Dataset Information

Hospital performance trends on national quality measures and the association with Joint Commission accreditation.

ABSTRACT:

Background

Evaluations of the impact of hospital accreditation have been previously hampered by the lack of nationally standardized data. One way to assess this impact is to compare accreditation status with other evidence-based measures of quality, such as the process measures now publicly reported by The Joint Commission and the Centers for Medicare and Medicaid Services (CMS).

Objectives

To examine the association between Joint Commission accreditation status and both absolute measures of, and trends in, hospital performance on publicly reported quality measures for common diseases.

Design, setting, and patients

Performance data for 2004 and 2008 from U.S. acute care and critical access hospitals were obtained using publicly available CMS Hospital Compare data augmented with Joint Commission performance data.

Measurements

Changes in hospital performance between 2004 and 2008, and percent of hospitals with 2008 performance exceeding 90% for 16 measures of quality-of-care and 4 summary scores.

Results

Hospitals accredited by The Joint Commission tended to have better baseline performance in 2004 than non-accredited hospitals. Accredited hospitals had larger gains over time, and were significantly more likely to have high performance in 2008 on 13 out of 16 standardized clinical performance measures and all summary scores.

Conclusions

While Joint Commission-accredited hospitals already outperformed non-accredited hospitals on publicly reported quality measures in the early days of public reporting, these differences became significantly more pronounced over 5 years of observation. Future research should examine whether accreditation actually promotes improved performance or is a marker for other hospital characteristics associated with such performance. Journal of Hospital Medicine 2011;6:458-465. © 2011 Society of Hospital Medicine.

SUBMITTER: Schmaltz SP

PROVIDER: S-EPMC3265714 | biostudies-literature | 2011 Oct

REPOSITORIES: biostudies-literature

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Publications

Hospital performance trends on national quality measures and the association with Joint Commission accreditation.

Schmaltz Stephen P SP Williams Scott C SC Chassin Mark R MR Loeb Jerod M JM Wachter Robert M RM

Journal of hospital medicine 20111001 8

<h4>Background</h4>Evaluations of the impact of hospital accreditation have been previously hampered by the lack of nationally standardized data. One way to assess this impact is to compare accreditation status with other evidence-based measures of quality, such as the process measures now publicly reported by The Joint Commission and the Centers for Medicare and Medicaid Services (CMS).<h4>Objectives</h4>To examine the association between Joint Commission accreditation status and both absolute ...[more]

PMID: 21990175

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Project description:ObjectiveTo evaluate the evidence upon which standards for hospital accreditation by The Joint Commission on Accreditation of Healthcare Organizations (the Joint Commission) are based.DesignCross sectional study.SettingUnited States.ParticipantsFour Joint Commission R3 (requirement, rationale, and reference) reports released by July 2018 and intended to become effective between 1 July 2018 and 1 July 2019.InterventionsFrom each R3 report the associated standard and its specific elements of performance (or actionable standards) were extracted. If an actionable standard enumerated multiple requirements, these were separated into distinct components. Two investigators reviewed full text references, and each actionable standard was classified as either completely supported, partly supported, or not supported; Oxford evidence quality ratings were assigned; and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to assess the strength of recommendations.Main outcome measureStrengths of recommendation for actionable standards.Results20 actionable standards with 76 distinct components were accompanied by 48 references. Of the 20 actionable standards, six (30%) were completely supported by cited references, six were partly supported (30%), and eight (40%) were not supported. Of the six directly supported actionable standards, one (17%) cited at least one reference of level 1 or 2 evidence, none cited at least one reference of level 3 evidence, and five (83%) cited references of level 4 or 5 evidence. Of the completely supported actionable standards, strength of recommendation in five was deemed GRADE D and in one was GRADE B.ConclusionsIn general, recent actionable standards issued by The Joint Commission are seldom supported by high quality data referenced within the issuing documents. The Joint Commission might consider being more transparent about the quality of evidence and underlying rationale supporting each of its recommendations, including clarifying when and why in certain instances it determines that lower level evidence is sufficient.

