* EC:Not Documented, Not Done: How to keep track of what you need to do for Joint Commission standards compliance—and prove that you’ve done it[®]  [Pearl: EOC, JCSC] EC News, February 2014, Vol 17, #2, Pg 8  JCe1402_B7

80% of EP’s in the 17 chapters of TJC standards are found in the 3 chapters of EC, EM and LS. More than 80 of those EP require documentation that needs to be available for both survey and the identification of opportunities to improve (as per EC.04.01.01-05). That documentation is often being performed by multiple persons at varying times in different locations throughout a facility.  As a result, it is challenging to have a good, accurate, overall understanding of the state of that documentation and some of it may drop between the cracks.  Pearl: This article presents a solution that helps to coordinate documentation efforts and can even serve as a useful presentation compliance demonstration tool during survey… an EC Frequency Documentation Checklist.  A sample of this 2-page grid is included on pages 10 and 11.  It identifies the documentation requirements and their frequency with columns for monthly checkoff.

Tip: To avoid ‘not documented – not done’ citations, consider adapting this checklist for your facility to track and document performance related to the 6 EC functions.  Install the checklist on a centralized/shared drive to improve access, coordination and permit multi-person updating.  Carry the checklist when escorting the LSC surveyor.