JCAHO will broadcast results on the Internet
Hospitals question new practice
Will it benefit or harm your hospital to have the results of its triennial survey posted on the Internet? How about your hospital’s report card? Once the information’s up there, serious health care shoppers as well as casual surfers will have equal access to it. They have a right to know or do they? What is the effect of this public laundering? Are health care organizations being forthright and informative or downright irresponsible?
In 1998, the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, plans to make performance reports for accredited organizations available on the Internet. And right now, if you visit web sites of selected hospitals throughout the country, you’ll see performance data posted. Visit Des Moines, IA-based Mercy Hospital’s Web site (http://www.mercydesmoines.org) and click on "Report card." You’ll see data comparing performance at that facility with four others in Iowa.
Some quality managers, like Sandi Levy, RN, director of quality management at Mt. Zion Hospital in San Francisco, are skeptical. They say the general populace doesn’t understand enough about the Joint Commission’s quality assessment system or any other performance measures to make a valid judgment about the hospital they’re interested in. People outside the profession, they say, cannot understand at first glance what the different subclassifications of performance improvement mean.
"I’m not a fan of the Joint Commission putting full performance postings on the Internet," says Levy. "The results of an accreditation survey can be misconstrued and damaging. People casually surfing’ don’t understand what they’re reading in such a cursory manner." Can hospitals, systems, and practitioners be evaluated by people who don’t have the skills to make a valid determination about what they’ve read?
"For example," says Levy, "how can the general public know what managing the environment of care’ means? Imagine someone totally unfamiliar with this jargon going to the Web site to decide what hospital to go to and seeing that his hospital falls down in managing the environment of care.’ I wouldn’t understand those words if I weren’t working in a hospital. Because I do, I know they in fact refer to housekeeping, fire walls, and things like that. The typical surfer may think the environment of care’ refers to how the OR performs. I have trepidation about it."
How is surfing different from snail mail?
The Joint Commission’s Web site (http:// www.jcaho.org), launched in May 1996, is intended to provide information to consumers and the health care community about the organization and its services and products. There you’ll find information about accreditation programs, surveys, and requirements. If you go to the Joint Commission’s Web site and click on "Information about accredited organizations," then click on "Performance reports," you’ll find a paragraph stating how to order performance reports from the Department of Customer Service. When you call, an operator offers to send you a performance report through the mail.
Hospital Peer Review asked Levy how the Joint Commission’s posting reports at the Web site differs from their offering to send a report through the mail.
"If the information is right there, it’s seen by people casually looking around. The person going to the trouble of calling the phone number, ordering the report, and waiting for it in the mail really has to want the information. He’s a prospective patient and has intent. The surfer, on the other hand, zooms to the page almost accidentally. He probably wouldn’t call for the report otherwise."
In response to concern about casual surfers misinterpreting what they come across at the Web site, Kay Kruse, director of the accreditation support team at the Joint Commission, explains, "We’re concerned about that issue as well, regardless of whether a potential consumer calls customer service and gets a report through the mail or sees the data on the Internet. Along with each performance report, printed and electronic, goes a 10-page explanatory document that defines terms, talks about the survey process, explains what accreditation means, and describes how surveyors conduct their on-site reviews."
Visitors to Mercy Hospital’s site see statistics showing how Mercy stacks up against four other major hospitals in Iowa. The data reflect cost-effectiveness and quality performance, including number of patients served, average length of stay, cost of care, results of new treatments, and patient satisfaction. Bar graphs enumerate discharges and the average charge per discharge. Average lengths of stay are documented by age and clinical pathway. Charts show the hospital’s infection control rate, C-section rate, and patient satisfaction scores.
Since 1994, Mercy Hospital has been distributing a printed report card every 18 months to physicians, staff, and UR managers as well as human resource executives of companies who use Mercy’s services. When the report card was available on paper it got very favorable reviews. "We anticipate that same response to the electronic version," says Kevin Waetke, manager of community relations.
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