Look to other quality measures besides the Joint Commission
The lead researcher in the study that criticizes the Joint Commission on Accreditation of Healthcare Organizations’ quality measures tells Hospital Peer Review that the research means hospitals should start looking at alternative methods of measuring quality instead of depending on Joint Commission standards.
Some critics of the Joint Commission have suggested that hospitals abandon the voluntary system altogether, depending instead on annual inspections from the Centers for Medicare & Medicaid Services, state bodies, or a quality measurement system such as ISO 9000. Most quality professionals would consider that a radical move, and John R. Griffith, a University of Michigan School of Public Health researcher, says he doesn’t advocate going that far — at least not yet.
For one thing, you would have to look at your provider arrangements and see if they require Joint Commission accreditation. It is common for many arrangements to make that a requirement, but some will use looser language that allows you to ensure quality in some other way, such as state or federal inspections. Even if the provider arrangements specify that you must have Joint Commission accreditation, it may be possible to renegotiate them.
Expect some resistance from payers if you try to jump off the Joint Commission bandwagon. Despite its voluntary status, many payers expect Joint Commission accreditation as a routine prerequisite. But that doesn’t mean you can’t supplement it with other quality measures.
"Everybody ought to be looking very seriously at outcomes measures," Griffith says. "Don’t depend entirely on the Joint Commission to make sure you’re doing a good job for your patients. You don’t have to abandon it either, but you’re not being true to your patients if you’re entirely focused on the Joint Commission."
Ann Kobs, MS, RN, president and CEO of Type I Solutions in Cape Coral, FL, agrees that quality professionals should start expanding their focus beyond the Joint Commission. As soon as the University of Michigan study came out, she heard more talk about whether providers should tell the Joint Commission to take a hike.
"People are looking for alternatives," she says. "You could go with the feds, but the federal standards have not caught up with the Joint Commission. I don’t know that I’d recommend people drop out of the Joint Commission, but I do hope all this gets the attention of the Joint Commission and makes it want to improve. And it should start with the surveyors."
The ultimate goal, Kobs says, should be to make the surveys "more reliable and consistent."
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