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Dayton Children’s fixing issues with accreditation

Dayton Childrens.
Dayton Childrens.

This summer Dayton Children’s Hospital received a preliminary denial of its accreditation from a leading industry rating agency, but says it has received two clean reviews each month since and is on its way to retaining its accreditation.

The Joint Commission, the leading medical industry accreditation agency in the U.S., notified Dayton Children’s Hospital in August that it had been graded poorly in a new round of tests the agency had begun using.

Deborah Feldman, president and CEO of Dayton Children’s Hospital, said it was the first time the commission used a new survey method when evaluating the hospital and the preliminary finding did not reflect quality issues at the hospital.

“Frankly, I don’t agree with it, I don’t think it in any way reflects Dayton Children’s, but I also think any other opportunity for quality improvement, to me, is always valuable,” Feldman said.

Dayton Children’s has since received two clear follow-up surveys and hospital officials say the facility will retain its stamp of approval from the Joint Commission.

The Commission evaluates safety and compliance with industry standards at more than 21,000 U.S. hospitals and programs. The Joint Commission is independent and not a government regulator, but accreditation means that a hospital meets federals standards and is eligible to be paid by Medicaid or Medicare.

Medicaid covers more than half of patients at Dayton Children’s, which has about $300 million in annual revenue and 3,000 employees.

Feldman said on the hospital’s 30-day revisit on Sept. 28, the Joint Commission surveyor cleared Dayton Children’s of all conditions.

A surveyor was on campus as of Monday completing a second re-visit and then reviewed the results with hospital officials Tuesday, according to Feldman.

“In phone conversations with leaders at Joint Commission, they were very positive about the outcome of this process,” she said.

A preliminary denial means the Joint Commission determined there was justification to deny accreditation. Dayton Children’s will have two more follow-up surveys from the Joint Commission.

When the Joint Commission did a survey of the hospital Aug. 16, it listed 44 areas at Dayton Children’s under which there were one or more requirements that needed improvement. The wide-ranging list includes “the hospital conducts fire drills,” “the hospital safely stores medications,” and “the hospital inspects, tests, and maintains medical equipment.”

The commission would not provide the Dayton Daily News with information about what compliance issues it found at Dayton Children’s.

Feldman said it was the number of issues, not the seriousness of them, that led to commission’s original finding. She said the new methodology counted each time an example of noncompliance was found instead of generally noting that there was an issue. For example, surveyors noted every time they saw an environmental service cart not locked correctly instead of generally noting that the carts should be locked in a different way.

Feldman said some of the problems cited were also related to behavioral health care and children who were treated in rooms not intended for behavioral health care. The hospital has had a large increase in the number of children seeking care for mental and behavioral health, including children who need to be admitted overnight for mental health care.

“So we are taking care of many more children in rooms that are not designed for behavioral health,” she said.

The hospital is in the midst of building its first inpatient mental health unit, which will have 24 beds and open in 2019.

Many of the issues that have since been resolved were also related to the recent surge in construction and expansion projects, Feldman said.

“It was a different survey we had ever had before at a period of time when we had been through a lot of change,” Feldman said.

She said Dayton Children’s has always had very positive survey results in the past from the Joint Commission. She also said Dayton Children’s just received Magnet re-designation for quality nursing care and is one of 31 hospitals in Ohio and 483 hospitals in the world that are Magnet designated.