Reducing the risk of patient harm associated with the use of anticoagulant therapy — otherwise known as blood thinners — is just one of the major changes in the sixth annual issuance of National Patient Safety Goals released this week by theJoint Commission (Oakbrook Terrace, Illinois).

The commission reported the 2008 National Patient Safety Goals and related Requirements this week for each of its accreditation programs and its Disease-Specific Care Certification Program. The goals and requirements, recently approved by the Joint Commission’s board of commissioners, apply to the nearly 15,000 Joint Commission-accredited and certified healthcare organizations and programs.

According to the organization, the new anticoagulant therapy requirement addresses a widely-acknowledged patient safety problem and becomes a key element of the goal to improve the safety of using medications. It is applicable to hospitals, critical access hospitals, ambulatory care and office-based surgery settings, and home care and long-term care organizations, the Joint Commission noted.

“If a patient’s level of anticoagulant therapy is too far out of range it subjects those patients to complications such as bleeding,” Peter Angood, MD, VP/chief patient safety officer for the Joint Commission told Medical Device Daily. “It’s important to have their level of anticoagulant therapy closely monitored.”

Healthcare workers in all Joint Commission-accredited and certified healthcare organizations and programs also will now have the option of following the World Health Organization (WHO; Geneva, Switzerland) Hand Hygiene guidelines as an alternative to the Centers for Disease Control and Prevention (CDC; Atlanta).

The reason for this change, Angood said, is that the WHO guidelines are generally understood to be a little more up to date and are applicable to a wider range of countries than the CDC guidelines.

Another change in the safety goals addresses the recognition of, and response, to unexpected deterioration in a patient’s condition. The new goal will ask hospitals and critical access hospitals to select a suitable method for enabling caregivers to directly request and obtain assistance from specially-trained individuals if and when a patient’s condition worsens. Each of the foregoing new requirements has a one-year phase-in period that includes defined milestones. Full implementation is targeted for January 2009.

In addition, an existing requirement to assure the timely reporting of critical test results has been extended to the long-term care program, the organization noted.

Finally, the requirement to limit and standardize drug concentrations, part of the goal to improve the safety of using medications, will be retired as a National Patient Safety Goal, but organization compliance will continue to be evaluated as part of the Medication Management standards, according to the Joint Commission.

“The 2008 National Patient Safety Goals seek to focus the efforts of healthcare organizations on the priority areas where the opportunities for improving patient safety are greatest,” Dennis O’Leary, MD, president of the Joint Commission, said in a statement. “Consistently putting these requirements into action will benefit millions of patients.”

The development and annual updating of the National Patient Safety Goals and Requirements continue to be overseen by an panel that includes widely patient safety experts, nurses, physicians, pharmacists, risk managers and other professionals who have hands-on experience in addressing patient safety issues in a wide variety of health care settings, according to the commission. Each year, this Sentinel Event Advisory Group works with The Joint Commission to undertake a systematic review of the literature and available databases to identify candidate new Goals and Requirements.

Following a solicitation of input from practitioners, provider organizations, purchasers, consumer groups, and other parties of interest, the Advisory Group determines the highest priority Goals and Requirements and makes its recommendations to commission.

Compliance with the requirements is a condition of continuing accreditation or certification for Joint Commission-accredited or Joint Commission-certified organizations.

Founded in 1951, the Joint Commission says it seeks to continuously improve the safety and quality of care provided to patients via healthcare accreditation and related services that support performance improvement.