Closing the loop: National consultations 2016

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Accreditation Canada thanks everyone who provided feedback during our recent national consultations. Here are the results.

Inpatient Services (formerly Medicine Services) 

A total of 104 respondents from across the country provided feedback on the proposed changes. Based on the feedback, which was positive overall, we made the following changes:

•    Added content on monitoring clients who are receiving opioids or sedation
•    Clarified the guidelines around the nutritional needs of clients
•    Added the use of structured communication tools in the process to escalate care
•    Clarified the guidelines about access to consultative resources through other means (e.g., telehealth) for small and/or rural organizations

 Critical Care

A total of 140 respondents from across the country provided feedback on the proposed changes. Based on the feedback, which was positive overall, we made the following changes:

•    Added content on early recognition and treatment of sepsis
•    Clarified requirements and guidelines where a need was identified and agreed on by the standards working group.

Pending further examination of other aspects of the Qmentum program, we have decided not proceed with changes to the Medication Reconciliation at Care Transitions, Medication Reconciliation as a Strategic Priority, and Falls Prevention and Injury Reduction Required Organizational Practices (ROPs) at this time. However, your input was valuable, and we would like to share the consultation results with you.

Medication Reconciliation ROPs

A total of 232 respondents from across the country provided feedback. Overall, responses were in favour of the proposed revisions and conveyed the following messages:

  • Remove the outpatient version of the Medication Reconciliation at Care Transitions ROP (Perioperative Standards) but clarify the rationale.
  • Keep the Emergency Department version of the Medication Reconciliation at Care Transitions ROP (do not make it a high priority criterion) but remove the requirements related to a target group of non-admitted clients.
  • Provide examples and resources to guide the identification of ambulatory care clinics that would require medication reconciliation.
  • Provide further resources to home and community care organizations with regard to medication reconciliation.

Fall Prevention and Injury Reduction ROPs

A total of 191 respondents from across the country provided feedback. Overall, responses were in favour of the proposed revisions and conveyed the following messages:

  • Clarify how teams communicate the identified fall prevention and injury reduction interventions for residents (Long-term care version).
  • Clarify the distinction between risk assessments and risk screenings and explain the approach taken (Long-term care version).
  • Provide examples of how to evaluate and assess fall prevention and injury reduction activities (Long-term care and Acute versions).
  • Explain the rationale for the changes to the Acute version of the ROP and why it differs from the long-term care and outpatient/ambulatory approaches.
  • Clarify that universal precautions encompass a client-centered approach and that changes to the ROP in different settings do not mean that falls risk assessments should not be done. Rather, risk assessments and appropriate interventions should continue to be based on client needs and clinical judgement.
  • Add more community-based examples of universal precautions to the high priority criterion guidelines.
  • Address clients’ choice to live at risk in the guidelines of all three versions.