A survey by The Joint Commission (TJC) may be stressful for administrators, but it can be good for patient outcomes. Recent research suggests that patients admitted to the hospital during an unannounced TJC survey have lower 30-day mortality rates than those patients admitted three weeks before or after the unannounced survey.
Researchers from Harvard Medical School and the Harvard T.H. Chan School of Public Health published a study in JAMA Internal Medicine that measured the effect of unannounced inspections on patient safety. They analyzed Medicare admissions at 1,984 surveyed hospitals from 2008 through 2012 in the period three weeks before to three weeks after the surveys, adjusting for patients’ sociodemographic and clinical characteristics. (An abstract of the study is available online at: http://bit.ly/2nxSLm3.)
Patients admitted during an inspection week had a 1.5% lower risk of dying within 30 days of admission compared to patients treated in the three weeks before or after a survey. The decrease in mortality during survey weeks was more significant at teaching hospitals, reaching 5.9%.
The researchers attributed the improved outcomes to “heightened scrutiny during visits” and the actual presence of TJC surveyors. They likened it to the “Hawthorne effect,” in which people alter their behavior for the better when they know they are under observation.
“These changes suggest that some aspect of predictable behavior change associated with TJC surveys might improve the quality of inpatient care,” the report says, noting that though the decrease in mortality was not dramatic, “even changes of this magnitude throughout the year could theoretically have a significant public health impact.”
