 2021. HO AKI episodes dropped by 6.2% (8.6%; 1,725 fewer events), and patient-days with hypoglycemia and severe hyperglycemia decreased by 5.8% (4.0%; 4,840 fewer events) and 22.8% (5.2%; 30,065 fewer events), respectively.</div></div><div><h3>Conclusion</h3><div>This systemwide initiative focusing on standardizing processes, feedback on performance, and accountability was associated with sustainable improvements in mortality and a reduction in infectious and safety events.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 2","pages":"Pages 86-94"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of Central Line–Associated Bloodstream Infections by Leadership Focus on Process Measures","authors":"Kathleen McMullen MPH CIC, FAPIC, FSHEA (is Executive Director, Infection Prevention and Sterilization, Mercy Center for Quality and Safety, Chesterfield, Missouri.),&nbsp;Fran Hixson RN, BSN, CIC (is Manager, Clinical Quality, and Clinical Quality Lead, Mercy Center for Quality and Safety.),&nbsp;Megan Peters RN, CIC (is Manager, Infection Prevention, Mercy Center for Quality and Safety.),&nbsp;Kathryn Nelson MHA (is Chief Quality Officer, Mercy Center for Quality and Safety.),&nbsp;William Sistrunk MD, FACP (is Infectious Diseases Physician, Mercy Center for Quality and Safety.),&nbsp;Jeff Reames MD, MBA, FACEP (formerly Regional Director of Emergency Medicine, Mercy Health System of Oklahoma, is Emergency Medicine Consultant, Mercy Center for Quality and Safety.),&nbsp;Cynthia Standlee RN (is Chief Nursing Officer, Mercy Hospital, Ada, Oklahoma.),&nbsp;David Tannehill DO, FACOI, FACP (is Chief Medical Officer, Mercy Hospital, Washington, Missouri.),&nbsp;Keith Starke MD, FACP (is Senior Advisor, Office of Clinical Excellence, Mercy Center for Quality and Safety. Please address correspondence to Kathleen McMullen)","doi":"10.1016/j.jcjq.2024.10.012","DOIUrl":"10.1016/j.jcjq.2024.10.012","url":null,"abstract":"<div><h3>Background</h3><div>The coronavirus disease 2019 (COVID-19) pandemic affected quality improvement work that was key to hospital-acquired infection (HAI) prevention efforts for many hospitals. Central line–associated bloodstream infection (CLABSI) standardized infection ratios (SIRs) were highly affected by the pandemic.</div></div><div><h3>Methods</h3><div>After seeing an increase in CLABSI SIRs through early 2021, a health care system including 12 acute care hospitals in the midwestern United States focused on processes and process measures for CLABSI prevention. Each hospital was asked to identify a medical provider, nursing, and infection prevention lead to champion the work (identified as a CLABSI triad). CLABSI triads emphasized best practice expectations, standardized technology and products, and implemented reporting and trending of compliance. Work started in July 2021, with multiple initiatives rolled out through the end of 2022. CLABSI SIRs and standardized utilization ratios (SURs) were analyzed with interrupted time series analysis; changes in several process measures were analyzed using Wilcoxon rank sum exact testing.</div></div><div><h3>Results</h3><div>A 47.5% decrease was seen in CLABSI SIR through the study period, with SIR = 0.61 from 2023 to April 2024. The slope of the trend line for CLABSI SIR and central line utilization had a significant downward trend in the intervention time frame (<em>p</em> = 0.04 and <em>p</em> &lt; 0.01, respectively). CLABSI prevention best practices improved statistically during the study period.</div></div><div><h3>Conclusion</h3><div>Intense focus by leadership on key CLABSI prevention process measures was associated with lower CLABSI SIRs.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 2","pages":"Pages 126-134"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"We Count Our Successes in Lives","authors":"Brent C. James MD, MStat (Clinical Professor, Clinical Excellence Research Center (CERC), Department of Medicine, Stanford University School of Medicine, Stanford and Adjunct Professor, David S. Eccles School of Business, University of Utah, Salt Lake City. Please address correspndence to Brent C. James)","doi":"10.1016/j.jcjq.2024.12.006","DOIUrl":"10.1016/j.jcjq.2024.12.006","url":null,"abstract":"","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 2","pages":"Pages 83-85"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Hospital Length of Stay: A Multimodal Prospective Quality Improvement Intervention.","authors":"Joseph Walker Keach, Mara Prandi-Abrams, Allison S Sabel, Romana Hasnain-Wynia, Jonathan M Mroch, Thomas D MacKenzie","doi":"10.1016/j.jcjq.2025.01.012","DOIUrl":"https://doi.org/10.1016/j.jcjq.2025.01.012","url":null,"abstract":"<p><strong>Background: </strong>Prolonged hospital stays beyond medical necessity pose avoidable risks and costs. Reducing length of stay (LOS) without compromising patient outcomes is a national priority for hospitals. The authors aimed to systematically and safely improve LOS and LOS index (LOSI) at an urban academic safety-net hospital.