Among the specific findings in the 2007 report:
- Accredited hospitals continue to show measurable improvements in performance. The magnitude of improvement from 2002 to 2006 ranges from 3.6 percent to 52.2 percent. Some improvements over the five-year period of data collection - such as in providing smoking cessation advice - have been dramatic. Hospitals provided this advice to 89.4 percent of patients admitted with pneumonia in 2006 compared with only 37.2 percent of such patients in 2002. Hospitals also demonstrated 90 percent or higher compliance with 10 of 16 National Patient Safety Goal requirements that address issues such as medication safety, caregiver communication and preventing patient falls.
- Requiring hospitals to follow standardized processes for quality measurement, reporting and improvement has contributed significantly to the positive results. For measures tracked for the first time in 2005, performance was generally lower and more variable than for measures tracked since 2002. This demonstrates a clear correlation between performance measurement and quality improvement. Much of the improvement reflected in this report can be attributed to the consistent application of focused, evidence-based measures which are the foundation of the Joint Commission’s performance measurement endeavors.
- Room for improvement exists for most of the quality measures. A 90 percent compliance level was achieved for only four of 22 quality-related measures tracked during 2006. In addition, certain treatments are not being performed consistently for some measures in place since 2002. For example, two measures introduced in 2002 that relate to prescribing of ACE inhibitors at discharge for patients with heart failure or with heart attack show the most room for improvement, with hospitals offering these treatments only 64 and 56 percent of the time, respectively.
- Hospitals continue to be challenged in meeting certain patient safety requirements. Non-compliance rates for six of the 16 National Patient Safety Goal requirements range between 16 and 37 percent. While some of this performance can be explained by more searching during on-site evaluations by Joint Commission survey teams, a number of hospitals appear to be struggling with the re-design of patient care processes - such as the reconciliation of medication lists when patients move from one care site to another - that the goal requirements are seeking.
- Significant variability exists in the performance of hospitals by state, as well as between the highest- and lowest-performing hospitals. For example, on the measure of providing pneumococcal vaccination, performance ranged from 55.5 percent to 91 percent. On specific measures of surgical care, the difference between the highest state rate and the lowest state rate ranged as high as 80 percent.
Theo Francis in WSJ Health Blog comments on the JC report.
