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RTN1409_B1_Top Standards 2014 (Jan-Jun)

  Recommended Readings, Tips & Pearls
*PR: Top Standards Compliance Data for First Half of 2014[®] [REF: 2014, JCSC, LDR, Phrm] Perspectives, September 2014, Vol 34, #9, Pg 1 JCp1409_B1

Once again, TJC has published the 10 most frequently cited standards in each program, for the first half of this year. There have been some interesting changes in the rankings as indicated below:
For BHC: CTS.03.01.03/Plan for care remains the #1 most frequent citation (x 2010) but HR.02.01.03/Clinical Responsibilities was nudged out of the #2 spot by NPSG.15.01.01/Suicide risk.  #7, CTS.02.01.11/Nutrition Screening and #9, MM.03.01.01 returned to the rankings for the first time since 2011 and 2010 respectively.  IC.02.04.01 entered the ranking for the first time this decade as #10.
For HAP: Although RC.01.01.01/Complete, Accurate Records dropped from #1 to #7 it is still being cited in 49% of hospitals and deserves continuing respect along with LS.02.01.20/Egress Integrity as one of two top recurring compliance concerns for TJC hospitals. The surprising change is the jump of EC.02.05.01/Utility Systems from #4 (47%) to #1 (53%). The first-time entrance of EC.02.02.01/Hazardous Materials/Wastes should also be noted in position #10.
Tip: BHC organizations should now pay particular attention to the issues in the top 3 positions and especially NPSG.15.01.01 as it has risen significantly since 2011. It would also be wise to invest review time in first timer IC.02.04.01 since upcoming surveys will coincide with the flu season.
Tip: Hospitals should continue to pay particular attention to #2, LS.02.01.20 and #3 EC.02..03.05 as these are also the two most frequently cited standards among SPHCC member hospitals over the last two years.  In fact, 4 of the standards ranked #1-#6 for TJC hospitals are also in our SPHCC Top 10.
Tip: Pharmacists should be alerted to pay a little more attention to new arrival of EC.02.02.01/Hazardous Materials/Wastes (especially EP#8) because (as we have been informed by D. Green, Pharm D, ESH), the DEA has “released their much-anticipated final rule this week relating to controlled substance disposal”. See also: More details on this provided in the comment section of this review.
See also: TJC Top Ten Trend Tables for BHC and Hospital.

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4 responses to “RTN1409_B1_Top Standards 2014 (Jan-Jun)”

  1. Dr. Fields,
    DEA released their much-anticipated final rule this week relating to controlled substance disposal. I feel that the biggest impact on hospitals is that the DEA maintains the position that wasting controlled substances by flushing or sewering does not result in them being “non-retrievable”. This will require many hospitals to invest in some type of equipment or technology that can accomplish this. Right now I know of only one, the Cactus SmarkSink (, but plan to continue my search for other options.

    I’m happy to provide more details if you’d like them. If I am able to locate additional disposal options I’ll send that to you as well.

    Derek Green, Pharm.D.
    Director of Pharmacy
    Evansville State Hospital

  2. Derek,
    Perfect timing. In preparing my upcoming newsletter I reviewed TJC’s latest listing of Top 10 Compliance Issues. #10 on the list (first time this decade) is EC.02.02.01/Hazardous Materials/Wastes which includes medications (EP#8).

    Thanks so much for keeping me in mind and taking the time to share.

    R. Fields

  3. Dr. Fields,
    I am writing to update you on a recent major change. On October 17th the DEA issued the attached statement. I spent considerable time last week trying to figure out what it actually means. Apparently they are clarifying that the new rule is not intended to changes practices at hospitals. They accomplished this by stating that hospitals do not have to meet 21 CFR 1317, which is the section in which they defined “non-retrievable”. As you can imagine this has been a very confusing month, but at this point it DOES NOT look like a Cactus Smartsink, or similar piece of equipment (See comment from 9/11/14 above), is going to be required to meet these new regulations.

    Please don’t hesitate to contact me for more information..

    Derek Green, Pharm.D.
    Director of Pharmacy
    Evansville State Hospital

    Note: The disposal clarification letter referenced above was issued by DEA’s Office of Diversion Control.

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