From JCAHO to DNV?

The Joint Commission (formerly Joint Commission on Accreditation of Healthcare

Organizations or “JCAHO”) as a private, nonprofit corporation that accredits a majority of hospitals and healthcare organisations nationwide has accomplished to help improve quality in healthcare organisations.

When the Medicare Program was created in 1965, Social Security Act stated that hospitals accredited by The Joint Commission were “deemed” to meet most of the requirements set forth in the Medicare CoPs (Conditions of Participation). The American Osteopathic Association did so immediately for its Health Facilities Accreditation Program (“HFAP”). A new statute that was signed into law on July 15, 2008 removed the statutory reference to The Joint Commission, effective July 15, 2010. This means that The Joint Commission will have to apply for deemed status and be approved by the federal government, just like all other accreditation programs.

Det Norske Veritas – DNV Healthcare Inc. that was established in 1864 in Norway and started operating in the USA in 1898, received the first additional CMS deeming authority for hospital accreditation on September 26, 2009.

DNV Healthcare’s Hospital Accreditation Program consists of an integration of NIAHO Standards with ISO 9001 Quality Management System Standards. DNVHC

accreditation meets CoP requirements and integrates the ISO 9001 Quality

Management System as a part of these requirements.

The NIAHO Quality Management System (QM) Requirements address six documented procedures that ISO 9001 requires(Control of documents, Control of records, Internal audit, Control of non-conforming product, Corrective action, Preventative action) in detail to ensure that hospital organizations comply with the ISO standard.

DNVHC surveys are conducted annually; focus on sequence and interactions of processes throughout the hospital. The survey team consists of three types of surveyors: Clinical, Generalist, and Physical Environment/Life Safety Specialist. DNVHC survey activities include observation of services, interviews, tracer methodology, and a comprehensive building tour.

Many hospital leaders and staff have felt frustration over some of JCI actions and processes. Cost of surveys and fees, concerns about ability of innovation are some of them. There is an anectodal evidence that hospitals find JCI so “prescriptive” and want their organizations to be free to decide how best to accomplish its performance improvement functions in its unique culture, and to innovate, so long as it meets the basic CMS substantive requirements.

Currently, there are 264 hospitals accredited by DNV in USA. DNV standarts that is directly related to the CMS Conditions of Participations is known to be less prescriptive with its focus to organizational innovations and improvement with best practices. DNV accreditation system assures quality with annual surveys of clinical and non clinicals areas, staff and patient interviews and Tracer Methodology to identify and document effective processes.

DNV aims to hold hospitals accountable to ensure that processes are planned, managed, measured, documented and continually improved. For that goal ıt uses ISO methods and materials.