SDS Accreditation Update

New competition for TJC: DNV Healthcare

Accreditor granted deeming authority from CMS

Is it the end of an era for The Joint Commission? Following on the heels of Congress' move to require the organization to reapply for deeming authority for the first time, DNV Healthcare has been granted deeming authority from the Centers for Medicare & Medicaid Services (CMS). It is the first organization to gain deeming authority in more than 30 years.

Just how big is this news, and how much will it affect you?

"It's a big issue. We haven't had an alternative to The Joint Commission and the American Osteopathic Association in my lifetime," says Sue Dill Calloway, RN, MSN, JD, director of hospital patient safety at OHIC Insurance Co./The Doctors Co. in Columbus, OH.

In the three years the company worked toward achieving deeming authority, it accredited 27 hospitals using its National Integrated Accreditation for Healthcare Organizations (NIAHO) program. Those hospitals, president Yehuda Dror says, are a testimony to the strength of its program as they "went through our accreditation process without gaining any favors or benefits from CMS." They also gave DNV the experience it could bank on in applying with CMS.

"The major difference [between DNV and The Joint Commission] is that in our program we have taken the Conditions of Participation from CMS and we have married it to ISO 9000," Dror says. ISO 9000 is an internationally recognized family of standards for quality management originally used in the manufacturing, aerospace, agriculture, banking, and steel industries among others.

"We like this standard," he adds, "not just from the certification point, but from the fact that is what I would call one of the better attempts to standardize common sense, as oxymoronic as it may sound."

The Joint Commission has "essentially become a monopoly in the last half of the last century, and it was very focused on health care," says Martin Merry, MD, CM, adjunct associate clinical professor of health management and policy at the University of New Hampshire and partner at Dynamic Health Systems. "It really was relatively slow to incorporate, in my opinion, some of the quality systems such as manufacturing."

Joint Commission is fine with competitor

Peter Angood, MD, vice president and chief patient safety officer for The Joint Commission, says, "We've been very successful in the marketplace and have been for over 50 years, so the fact that there is a new competitor in the hospital marketplace is fine by us. "

The Joint Commission has a longstanding legacy of excellence, he says. "We've got over 80% of the hospitals accredited by us, and in sum total, we do well over 10,000 more types of health care facilities in an accreditation program; and in so many ways, we are the gold star of accreditation in America," Angood says.

He says The Joint Commission is evaluating DNV standards, "but it looks like they're more or less focused on the CMS standards and haven't gone much beyond it."