Devil’s Advocate

What the Joint Commission will tell you:

This Joint compliance standard is robust: it includes internal reporting requirements and follow up.

This standard has been approved by the CMS.

Equipment not located for inspections must be reported to affected departments and include follow up to assure completion of periodic maintenance inspections.

This policy rewards departments for their efforts in complying, recognizing that different institutions present a range of obstacles that are typically found in healthcare.

The surveyor always has the authority to drill down and follow wherever the evidence leads.

Survey organizations will not explain the following.

Focusing compliance on adherence to a schedule, rather than numbers of devices actually inspected on time, enables care facilities to budget maintenance departments (“Biomed”) more stress-free: a department reporting only 90% of equipment inspected, when the standard may be 95% to 100%, has a greater argument to support increased staff expenditures, compared with reporting being behind in meeting a schedule.

In other words, a maintenance department can more easily demand more of their staff in order to meet a schedule – “while doing all the right maintenance on each device inspected” – then they can demand technicians to increase the number of devices inspected in an hour (perhaps limiting all the right maintenance on each device inspected).

I can fully appreciate how difficult it is to challenge The Joint: in some cases, your job may even be at stake.

I’ve been there, I understand.