Nurses’ “to-do” checklists change rapidly when they learn that The Joint Commission (TJC) members arrived at one of their sites for an inquiry. When they discover that the Centers for Medicare and Medicaid Services (CMS) has assigned the state health department to investigate a patient’s accusations, their meticulously planned day is significantly changing (Hansen, 2020). Whereas the presence of such agencies can immediately shift one’s priorities for the day or the following few days, there still is considerable misunderstanding about their function in healthcare (Hansen, 2020). As a result, it is critical to analyze the organizations mentioned above’ duties, discrepancies in their techniques, and problem-solving results based on various reports.
First, it is necessary to define what each department represents. CMS is the government body in charge of ensuring that hospitals around the country that get Medicare and Medicaid payments comply with administrative criteria by certifying them (Hansen, 2020). These government guidelines are designed to assure high-quality, appropriate care while promoting patient and employee safety (Hansen, 2020). TJC works to guarantee that health care is safe, effective, and of the most acceptable value and reliability (Hansen, 2020). While TJC is a non-profit organization, it has created rules based on CMS criteria and, in certain circumstances, exceeds federal requirements (Hansen, 2020). As a result, the Centers for Medicare and Medicaid Services (CMS) has designated TJC as a body capable of accrediting clinics and other healthcare institutions.
The identification of significant differences is also an essential element of this analysis. Hospitals interested in participating in TJC’s survey procedure must join and pay a fee (Hansen, 2020). Apparently, the surveying processes for both organizations are different. TJC surveyors contact hospital employees more, but they also analyze procedures and policies to compare them to everyday practices (Hansen, 2020). Surveyors use the tracing methodology to identify regions of violation (Hansen, 2020). This method is used to “track” the care patients receive while at a facility (Hansen, 2020). Furthermore, it enables surveyors to limitations of the current by examining a hospital’s and other healthcare institutions’ practice of providing care, treatment, or services (Hansen, 2020). Surveys conducted by the CMS, usually by the state Department of Health, focus on health records and rules and procedures (Hansen, 2020). Hospital notes are scrutinized for cases of non-compliance, which may result in discussions with healthcare staff (Hansen, 2020). As a result, CMS auditors tend to focus on evaluating paperwork rather than care delivery.
The main goals of the organizations mentioned above’ surveys and investigative aspects are to determine a resolving approach based on the findings. According to various studies, strengthening nurse staffing has a substantial impact on Never Events and significantly contributes to a hospital’s savings plan (NewsCAP, 2018). Return on capital employed estimates and inquiry findings will demonstrate that having a large number of skilled nursing personnel in the safety culture framework can reduce the severe costs of adverse outcomes (NewsCAP, 2018). Thus, focusing both research and public attention on such a humanitarian direction is essential.
In conclusion, the above analysis provided a general retrospective on the scope of nurses’ evaluation. The influential organizations certified for such activities, particularly CMS and TJS, were reviewed. Moreover, based on the available data, the key factors that differentiate the survey methodologies of the two departments were presented. As an integral part of such investigations, possible solutions were presented, including developing a work culture and creating a safe environment. An essential part of such investigations is considering and evaluating specific cases that lead to the need to conduct inspections.
References
Hansen, M. (2020). What’s the difference between The Joint Commission and the Centers for Medicare & Medicaid Services? The Beryl Institute. Web.
NewsCAP. (2018). The ICN issues a position statement on evidence-based safe nurse staffing. AJN, American Journal of Nursing, 118(11), 13.