</p><p><strong>Methods: </strong>The research team conducted a multifaceted quality improvement initiative in a 550-bed hospital, focusing on improving LOSI and reducing LOS. Interventions included institutional investment in an LOS reduction program, development of rigorous internal LOS data analytics, and multiple Diagnosis Related Group (DRG)-focused LOS reduction initiatives (specifically, sepsis, obstetric, and psychiatric DRGs). Initial interventions occurred in mid-2019, with subsequent iterative improvement through 2023. Statistical analyses assessed pre- and postintervention outcomes.</p><p><strong>Results: </strong>Mean LOSI significantly improved postintervention from 1.15 to 1.02 (-0.13, p < 0.0001), with sustained performance for more than three years. The average LOS demonstrated a non-statistically significant but clinically relevant improvement from 6.24 to 5.91 days (-0.33 days, p = 0.45). Excluding outlier long-LOS encounters, the LOS demonstrated a statistically significant improvement in the postintervention slope change (-0.02 per month, p = 0.04), indicating a delayed improvement to LOS postintervention. There were no adverse effects on readmissions or mortality.</p><p><strong>Conclusion: </strong>A multifaceted approach to LOS and LOSI improvement in a safety-net hospital yielded clinically significant and sustained results, showcasing the value of integrated strategies and organizational commitment.</p>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Prevalence of Suicide Risk Screening Practices in Accredited Hospitals.","authors":"Salome O Chitavi, Scott C Williams, Jamie Patrianakos, Stephen P Schmaltz, Edwin D Boudreaux, Brian K Ahmedani, Kimberly Roaten, Katherine Anne Kate Comtois, Farzana Akkas, Gregory K Brown","doi":"10.1016/j.jcjq.2025.01.010","DOIUrl":"https://doi.org/10.1016/j.jcjq.2025.01.010","url":null,"abstract":"<p><strong>Background: </strong>The Joint Commission's National Patient Safety Goal (NPSG) on suicide prevention (NPSG.15.01.01) requires accredited hospitals to screen all patients aged 12 years and older who are being evaluated or treated for behavioral health conditions as their primary reason for care for suicidal ideation using a validated screening tool. Some hospitals have expanded screening to include nonbehavioral health care patients.</p><p><strong>Methods: </strong>This cross-sectional observational study explored the prevalence and challenges of suicide risk screening practices among Joint Commission-accredited hospitals. An online questionnaire was sent to 859 general medical/surgical hospitals. Chi-square tests were used to evaluate differences in response rates, and responses were adjusted by hospital characteristics (bed capacity, location, system, and teaching status).</p><p><strong>Results: </strong>A total of 284 (33.1%) hospitals responded. The majority (n = 225 [79.2%]) reported screening all patients hospitalwide, and 185 (65.1%) had implemented a suicide prevention framework that includes protocols for positive screens and risk assessment. Challenges for implementing a comprehensive universal suicide risk screening and assessment protocol included insufficient staffing and lack of secure environments for at-risk patients. Of the 59 organizations not conducting hospitalwide screening, 94.9% indicated multiple reasons, including negative impact on workflow (30 [50.8%]), burden on providers (30 [50.8%]), not a requirement (29 [49.2%]), and workflow feasibility (28 [47.5%]).</p><p><strong>Conclusion: </strong>Results suggest the majority of accredited hospitals have implemented suicide risk screening practices that exceed current Joint Commission requirements. The lack of sufficient resources to adequately address patients who screen positive for suicide risk remains a key challenge to universal screening.</p>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Measurement of Diagnostic Excellence for Better Healthcare.","authors":"Jenna Williams-Bader, Kathryn M McDonald, Elizabeth E Drye","doi":"10.1016/j.jcjq.2025.01.011","DOIUrl":"https://doi.org/10.1016/j.jcjq.2025.01.011","url":null,"abstract":"","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic Profile and Oversight Duties of Today's Health Care Quality Leaders.","authors":"Kimiyoshi J Kobayashi, Amy C Lu, Christopher S Kim, Bela Patel, Jennifer Wiler, Mbonu Ikezuagu, Jodi L Eisenberg, David M Safley","doi":"10.1016/j.jcjq.2025.01.009","DOIUrl":"https://doi.org/10.1016/j.jcjq.2025.01.009","url":null,"abstract":"","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}