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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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