The Joint Commission has approved revisions to Medical Staff Standard MS.01.01.01, formerly known as MS.1.20, that addresses the Medical Staff's self-governance and its accountability to the governing body for the quality and safety of patient care.
The Medical Staff Bylaws are a written set of documents that describe the medical staff's organizational responsibilities and how the medical staff and governing body will work together.
Standard MS.01.01.01 provides the framework for constructing, writing and implementing these bylaws.
The revisions are based on the unanimous recommendations of an 18-member task force representing the American College of Physicians, American College of Surgeons, American Dental Association, American Hospital Association, American Medical Association, Federation of American Hospitals and the National Association Medical Staff Services.
The Joint Commission says Standard MS.01.01.01 recognizes that while a hospital's governing body is ultimately responsible for the quality and safety of care, the governing body, medical staff and administration must collaborate to achieve that goal.
The revised standard goes into effect March 31, 2011, giving hospitals and their medical staff a year to come into compliance and The Joint Commission an opportunity to answer any questions.
Following that date, all hospitals and critical access hospitals must be in full compliance. The Joint Commission plans to provide additional education to support hospitals and prepare them for implementation of the standard.
"The intent of these revisions is that the Medical Staff Bylaws can both maintain the medical staff's self-governance and enhance its collaboration with the hospital's governing body, while optimizing the efficiency of maintaining the bylaws," said Robert Wise, MD, vice president of the Division of Standards and Survey Methods at The Joint Commission.
Detailed information about revised standard MS.01.01.01 will be published in the 2011 version of the accreditation manuals for hospitals and critical access hospitals that is distributed in the fall of 2010.