ARE YOU READY for The Joint Commission New Perinatal Standards? 

Author:  Lauren Nunally, MPH, BSN, RNC-OB

 The Joint Commission has introduced two new standards to address complications in the areas of maternal hemorrhage and severe hypertension/preeclampsia.

Effective July 1, 2020, new Elements of Performance (EPs) for The Joint Commission accredited hospitals, require that they demonstrate compliance with 13 policies.  These policies are designed to improve the quality and safety of care provided to women during all stages of pregnancy and postpartum to help prevent the likelihood of hemorrhage and severe hypertension.

The new EP’s within the Provision of Care, Treatment, and Services (PC) chapter, were developed based on recommendations from The Alliance for Innovation on Maternal Health (AIM) program’s maternal safety bundles that recommend best practices for maternity care.  These standards were developed with input from the American College of Obstetricians and Gynecologists (ACOG), California Maternal Quality Care Collaborative (CMQCC), The American Hospitals Association and other leading national experts.

These standards are in response to the successful outcomes from increased adoption and implementation of evidence-based practices to prevent maternal mortality as a result of hemorrhage and hypertension, two of the of leading preventable contributors to maternal death in the country.  The U.S. currently ranks 65th amongst industrialized nations with regard to maternal mortality.

As a consequence of the increasing rates of maternal morbidity and mortality, The Joint Commission evaluated expert literature that revealed the highest impact on decreasing maternal complications were early recognition, and timely treatment for maternal hemorrhage, and improved maternal outcomes among states working on management of hypertension/preeclampsia.

Joint Commission-Provision of Care, Treatment, and Services Standards for Maternal Safety

 

Many Joint Commission accredited hospitals are performing a gap analysis by reviewing new standards compared to the current structures and protocols, to identify how to meet the new EP’s, some of which require documented evidence of compliance.  Some hospital administrators are implementing or discussing organizational measures for accountability tying education/simulation to credentialing and annual clinical reviews.

Implementation of the EP’s is an ongoing process, and may be difficult for some hospitals, particularly those where challenges exist with development of evidence-based protocols. It is essential to ensure that all healthcare providers are well versed with the management of obstetric emergencies.  The Joint Commission does plan to provide more detailed information, support and guidance to ensure accredited hospitals can meet these new requirements.  In the interim, Obstetric providers are self-accountable for adopting and adjusting to the new elements of performance that may require changes to their practice.

 

References/Resources

https://www.jointcommission.org/standards/prepublication-standards/new-standards-for-perinatal-safety/

https://safehealthcareforeverywoman.org/patient-safety-bundles/

https://www.cmqcc.org/qi-initiatives