Project description:BackgroundMaternal and child health are internationally considered to be among the best measures for assessing health-care quality. The study was carried out with the following aims: 1) to assess the quality of perinatal care (PC) by measuring the frequencies of the five PC indicators developed by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and comparing results with international standards; 2) to examine whether maternal, pregnancy care and neonatal characteristics could be factors associated with the quality of perinatal care hospital performance, measured through these indicators.MethodsWe retrospectively reviewed medical charts of women over the age of 18 who experienced delivery in Gynecology/obstetrics wards between January-December 2016, and those of their newborns hospitalized in the Neonatology or Neonatal Intensive Care Unit (NICU) of a public non-teaching hospital in Catanzaro (Italy). Indicators were calculated according to the methodology specified in the manual for JCAHO measures. Univariate and multivariate analyses were performed to test the independent association of maternal, pregnancy care and neonatal characteristics on the adherence to JCAHO PC indicators.ResultsThe records of 1943 women and 1974 newborns were identified and reviewed in order to be included in at least one of the PC indicators. Elective/early-term delivery, was performed in 27.6% of eligible women, far from the recommended goal (0%); cesarean section in nulliparous women with a term, singleton baby in a vertex position exceeded the suggested target of <?24% and the adherence to antenatal steroids administration was suboptimal (87%). Results of the exclusive breastfeeding indicator achieved a better performance (81%) and compliance with the PC-04 indicator was satisfactory with only 0.4% healthcare-associated bloodstream infection developed in eligible newborns.ConclusionsThis is the first study performed in Italy that has evaluated the quality of PC by using all the five JCAHO indicators. The application of this feasible set of indicators allowed us to measure several aspects of PC for which there is no standardized monitoring system in Italy. Our findings revealed significant deficiencies in the adherence to recommended processes of PC and suggest that there is still substantial work required to improve care.

Project description:BackgroundThere are few data comparing the drug management standards of the US and Canadian agencies that accredit health care institutions.ObjectiveTo evaluate the clarity and assessability of criteria in the drug management standards adopted by Accreditation Canada and the Joint Commission (United States).MethodsA pilot study was conducted to compare the clarity and assessability of the criteria listed in the 2 standards. Criteria that were common to the 2008 versions of the Canadian and US drug management standards were identified. A panel of 12 health care professionals was assembled to independently rate the clarity (i.e., clear or unclear) and the assessability (i.e., assessable or not assessable) of each statement, using a validated comparative grid.ResultsIn total, there were 143 Canadian standards and 103 US standards. Sixty-two (43%) of the 143 Canadian criteria could be directly paired with a US criterion, whereas 70 (68%) of the 103 US criteria could be paired with one or more Canadian criteria. Six of the US criteria were paired with more than one Canadian criterion, and 12 of the Canadian criteria could be paired with more than one US criterion. Four of the 22 themes in the Canadian standards had no equivalent criteria in the US standards. Panel members from the pharmaceutical practice group evaluated the clarity and assessability of the Canadian criteria more severely than panel members from the nursing practice group: 86% versus 95% of individual ratings were deemed "clear" by these two groups, respectively (p < 0.001) and 64% versus 88% of individual ratings were deemed "assessable" (p < 0.001). There were no criteria that were considered unclear or unassessable by all of the panel members.ConclusionsFew data are available on drug management standards and their impact on health care. A better understanding of these standards, as well as comparisons of Canadian standards with those of other countries, might help in determining their clarity and assessability. A larger-scale study is required to validate the observations reported here.

Dataset Information

Hospital performance trends on national quality measures and the association with Joint Commission accreditation.

Background

Objectives

Design, setting, and patients

Measurements

Results

Conclusions

Publications

Hospital performance trends on national quality measures and the association with Joint Commission accreditation.

Similar Datasets

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