By Ruth Elzer, RN, MS

Earn cash for Joint Commission Compliance?

Well, not in the way that you think.

EARN CASH is a mnemonic device that outlines expectations for patient education in applicable patients. The expectations for the specific elements of patient education have gradually increased over the years and have now been combined under a single standard, PC.02.03.01.

The EARN CASH  mnemonic was designed to remind clinical staff of the elements that need to be addressed in patient education documentation, as applicable to the patient’s individual plan of care. The mnemonic reads as follows:

E- Equipment being used in the hospital and medical equipment anticipated for home use
A- Assessment of pain and pain management techniques, including the use of an appropriate pain scale
R- Rehabilitation techniques, such as crutch walking, and activities of daily living
N- Nutrition, including prescribed diets

C- Care plan, such as expected time line of hospital stay and discharge planning
A- All medications, including topical and respiratory medications
S- Safety, which may relate to fall prevention, cal bell use or participation in the safety program, including the National Patient Safety goals
H- Health and hygiene, including oral hygiene for applicable patients

Compliance with PC.02.03.01 is not solely dependent on meeting the expectations of EARN CASH. The process is the implementation aspect of the education standard. The first several EPs of the standard outline expectations for the learning needs assessment, completed on admission, which include the following elements:

• Cultural and religious beliefs
• Emotional barriers
• Desire and motivation to learn
• Physical and cognitive limitations
• Barriers to communication

The final EP of the standard is a “C” standard necessitating an MOS that requires that the hospital evaluate the patient’s understanding of the education and training provided.

What is the best approach?

While timely and complete patient education is a requirement, the Joint Commission allows for great latitude in how the education is documented. The right solution for each organization is going to be based on the options available, habits of various disciplines and the nature of care provided. The important thing to remember is that a single solution may not be the right answer. A combination of approaches that differs according to the care provided (inpatient vs. Outpatient) may hold the most complaint solution. When determining the solution that is right for you, consider the pros and cons. This tool lays out some general approach categories and their positive and negative aspects.

Next steps:

Choosing the best way to document patient education will largely be dependent on the options open to each patient care area. Regardless of the choice you make, the EARN CASH mnemonic can be helpful in assuring compliance.

Consider using it in one of the following ways:

• Use it to create categories on a multidisciplinary flowsheet for education documentation.
• Work with IT to integrate education into patient activities in each category. For example, when oral hygiene is documented, an educational screens pops up to record that activity as well.
• Use it for educational posters to remind staff to document key aspects of patient education. Prepare a different poster for each unit with examples serving as a case study of a common patients seen.
• Use the EARN CASH  mnemonic as a quality collection tool for proactively measuring compliance with PC.02.03.01.

Need more?

If you are struggling to understand the expectations for this topic or other areas, call for a free phone consultation. Call Ruth Elzer at 513-241-0142

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