Joint Commission proposal against overtesting, excessive procedures

With a brighter spotlight on overtesting and excessive procedures, The Joint Commission this week proposed a national patient safety goal (NPSG) for hospitals and critical access hospitals, addressing safety and quality issues.

Under the proposal, accredited hospitals would need to initiate programs that look at tests, treatments, and procedures that harm patients when overused. With a proposed Jan. 1, 2013 start date, hospitals and critical access hospitals select a particular test, treatment, or procedure based on the hospital's clinical risk assessment or from literature about potential harm and then evaluate its overuse and effectiveness. Alternatively, hospitals could specifically look at early labor induction, insertion of tympanostomy tubes, red blood cell transfusions, percutaneous coronary interventions, or diagnostic ionizing radiation.

The accrediting body is responding to a growing concern about the overuse of treatments, procedures, and tests. The Joint Commission defines overuse as the "use of a health service in circumstances where the likelihood of benefit is negligible and, therefore, the patient faces only the risk of harm."

The move from the accreditation agency isn't completely surprising, given its recent release of a Sentinel Alert warning providers about the potential long-term risk of diagnostic radiation testing to patients. In August, The Joint Commission encouraged healthcare organizations to implement "reasonable alternatives."

The NPSGs were first effective in 2003 to help accredited organizations define patient safety aims.

The proposal addressing overtesting and excessive procedures and treatments is open for comment until Jan. 24, 2012.

For more information:
- check out the proposed Joint Commission standards information (.pdf) for hospitals
- check out the proposed standards (.pdf) for critical access hospitals
- here's the survey and online comment form for the proposed standards
- read frequently asked questions (.pdf) about the NPSGs

Related Articles:
Imaging scans still overused despite costs, risks
ER docs order tests to avoid lawsuits first, help patients second
Report: Medical imaging spending drop 13%
Alarm fatigue, radiation overexposure among most dangerous health IT risks
TJC sentinel alert cautions hospitals from over-radiating patients