JCAHO Professional and Technical Advisory Committee Meetings

March 6-8, 2006 - Chicago Illinois  

  

AAPA staff and member representative attended the JCAHO Hospital Professional and Technical Advisory Committee (PTAC) meeting in Chicago March 6-8, 2006. Among many topics discussed was that of proposed revised standards for the administration of sedation and anesthesia.

 

The focus of the proposed changes is to outline requirements that practitioners must adhere to when administering sedation or anesthesia. One of the requirements is for practitioners who are NOT licensed independent practitioners to get approval from "independent" practitioners before administering sedation or anesthesia. This may have an effect on how PAs practice in certain settings, particularly the emergency department and/or ambulatory surgical centers.

 

In some instances, both the practitioner administering sedation/anesthesia and the practitioner performing the procedure are not "independent" practitioners. This raised concerns of a JCAHO discussion group, in which the AAPA has representation, last year.

 

In January 2006, the JCAHO made a decision to put the proposed standards out for public comment, otherwise known as a "field review." More than 1,000 responses from interested parties were received during the review period. Many individual AAPA members and specialty and state organizations responded to the field review.

 

In response to the question, "How often in your organization do two non-independent licensed practitioners, such as Physician Assistants or, in some cases, CRNAs, perform both the procedure and administer the moderate or deep sedation or general anesthesia?"

 

75% (614 respondents) answered "Never"

8.4% (69 respondents) answered "Rarely"

6.6% (54 respondents) answered "Frequently"

6.5% (53 respondents) answered "Often"

3.5% (29 respondents) answered "Very Often"

 

The Joint Commission issued a statement saying they neither condone nor prohibit this activity at this time; however, it raises issues about the potential safety of this practice. JCAHO staff plans to gather more information about the circumstances when this practice is occurring, why it is occurring, and what safeguards are being used to maintain patient safety. A new field review is being constructed that will help answer some of these concerns. The proposed changes are being put on hold for the time being until the JCAHO has a clearer understanding of this practice.

 

 

 

 

 

Last Revised: 3/24/06