The Joint Commission

The Joint Commission is a healthcare accrediting organization whose role in the account spans hospital accreditation, state oversight, and emergency-preparedness standards. Its significance is sharply tested by the Katrina crisis at Memorial Medical Center: formal plans and accreditation did not ensure a coherent response, while later changes to emergency-power requirements reflected lessons drawn from failures during major disasters.

Identity and Regulatory Role

The organization was formerly known as the Joint Commission on Accreditation of Healthcare Organizations, or JCAHO; it took the name The Joint Commission in 2007. Robert Wise served as vice president of its division of standards and survey methods and later as a medical advisor in healthcare quality evaluation. His perspective connects the commission’s standards to their practical use: they could guide how hospitals prepared, but their existence alone did not establish that a hospital could act effectively under pressure.

Accreditation also had consequences beyond the commission’s own review. In Louisiana, accreditation by JCAHO could be accepted by the state health department in place of its annual resurvey. That arrangement gave the accrediting process a role in state oversight, making the quality and substance of its standards consequential for hospitals and the public, not merely a matter of institutional recognition.

Accreditation and Preparedness at Memorial

Memorial’s JCAHO hospital and home-care accreditation survey took place May 17–19, 2005, only months before Katrina. The subsequent crisis revealed a weakness in how preparedness could be understood and documented. Memorial had twenty separate emergency-preparedness plans. Wise later criticized them as disconnected from one another and argued that staff could not reasonably be expected to know so many plans. In his assessment, the hospital had treated the newer preparedness standards as paperwork to satisfy an accreditation inspection rather than as a basis for planning across hazards.

That distinction mattered when floodwaters threatened the hospital. In a hastily assembled command meeting, the atmosphere shifted from a hospital emergency to what staff experienced as a military operation, with the immediate objective of acting before power failed. Nearly two hundred patients needed to be brought to safety, and staff had to determine who should leave first while seeking outside transportation. The commission’s standards did not themselves supply a workable, integrated response to those demands; Memorial had to improvise despite years of committee meetings and plan revisions.

Emergency Power and Changing Standards

The disaster also exposed the limits of relying on technical compliance as proof of resilience. Hospital generators were required to be tested monthly, but only for short periods. A year after Katrina, The Joint Commission issued a Sentinel Event Alert warning that meeting relevant codes and standards was only a starting point: experience showed that emergency power systems could meet those requirements and still prove inadequate in a major catastrophe.

In 2007, the organization added a requirement for generators to undergo a continuous four-hour test once every thirty-six months, on top of the existing monthly tests of thirty minutes. The change strengthened testing expectations, but did not end concerns about reliability. Later generator failures at hospitals and nursing homes during prolonged utility outages—including during Hurricanes Gustav, Isaac, and Sandy—indicated that systems could remain inadequate even after standards changed.

Significance

The Joint Commission’s place in the narrative is therefore neither that of a direct disaster responder nor a guarantee of safety. Its accreditation could substitute for a state resurvey, and its standards helped define what hospitals were expected to prepare for; yet Memorial’s fragmented plans show how compliance could become detached from operational readiness. The later emergency-power alert and testing requirement mark an institutional response to that gap, while the continuing failures described in the account caution against treating revised rules as equivalent to reliable performance.