Joint Commission: National Patient Safety Goals



Patient safety remains to be one of the main concerns in areas of health care and nursing. The Joint Commission is an organization that is responsible for accrediting health care facilities, and patient safety is one of the main criteria to consider while making a decision in hospitals (The Joint Commission, 2016).

The National Patient Safety Goals (NPSGs) are promoted by the Joint Commission to guarantee protection and safety of clients in all facilities (The Joint Commission, 2016). The problem is in the fact that there are many situations in hospitals when patient safety can be jeopardized. Therefore, NPSGs are proposed to guarantee the improvement of safety in healthcare environments.

The area that needs to be discussed in detail in the context of NPSGs is Critical Access Hospital (CAH). Thus, it is important to focus on such two goals as “Improve staff communication” (NPSG.02.03.01) and “Prevent infection” (NPSG.07.01.01) (National Patient Safety Goals, 2016). The purpose of this paper is to discuss the two NPSGs and explain how they are addressed in CAHs.

NPSG 1: Improve Staff Communication

Discussion of the Goal

The coordinated communication between employees in healthcare facilities is important to avoid errors. According to Dingley, Daugherty, Derieg, and Persing (2008), “ineffective communication among health care professionals is one of the leading causes of medical errors and patient harm” (p. 1).

For CAHs, the associated goal is NPSG.02.03.01: “Get important test results to the right staff person on time” (National Patient Safety Goals, 2016). Although the shared test results are important to prescribe the effective treatment, the problem is in the fact that, in many hospitals, the communication between employees is not organized.

As a result, communication failures can cause more than 70% of problematic situations and errors (Dingley et al., 2008, p. 1). Thus, employees can fail to communicate within a team, discussions can be irrelevant to the problem, and communication can be late (Abraham, Kannampallil, Almoosa, Patel, & Patel, 2014; Dingley et al., 2008).

Obstacles and Interventions

In their work, professionals can ensure sharing test results with right members of the team to contribute to patient safety. Still, there are some obstacles that need to be overcome. Thus, healthcare providers can have “limited opportunities for regular synchronous interaction” (Dingley et al., 2008, p. 2).

They can also prioritize activities according to their visions, and such approach causes delays in sharing test results (Abraham et al., 2014). Nevertheless, it is possible to address these obstacles and minimize errors caused by ineffective communication.

Hospitals need to implement standardized communication tools, such as SBAR (Situation, Background, Assessment, Recommendation) protocols to provide the “structure for communication” (Dingley et al., 2008, p. 4). It is also important to organize daily quick meetings and multidisciplinary rounds using protocols in order to discuss patient’s diagnoses and desired outcomes (Dingley et al., 2008).

As a result, it is possible to expect that team members will know whom to communicate in different situations and with whom to share test results. From this point, practical habits that can be followed in CAHs are the identification of team members’ responsibilities before the shift and the use of protocols.

NPSG 2: Prevent Infection

Discussion of the Goal

One of the main risks to patient safety in healthcare facilities is hospital-acquired infections. According to the study conducted by the Centers for Disease Control and Prevention, “approximately 1 in 25 hospital patients has at least one healthcare-associated infection” (Tabatabaei, Pour, & Osmani, 2015, p. 2). As a result, risks of complications and morbidity increase (Mehta, Gupta, Todi, Myatra, & Samaddar, 2014).

Many patients are susceptible to infections, and employees must follow certain guidelines in order to prevent the spread of infections. In CAHs, employees should focus on NPSG.07.01.01 associated with following “the hand cleaning guidelines” (National Patient Safety Goals, 2016). If healthcare providers do not wash their hands regularly, infections can spread through contacts with patients.

Obstacles and Interventions

In spite of several obstacles, the discussed NPSG is realistic because when professionals focus on the problem and follow hand cleaning guidelines, it is possible to decrease a rate of hospital-acquired infections in the concrete facility.

The main barriers to following the discussed guidelines are the lack of time, experienced pressure, ineffective procedures of washing hands, and avoidance of washing hands after contacting patients (Tabatabaei et al., 2015).

However, it is possible to guarantee following the goal in CAHs while focusing on certain interventions. It is important to wash hands before and after contacting with patients and fluids, and it is necessary to wash hands before performing a range of procedures (Mehta et al., 2014).

Furthermore, team leaders need to monitor what detergents are used by healthcare professionals to wash their hands and prepare for procedures. In a clinical setting, it is possible to observe that healthcare providers wash their hands using water and soap. Still, it is necessary to control the use of other detergents and ethanol.


There are many risks associated with guaranteeing patient safety. If recommendations regarding patient safety are not followed, clients can be at risk of suffering from medical errors.

In order to avoid failures in communication or in following guidelines regarding professionals’ hygiene, it is necessary to concentrate on NPSGs and implement certain interventions that are proposed to address critical situations. From this point, the goals regarding promoting the communication between employees and preventing infections can be discussed as the most important ones in the setting of CAHs.


Abraham, J., Kannampallil, T. G., Almoosa, K. F., Patel, B., & Patel, V. L. (2014). Comparative evaluation of the content and structure of communication using two handoff tools: Implications for patient safety. Journal of Critical Care, 29(2), 311-323.

Dingley, C., Daugherty, K., Derieg, M. K., & Persing, R. (2008). .

Mehta, Y., Gupta, A., Todi, S., Myatra, S. N., & Samaddar, D. P. (2014). Guidelines for prevention of hospital acquired infections. Indian Journal of Critical Care Medicine, 18(3), 149-163.

National Patient Safety Goals: Critical Access Hospital. (2016).

Tabatabaei, S. M., Pour, F. B., & Osmani, S. (2015). Epidemiology of hospital-acquired infections and related anti-microbial resistance patterns in a tertiary-care teaching hospital in Zahedan, Southeast Iran. International Journal of Infection, 2(4), 1-6.

The Joint Commission. (2016). 2016 National Patient Safety Goals.

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