News | October 18, 2011

New Study Evaluates Performance of Joint Commission-Accredited Hospitals

October 18, 2011 – New research published in the October issue of the Journal of Hospital Medicine shows hospitals accredited by The Joint Commission (JC) outperformed non-accredited hospitals on a number of nationally standardized quality measures. The measures included acute myocardial infarction (AMI), heart failure, and pneumonia. The research also shows the performance gap between JC accredited and non-accredited hospitals increased over the years of the study. 

The study, Hospital Performance Trends on National Quality Measures (S.P. Schmaltz et al. “Hospital Performance Trends on National Quality Measures and the Association with Joint Commission Accreditation.” Journal of Hospital Medicine, 2011, Oct. 6 (8):  454-61), is the first to show the association between Joint Commission accreditation status and performance improvement over a five-year reporting period. 

Researchers also found JC-accredited hospitals had greater performance improvements from 2004 to 2008 than non-accredited hospitals, even though the former started with higher baseline performance levels. This accelerated improvement was broad-based: accredited hospitals were more likely to achieve superior performance (greater than 90 percent adherence to quality measures) in 2008 on 13 of 16 nationally standardized quality-of-care measures compared to hospitals that were not accredited. The accredited hospitals were also superior on three clinical area summary scores and an overall score

Only 69 percent of hospitals that have never been accredited achieved a 2008 composite rate of greater than 90 percent adherence to quality measures; this compares to 84 percent for hospitals that have been continuously accredited by The Joint Commission. These results are consistent with other studies examining both process and outcome measures and accreditation.

“Although Joint Commission accreditation is recognized as the ‘gold standard’ for health care quality among key stakeholders, evidence is necessary to establish that Joint Commission accreditation is associated with better performance on key measures of quality and safety. This examination of two independent assessments of the quality of care provided by an organization—accreditation and publicly-reported quality measures— over time provides that link between accreditation and significantly better performance on important measures of health care quality,” says Jerod M. Loeb, Ph.D., executive vice president, division of healthcare quality evaluation, The Joint Commission, and an author of the study.

The other authors from The Joint Commission include lead author Stephen Schmaltz, M.P.H., Ph.D., associate director, department of health services research; and co-authors Scott C. Williams, Psy.D., associate director, department of health services research; and Mark R. Chassin, M.D., FACP, M.P.P., MPH, president. An additional co-author is Robert M. Wachter, M.D., professor and associate chairman, department of medicine, University of California, San Francisco.

The authors call for future research to examine whether accreditation actually promotes improved performance or is a marker for other hospital characteristics associated with such performance. In addition, as more standardized measures are added to the Joint Commission and CMS databases, it will be possible to use the same study methodology to incorporate these additional domains.

The 16 measures used in this study of 3,891 hospitals address hospital compliance with evidence-based processes of care recommended by the clinical treatment guidelines of respected professional societies. United States hospitals have been collecting data since July 2002 on standardized measures of quality developed by The Joint Commission and CMS.

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