Seal of Approval


A report in this month's Journal of Hospital Medicine suggests that hospitals accredited by the Joint Commission outperform those that aren't when it comes to treatment of acute myocardial infarction (AMI), heart failure (HF), and pneumonia.

The study, "Hospital Performance Trends on National Quality Measures and the Association with Joint Commission Accreditation," also found that over a five-year reporting period, accredited institutions improved more than their non-accredited counterparts. HM pioneer Robert Wachter, MD, MHM, chief of the Division of Hospital Medicine at the University of California at San Francisco, was a coauthor of the study.

Joint Commission staffers and fellow coauthors Jerod Loeb, PhD, executive vice president of the Division of Healthcare Quality Evaluation at the Joint Commission, and Stephen Schmaltz, MPH, PhD, associate director of the Department of Health Services Research, say that researchers were not able to compare hospitals based on accreditation and quality control until the commission and the Centers for Medicare & Medicaid Services (CMS) adopted identical measures in 2004.

"We had a strong suspicion that accredited facilities would perform better, which was demonstrable in a statistically significant manner," Dr. Loeb says. "Of course, we worried that one of the questions that reviewers or others who read this might ask is, 'Sure, this is what we might expect from the Joint Commission to say that.' This is why the data is publically available, from us and CMS. Anyone can do the same type of analyses we’ve done and clearly come up with the very same conclusion.”

The next step of the research, Drs. Loeb and Schmaltz say, is to try to delineate whether the "gold seal" of accreditation is what "actually promotes improved performance or is a marker for other characteristics associated with such performance."

"There is something to this broad rubric associated with accreditation that is actually making a difference in the context of measures that clinical outcomes," Dr. Loeb adds. "This isn't the end of the game for us by any stretch of the imagination. It's clear that more research is needed."

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