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March 1, 2001 Dennis
S. O’Leary, MD
President
Joint Commission
on Accreditation of Healthcare Organizations
One Renaissance
Boulevard
Oakbrook, Illinois 60181 Dear
Dr. O’Leary: The Infectious Diseases
Society of America (IDSA) recently issued a policy
statement concerning the current trend by hospitals and other
health centers to move their clinical microbiology laboratories away
from the principal sites of patient care. IDSA’s policy
statement, which is attached for your review, enumerates the many
unique functions that clinical microbiology laboratories serve related
to the effective management of infectious diseases. IDSA is concerned
that these functions may be threatened as microbiology laboratories are
being located away from the principal sites of patient care.
Accordingly, the Society strongly believes that adequate prevention
efforts must be achieved to ensure that the transport of specimens
containing fragile microorganisms, communication among laboratory
personnel and health care providers, and/or physician access to timely
diagnostic reporting and personal analysis of specimens are not
compromised. IDSA is a medical society comprised of
more than 6,000 physicians, scientists and other health care
professionals who share a common focus on the epidemiology, diagnosis,
prevention, investigation and treatment of infectious diseases. We are
committed to the highest standards in health care, research and
education related to the broad discipline of infectious diseases. To
this end, the Society supports maintenance of essential infrastructure
in all health centers to provide microbiology services to patients,
including high-quality clinical microbiology laboratories located in
close proximity to the principal sites of patient care and, ideally,
within the health center itself. To ensure that the
highest quality microbiology services are maintained in our
nation’s health centers, regardless of whether laboratories
remain in the health center or are moved off-site, IDSA is urging the
Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
to immediately modify its accreditation standards related to clinical
microbiology services to require that: - health
centers be required to provide a written statement drafted by an
institution’s director of adult and pediatric infectious
disease services and infection control stating their expert opinion as
to whether the off-site microbiology laboratory facilities are able to
provide the requisite services for patient care and infection control;
- all off-site laboratories comply
with written requirements, which the health care center’s
infection control and clinical leadership personnel have approved,
relating to the prompt and reliable transport, processing, quality
control and reporting of both routine and urgent microbiological
specimens;
- off-site
microbiology laboratories keep sufficient records to verify that the
above-referenced written requirements have been met to ensure that the
location of the laboratories creates no delay in the provision of
critical patient care or infection control decisions; and
- off-site laboratories comply with public health
disease reporting requirements, which is particularly critical where
the laboratories are located in jurisdictions different from that in
which the specimen was obtained.
IDSA’s
members see the implementation and enforcement of these changes to
JCAHO standards as critical to the maintenance of high quality
microbiology services across our nation. We would
be happy to closely work with JCAHO to answer your questions and to
provide any additional background material that you may need. Should
you have any questions related to this important matter, please contact
Robert J. Guidos, J.D., director of public policy at IDSA at
703-299-0202. Sincerely, Carol
J. Baker, MD
President
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