The panel that accredits U.S. hospitals has asked Johns Hopkins Hospital to review its security measures — and potential improvements — in the wake of the shooting of a doctor by the distraught son of a patient last week.
Hopkins has 45 days from when Dr. David B. Cohen was shot to submit a report to the Joint Commission, the independent, nonprofit panel that offers accreditation for more than 18,000 health care organizations and programs in the United States.
The commission says it identifies "sentinel events" such as postoperative complications or medical errors and uses them to improve the safety and quality of health care provided to the public. A sentinel event is "an unexpected occurrence involving the death or serious physical or psychological injury or the risk thereof."
The commission noted, "Not all sentinel events occur because of an error and not all errors result in sentinel events."
The Joint Commission routinely reviews hospitals that face sentinel events — there have been 6,923 recorded since 1995, including 968 in 2009 and 323 through the second quarter of 2010. In Maryland, 146 events were reviewed between 1995 and 2008. The most common problems nationwide are wrong-site surgery, suicide, postoperative complication, delay in treatment and medical error.
Violence in hospitals is far less common. In all, a little less than 4 percent of the incidents have been categorized as "assault/rape/homicide." It's the eighth most common type of problem over time, with 263 incidents recorded since 1995.
Now that the commission has identified the Hopkins shooting as a sentinel event, the hospital will not only need to look at what went wrong but also at what officials plan to do to keep a similar event from happening.
The commission will review the confidential Hopkins report and continue to follow the hospital for a few months to ensure the plan is "implemented successfully," said Ken Powers, a commission spokesman.
Powers said the commission could determine that all proper policies and procedures were followed.
Johns Hopkins security officials have said putting metal detectors at all the entrances and screening some 80,000 workers and visitors a week would be logistically difficult and would change the hospital's welcoming atmosphere.
"Hospitals are and must remain places of hope and healing that are open to the public," Hopkins officials said in a statement after the shooting. "They cannot be turned into armed citadels. Johns Hopkins never closes. Our doctors, nurses and staff took care of our very sick patients even during the crisis."
Hopkins officials do use magnetometer "wands" to check visitors during high-risk situations in the emergency room only. Gunshot victims, officials say, are routinely treated and rival gang members can show up as patients or visitors.
Still, the officials have said they will continue to reassess security needs.
In all, 7,064 patients have been impacted by sentinel events since 1995. The commission doesn't say how many hospital staffers have been involved.
About the investigation, Hopkins spokesman John Lazarou said, "It is within the Jurisdiction of the Joint Commission to investigate any concerns they have related to the care and treatment of patients, and Hopkins cooperates with all regulatory bodies."
Cohen remains in good condition as he recovers from the shooting.