The Survey Deficiency Repair Kit contains a listing of the most common Joint Commission accreditation survey deficiencies identified by surveyors, with a compilation of policies, procedures, forms and other tools to help your organization avoid these common survey pitfalls.

No lengthy, confusing and complex explanations, just which standards are frequently cited, with action tools for your organization to implement to assure compliance. The Survey Deficiency Repair Kit is a quick and simple method to assure those standards most organizations find difficult to comply with are addressed. And, the repair kit provides practical, easy to implement polices, procedures and other tools that guide your organization to compliance.

Eliminate survey deficiencies and approach the new Joint Commission accreditation process with confidence knowing that you possess best practices and key policies, procedures and other documents to demonstrate your compliance with the most challenging standards

Let the Survey Deficiency Repair Kit take the worry out of meeting compliance with some of The Joint Commission's most difficult and challenging standards. Use this efficient, effective deficiency repair kit to drive your organization's successful survey!

The Survey Deficiency Repair Kit includes key documents to eliminate the fear of deficiencies. The documents included in this useful survey success tool will drive your organization's compliance achievements with the most difficult to meet standards and related elements of performance. Here are just some of the compliance issues addressed by the Survey Deficiency Repair Kit :

• Identification and mitigation of impediments to efficient patient flow
• Staff competency requirements
• Assessment of staff member's ability to fulfill job expectations
• Staffing effectiveness standards
• Application of credentialing criteria to all LIPs who provide patient care services
• Primary source verification for all clinical staff
• Conducting a risk assessment and hazard vulnerability analysis
• Safe and proper medication storage (in accordance with CMS requirements)
• Safe preparation of medications (in accordance with USP 797)
• Safe provision of medications when the pharmacy is closed
• Emergency medications
• Designated qualified personnel accept and transcribe verbal orders from authorized individuals
• Verifying presedation/preanesthesia assessment of the patient
• Operative site, procedure and patient verification and communication (universal protocol)
• Adequate and consistent pain assessment
• History and physical examination
• Initial and ongoing nursing assessments
• Provision of care, treatment and services in an interdisciplinary manner
• The safe and effective provision of services by consultants, contractual arrangement or other agreements
• The organization provides care, treatment and services for each patient according to the plan of care, treatment and services
• Leadership's development of policies and procedures for care, treatment and services
• Organ procurement
• Operative progress note
• Information security and data integrity
• Ongoing medical record review at point of care
• Medical record content requirements (including new requirements for demographic information)
• Proper use of abbreviations
• Emergency management planning that includes cooperative planning with healthcare organizations in the contiguous geographic area
• Verifying processes to assure the patient's right to cultural, psychosocial, spiritual and personal values, beliefs and preferences are respected
• Setting performance improvement priorities and identifying how the organization adjusts priorities

... and much more!