About Us   News
The Joint Commission To Certify Health Care Staffing
Companies:
An interview with Laure Dudley of the Joint Commission and Frank Shaffer,Ed D,
RN, FAAN of Cross Country Staffing
By Leah L. Curtin, RN, ScD(h), FAAN, Journal
of Clinical Systems Management
The Joint Commission plans to start certifying supplemental staffing
agencies by September 2004 to help assure safe care to patients
through assuring high standards and greater consistency among health
care staffing companies. And for good reason. In 2001, the American
Hospital Association surveyed its accredited organizations and
found that 56% of them spent $71 million a year for supplemental
staffing. In 2003, the Joint Commission again surveyed 1200 of
its accredited organizations to ascertain whether or not they wanted
and would support a program of certification for health care staffing
companies: 80% said that there was a need for quality and standards
in the industry, and 79% said that they would give preference to
a Joint Commission certified health care staffing companies. Moreover, the
health care staffing industry itself supports Joint Commission certification:
when the Joint Commission surveyed 504 health care staffing companies, ranging
from small local organizations to large, multi-site organizations,
58% said they would be interested in seeking Joint Commission certification
if it was offered.
Armed with this information, Joint Commission
staffers approached industry experts to form and Advisory Council
to explore certification. Accordingly, The Journal
of Clinical Systems Management (JCSM) arranged to interview Laure Dudley, executive
director of marketing and product development for the Commission, for its perspectives
and Dr. Franklin Shaffer of Cross Country Staffing for the industry's perspectives.
JCSM: Ms. Dudley, how would certification
of health care staffing companies benefit your accredited organizations?
Laure Dudley: We have received
calls from both our accredited organizations and from the staffing
industry in regard to certification of staffing companies. Thus the Joint Commissionundertook market research on 1200 hospitals and health care
organizations, and found widespread support for certification among
our organizations and the staffing companies themselves. Among
the benefits, from the health care organization's stand point are:
- Certified health care staffing companies would have the framework
and processes in place to help assure high quality personnel
- and. Of course, there would be far less diversity of quality
among certified companies, so health care organizations could
be assured of high levels standardization.
- Standardizing health care staffing company processes would
help assure that contract staff have been properly trained in
terms of their competencies.
- The Joint Commission may be able to give some survey advantages to accredited
organizations (or those seeking accreditation and/or renewal)
for using only certified health care staffing companies. For
example, currently the Joint Commission requires organizations to demonstrate
that any additional staff they use are competent and to demonstrate
the processes through which they ascertain the competencies of
supplemental staff. Facilities will, of course, still be responsible
for orienting agency personnel to their facility and its unique
policies and procedures.
- Health care organizations will also be benefited because their
patients will benefit from higher quality supplemental personnel.
And while a recent IOM study indicated that supplemental staffing
personnel make more medication errors as the number of shirfts
worked by supplemental staff increase. such has not been reported
to the Joint Commission in any of its field research. And, as you know, the
Joint Commission's primary mission is to help assure safe, high quality
patient care.
JCSM: Dr. Shaffer, what advantages do
you see in certification for supplemental staffing industry?
Dr. Shaffer: There are many
advantages from our perspective.
- Currently, many hospitals have developed unique processes
for contracting with staffing companies - and needless to say,
many of them differ! Thus, agencies have to deal with a lack
of standardization among the expectations/requirements of their
clients. Certification should help us streamline the contracting
process. We have standards that fit most hospitals but then there
are hospital specific requirements. However there already is
a core of requirements or standards (OSHA, CDC and state level
ones) that cover most of the clients.
- It will 'level the playing field', and by that I mean that
it will help the health care industry differentiate among high
quality staffing companies and those who are less concerned about
quality. Moreover, Joint Commission certification will go far to give the
credibility to our industry.
- Certification will provide a framework for thinking about
quality, safety and improved performance. Using standards as
a guide will help supplemental staffing agencies achieve and
maintain excellent operational systems. It will also help standardize
industry practices as well as the scope and level of expected
outcomes. Also, and very importantly, it provides external validation
of an agency's quality.
- Certification also will provide access to consultation, best
practices and innovation on an ongoing basis.
- Certification will certainly be a valid marketing tool and
will lead to enhanced contract opportunities.
JCSM: Ms. Dudley, what is the Joint Commission’s process and timeline in
regard to this certification?
Laure Dudley: The process,
planning, field review, public response and field testing will
all be occurring in the next few months. Currently, we are working
with the Advisory Council and developing the Expert Panel that
will, in turn, develop the Standards, Application Process and determines
the qualifications of the Surveyors. Over 100 health care staffing
companies have already indicated an interest in certification,
and we do have some excellent frameworks to use as models for standard
development. We already are working on agency eligibility criteria
and will publish them soon at our website (www.jointcommission.org)
and on our Listserv to elicit public comment. These frameworks
have been in use - and been effective in states like Arizona for
some time. This, we believe that we can move through our process
fairly quickly. We also plan to publish proposed standards at our
website, on our listserv and in our appropriate newsletters, once
again to elicit public comment. Thus the Joint Commission:
- intends to pilot test the processes on the health care staffing
industry in late July/early August of 2004,
- plans to accept start accepting applications in September
of 2004
- will conduct its first survey in early October of 2004.
We are in the midst, right now of determining eligibility
for certification, and as soon as the processes are in place,
pricing
-- most likely
differentiated by size and number of locations – will
be addressed. All, of course, with plenty of feedback from
the Advisory
council which held its first meeting via conference call
on 2/27/2004.
JCSM: Dr. Shaffer, how do you think that the staffing industry
will respond to the certification process and to the Joint Commission’s
public disclosure requirements?
Dr. Shaffer: I think I can
say with confidence that the majority of the good citizens in our
industry will welcome certification with open arms. Certainly Cross
Country Staffing is delighted that the Joint Commissionwill be helping to assure
quality in our industry. The development of Joint Commission certification
and quality standards has been one of my career goals since I joined
Cross Country in 1995. Moreover, I believe that certification will
also help relieve the perception/opinion expressed in the recent
IOM report on staffing, that all supplemental personnel are more
error prone.
The setting of standards, and the publication of those companies
that have met those standards should relieve a great deal of the
concern held by some people in hospitals and health care organizations.
As sitting member of both the Advisory Council and the Expert Panel,
I am fully aware of how carefully the Joint Commission's working to assure continuity
and communication between both groups.
Laure Dundley: Also, I must
add that the Joint Commission's public disclosure requires that we list those
who have passed certification. , Certification does not result
in a grade, but rather is on a pass/fail basis only. We do not
disclose who has applied and failed - the Joint Commission keeps that information
confidential.
JCSM: The journal thanks Ms. Dudley
and the Joint Commission, and Dr. Shaffer and Cross Country Staffing, for
taking the time to share your perspectives with our reading audience
on this important, development in the staffing of health care
organizations.
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