Site Verification Update

Effective immediately, the Joint Commission has modified how it scores JCAHO National Patient Safety Goal #4, which requires organizations to Eliminate wrong-site, wrong-patient, wrong-procedure surgery. Specifically, the change affects the scoring of the second recommendation under this goal, 4.b., which states that organizations must Implement a process to mark the surgical site, and involve the patient in the marking process. Organizations will still be required to mark the surgical site in cases involving right/left distinction, multiple structures (such as fingers or toes), or levels (such as the spine). This requirement will continue to be scored. However, JCAHO is no longer requiring that the site be marked for other types of procedures, including mid-line sternotomies for open-heart surgery, Cesarean sections, laparotomy and laparoscopy, and interventional procedures for which the site of insertion is not predetermined, such as cardiac catheterization procedures. Organizations not marking the site in these cases will not be scored noncompliant for recommendation b of Goal #4 as long as they are consistently marking the sites involving right/left distinction, multiple structures, or levels. In addition, JCAHO has instituted a change regarding marking teeth prior to surgery to extract. JCAHO is supporting the position of the American Dental Association (ADA) on this issue, exempting dental procedures from the site-marking requirement. The ADA acknowledges, and JCAHO supports, that there is not a reliable method to directly mark teeth intended for extraction. This change was also made as a result of discussion at the summit. These changes are being instituted as a result of consensus reached at the May 9 Wrong Site Surgery Summit sponsored by JCAHO, its corporate members, and the American Academy of Orthopaedic Surgeons. Senior leaders of over 20 other professional groups related to the surgical process also participated. Additional results of this summit are forthcoming.

NULL