Mock Visits, JCAHO, & the NIH

I just can't tell you what FUN mock visits are. Mainly because they are not any fun at all. :)

For the past two weeks we have been preparing for our site visit for our grant renewal as well as the review for our affiliated hospital.

We have almost 10000 charts, none of which have been audited in the past 5 years; plus we've changed our forms and methods numerous times in the 2 years I've been here (and who knows how many times prior to that). The changes keep happening for several reasons; one is that the business side has run off every nurse manager we've had, so there's no continuity. Our business manager wants total control, even though she hasn't a clue about the clinical side...and she seems to have a very low opinion of nurses in general. Which is a pity, since my coworkers are about as good as it gets in research nursing...responsible, intelligent self-starters with an eye for detail. They are GOOD.

Now, normally when you change the way you do things in research, you include a
"note to file" in the charts or in clinic documentation which states the way things are changing and that all previous charts are therefore different. So you don't have to actually go back through and change everything. However, the decision was made 4 weeks prior to this grant renewal visit that we would change EVERYTHING in our 10000 charts so that they were all the same, and notes to file would be reserved only for things that were mistakes that couldn't be fixed. So, we are auditing every single chart that we have. My desk is a foot deep in charts and I have nowhere to work (so I'm goofing off and posting to my blog instead -- although when you consider I've done overtime every day for the last two weeks, I suppose my employer can suck up 15 minutes for me to vent a little). Thank goodness I can skim quickly so that it doesn't actually take me too long for any one chart.

In addition to our site visit, the MD in charge of this disaster decided that since we were hosting ONE visit, we might as well "get jcaho out of the way at the same time". JCAHO is the hospital oversight group; they come in and look at any potential safety hazard...such as when the liquid soap in the restroom expired (I didn't know soap COULD expire), or how far off the floor the sharps containers are anchored, or how close to the ceiling are things stored (can't be closer than 18 inches)...are you getting the idea that they are SUPREMELY picky?

Probably not a good decision on the part of our fearless leader...not that he'd ever bother to ask US.

Plus...and this is the part I really hate...either group can ask any employee any question about our operation and we are expected to KNOW whatever the heck it is. And I'm just not GOOD at answering on demand (now, written exams I can probably pass even if I don't know anything about the topic. You get some gifts but totally lack others, sigh).