AARC Joins Fellow Organizations at JCAHO Medical Abbreviations Summit

AARC Joins Fellow Organizations at JCAHO Medical Abbreviations Summit

December 15, 2004
Given the number of abbreviations, acronyms, and symbols used in medicine today, it’s easy to see how medical errors involving misuse and/or misunderstanding of these representations could occur. At the end of November, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) sponsored a national summit to discuss the issues involved and brainstorm solutions.

The AARC was represented at the meeting by Tom Kallstrom, RRT, FAARC. “In 2004, JCAHO issued a minimum list of dangerous abbreviations that must not be used,” explains the registered respiratory therapist. “They also began requiring each organization to identify at least three additional items for its own ‘do not use list.’” The restrictions went into effect immediately for all handwritten, patient-specific documentation and were set to apply to all media in 2005, with the expectation that there would be at least 97 percent compliance to the requirement next year.

Items currently on the JCAHO “do not use” list include:

u (Write “unit” instead)

iu (Write “international unit” instead)

Q.D. or Q.O.D. (Write “daily and “every other day” instead)

Trailing zero or lack of leading zero (Never write a zero by itself after a decimal point, and always use a zero before a decimal point)

MS, MSO₄, MgSO₄ (Write “morphine sulfate” or “magnesium sulfate” instead)

Unfortunately, continues Kallstrom, compliance with the initial requirement was poor, and the JCAHO experienced considerable criticism and concern about the issuance of the list. “The summit sought to reach some consensus regarding the scope and seriousness of the problem and to discuss alternative solutions.” Four working groups were convened to address various components of the issue. Kallstrom took part in the session charged with determining which abbreviations, acronyms, and/or symbols should be permanently prohibited.

“We did reach a consensus that there should be a permanent, ‘universal list’ that all medical professionals should respect and follow. In addition, we agreed that this list should be fairly short and only include those items known to cause the greatest level of possible harm,” says Kallstrom. “The group did not feel that a national list of acceptable abbreviations/acronyms/symbols was necessary.”

The results of the sessions are now being compiled into a review of the meeting that will be distributed to all of the professional organizations who participated in the summit. From there, the results will undergo a JCAHO board review and subsequent open period for comment by all interested parties. Due to the suggested changes, Kallstrom says it is expected that organizations reviewed by the JCAHO in the first quarter of next year will not be held to all the new requirements of the standards for 2005 during their site visit.