JCAHO's Unit-of-Use Mandate

Erik Swain
 

A major hospital-accrediting organization has seen sufficient evidence to conclude that the dispensing of medication in unit-of-use packaging reduces errors. It is proposing that the hospitals it certifies use this type of packaging when possible.

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO; Oakbrook Terrace, IL), which evaluates and accredits 18,000 organizations, accounting for 80% of the nation's hospitals and 96% of its hospital beds, is proposing a new set of medication-use standards. These include mandating that an organization has "a safe and effective medication-distribution system that is consistent throughout the organization," said Paul M. Schyve, MD, JCAHO's senior vice president.

As part of that mandate, the standard will require unit-of-use packaging "when the medication is available from the manufacturer in such packaging, or repackaging by pharmacy into unit-dose is feasible."

Schyve made these comments to attendees at the Healthcare Compliance Packaging Council's (HCPC; Falls Church, VA) 10th Annual National Symposium on Patient Compliance, held May 14–15, 2002, in Philadelphia. He acknowledged that it may be difficult to come up with a consensus on how to define "feasible."

"We want to move from making it a recommendation that gets cited when an organization steps backward [from using unit-of-use packaging to using bulk packaging] to affirmatively asserting it and changing the emphasis," he said. "I expect it to be adopted."

The rationale, he said, is to dispense medications "in the most ready-to-administer form possible to minimize opportunity for error."

When setting standards, he said, JCAHO tries to incorporate evidence-based and ISO 9000 concepts as well as get a consensus in the field through surveys. Through the surveys, he said, they found that "most said the unit-dose format was a good idea."

JCAHO anticipates adopting the standards by the end of 2002 and publishing them in January 2003, making them effective for accreditation by July 2003, Schyve said.