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An
Emphasis on Nutritional Assessment and Care
The true
cost of malnutrition is one of the two major forces
that are compelling institutions to finally address
the problem. The other is the emphasis placed on proper
nutritional assessment and care by the Joint Commission
on Accreditation of Healthcare Organizations (JCAHO).
JCAHO has
recognized the negative impact of malnutrition in hospitals,
institutions, and organizations; and has, in turn, made
nutritional assessment, support, and ongoing re-assessment
an integral and essential part of current accreditation
requirements. With its focus on organizational effectiveness,
JCAHO is uniquely qualified to help healthcare professionals
work together in fighting malnutrition.
The JCAHO
standards focus on 14 specific functions, described
in the chart below, that must be performed well by a
healthcare organization in order to achieve accreditation.
JCAHO-Evaluated Functions
| 14 Functions |
| Six Patient-Focused Functions |
- Rights (RI)· Assessment (PE)
- Care, Service, Treatment & Rehabilitation
(TX)
- Education (PF)· Continuum of Care
(CC)
- Health Promotion, Disease Prevention (PS)
|
| Six Organization-Focused Functions |
- Improving Organization Performance (PI)
- Leadership (LD) · Managing the Environment
(EC)
- Managing Human Resources (HR)
- Managing Information (IM) Surveillance, Prevention,
and Control of Infection (IC)
|
| Two Lab Organization-Focused Functions |
- Quality Control (QC)
- Waived Testing (WT)
|
| Four Hospital Structures |
- Governance (GO)
- Management (MA)
- Medical Staff (MS, LIPs)
- Nursing (NR)
|
The standards
that bear on nutrition care are found in three different
function areas: assessment (PE); care, service, treatment,
and rehabilitation (TX); and performance improvement
(PI).
The nutrition
assessment standard is PE.1.2–all individuals
must be assessed for possible nutrition problems upon
entry into the healthcare organization. The standard
spells out the course of action, including a full-blown
assessment, if one or more nutritional screens are failed
by an incoming patient.
Once the patient's
needs have been identified, the standards for nutritional
care are addressed in TX.4. These standards focus on
multidisciplinary teams that determine the patient's
care needs, and plan and deliver the nutritional care,
then monitor the patient throughout the process.
In the leadership
function, the LD.4 standards require organization leaders
to prioritize and support performance improvement activities.
For more detailed information about JCAHO accreditation
standards that bear on nutrition assessment and support,
please visit the JCAHO
website.
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