Does accreditation mean better outcomes?

Journal of Hospital Medicine study results

Being accredited by The Joint Commission makes a difference in outcomes for patients with certain diagnoses, according to a study in the October issue of the Journal of Hospital Medicine1. Accredited facilities out-performed their non-accredited peers on standardized quality measures of acute myocardial infarction (AMI), heart failure, and pneumonia, and the difference between the two groups of hospitals expanded over time.

Author Steven Schmaltz, MPH, PhD, associate director of the Department of Health Services Research, and his co-authors looked at data from 2004 to 2008 and found that even though they started at a higher baseline level, accredited hospitals not only performed better, but had greater improvements in performance than other hospitals. They were more likely to have what was deemed superior performance — greater than 90% adherence to quality measures — with only 69% of non-accredited facilities achieving that status compared to 84% of the accredited facilities.

The study looked at 16 different measures, all of which are among the accountability measures The Joint Commission will require accredited hospitals to meet starting in January. The measures were:

For AMI:

  • aspirin at admission;
  • spirin at discharge;
  • ACE inhibitor for LV dysfunction;
  • beta-blocker at discharge;
  • smoking cessation advice;
  • PCI received within 90 min;
  • thrombolytic agent within 30 min.

For Heart Failure:

  • discharge instructions;
  • assessment of LV function;
  • ACE inhibitor for LV dysfunction;
  • smoking cessation advice.

For Pneumonia

  • oxygenation assessment;
  • pneumococcal vaccination;
  • timing of initial antibiotic therapy;
  • smoking cessation advice;
  • initial antibiotic selection.

The complete study can be seen at http://onlinelibrary.wiley.com/doi/10.1002/jhm.905/full.

Reference

  1. Stephen Schmaltz S. Williams SC, Chassin MR, Wachter R. Hospital Performance Trends on National Quality Measures and the Association with Joint Commission Accreditation. Journal of Hospital Medicine, 2011, October; 6 (8): 454-61.