The Joint Commission has finalized new requirements for accredited behavioral health organizations that treat individuals with eating disorders. The new requirements go into effect July 1, 2016. They are the result of collaboration between the TJC Behavioral Health Care Accreditation Program and leaders of prominent eating disorder programs throughout the country. The goal is to offer specific BH standards that focus directly on eating disorder programs and support best practices in the field. Some of the requirements being introduced are actually new standards and others are elements of performance that are being added to existing standards. The requirements are applicable to organizations accredited under the Behavioral Health Care manual who provide outpatient or residential eating disorders treatment. They are also applicable to hospital based residential and outpatient eating disorder programs that are surveyed under the Behavioral Health manual. They are not applicable to inpatient hospital programs that are surveyed under the Hospital manual and treat individuals with eating disorders.
Highlights of the new requirements are as follows.
Assessments
Specific tests, screenings, and procedures including:
- Complete blood count
- Comprehensive serum metabolic profile
- Thyroid function test
- Electrocardiogram
- Body Mass Index
- Heart rate
- Screening for eating disorder behaviors
- Collection of health information from previous providers
- Assessment of emotional support received from family friends and others
- Assessment of fall risk
- Assessment for refeeding syndrome
Treatment Planning
The plan of care must provide for “sufficient nutritional rehabilitation to support regular and consistent weight (including expected rates of controlled weight gain), and/or measurable improvement in eating disorders behavior (for example, restricting, binge eating, purging).”
Outcomes of Care
Outcomes of care must be assessed based on data collected at admission. Data must be collected using valid and reliable instruments such as the Beck Depression Inventory, Eating Disorder Quality of Life scale, SF-36 and Eating Disorder Inventory-3 as well as client satisfaction data.
Care Coordination
If the client is transferred to the hospital, the organization must provide a clinical contact person.
There are specific requirements for content of the discharge plan and communication with after-care providers.
Provision of Care
Minimum types of clinical services are to be provided (individual and group therapy, medication monitoring, nutritional counseling, etc.)
The organization must be knowledgeable about evidence based guidelines for eating disorders.
Staff supervision of daily activities is required to prevent clients from engaging in detrimental behaviors.
Staffing
The program must have a multidisciplinary team experienced in treating eating disorders including clinician, MD/DO, psychiatrist or psychologist, dietitian, RN.
For organizations providing 24-hour care, a registered nurse must be on duty 24/7.
For the full text of the new requirements, see the TJC website: Prepublication Standards – Requirements for Behavioral Health Care Eating Disorders Care, Treatment, or Services.