DNV Healthcare, Joint Commission emphasize differences
Four years on, upstart nears 350 clients
In the few years since DNV Healthcare became the first new company in 40 years to win deeming status from the Centers for Medicare & Medicaid Services (CMS), some 320 of the 5,800 registered facilities have opted to use the OH-based company rather than The Joint Commission (TJC). So far, 250 of those facilities have been surveyed and accredited, says Yehuda Dror, president of the organization. It may not seem a large number, but the growth rate is increasing at a pace that Dror says is validating.
"No one else has started something completely new like this. In the first year after we received deeming authority in late 2008, we had to wait for people to come join the party," he says. Organizations want to do due diligence before they switch, and while DNV was well known and highly regarded outside healthcare, it was unknown within it. That meant selling the first folks on the switch was hard. But as more organizations make the change, word is spreading. "The more references they have to check, the easier it gets for us."
Dror says he has found the whole decision-making process to change from The Joint Commission (TJC) to DNV interesting to watch. "They can make decisions to buy multimillion-dollar pieces of equipment in a matter of weeks. But switching accreditation bodies takes months or even years."
He believes that what sets DNV apart is the integrated use of ISO 9001 (a set of standards for quality management created by the International Organization for Standardization in 1987) and focus on the CMS Conditions of Participation (CoPs). The former means that there isn't a focus on a quality improvement project here and another project there, but a systemic approach to quality. "If you don't understand an overall quality management structure, then what you do is incidental and doesn't relate to the whole organization. ISO 9001 provides a great infrastructure to hospitals. It helps you to understand where to look when there is a problem."
Having the CoPs as the basis of standards means a facility doesn't have to duplicate data collection. "There are plenty of metrics out there," says Dror. "You have to find a balance between how much you measure and the returns you get on those measurements. We don't want to focus on measuring, but on the objectives."
Potential clients often ask Dror how they should prepare for a survey. "They spend so much time preparing for it like an exam. We don't want them to do that, but rather to do what's right for patient safety. We may end up giving them more findings, but unless they are jeopardizing patient safety, there is no penalty. Just take the findings and use them to improve."
So many times, a surveyor will leave the quality staff looking through their policies and wondering just why they do something, he says. "Sometimes it's done because it is mandated. But sometimes, it's just someone's interpretation of a rule. If it works, keep it. But our position is that if it isn't mandated, there isn't a good reason to do it, and it doesn't work, don't do it."
Older doesn't mean out of it
The Joint Commission looks at the competition with an increasingly serious eye. Six months ago, the organization moved Ann Scott Blouin, RN, PhD, FACHE, from her role as executive vice president of certification and accreditation to a new role as executive vice president of customer relations. "The purpose was to better understand the voice of the customer and respond in a more consistent manner," she explains.
She explains that there are a bevy of methods being used now to keep customer needs and desires front of mind: a customer loyalty survey administered by third party to CEOs of the organizations TJC certifies, a customer value assessment in which clients are asked their expectations of the survey process, and a post-survey chance to grade TJC against those expectations. A newly hired director-level position assists Blouin in staying in contact with clients.
She and other customer relations staff respond to positive and negative comments as received, and Blouin says that the number of complaints has dropped "dramatically" since 2008. She trends the data and looks for patterns. If a client does leave, there is an exit interview, the results of which are forwarded to the executive director of whichever certification program — hospital, lab, etc. — the client is part of; anything that isn't clear from that interview inspires Blouin to make a call to the organization for further information.
Along with that continual focus on clients, she says there are things that make TJC different from both DNV and the other deemed accreditation provider, Healthcare Facilities Accreditation Program (HFAP, which has about 200 clients). TJC is the only one that accredits across the continuum of care, and Blouin emphasizes the role it played in developing the Baldrige criteria. It has a close relationship with CMS, including its attendance at TJC board meetings, weekly meetings between the two at TJC's Washington, DC, office, and using that office as a base from which to lobby on Capitol Hill.
She thinks the robust collaborative endeavors that TJC fosters among clients, as wells as the large number of tools they make available offer something special to clients. Cost responsiveness — no fee increases in the last several years — and customer focus prove that TJC understands its clients, Blouin notes.
Dror says there is plenty of room for more than one organization in accreditation, and indeed, competition is good for both, and Blouin says she agrees. "They fill an important role," Dror says. "One of them is to keep us on our toes."
In the few years since DNV Healthcare became the first new company in 40 years to win deeming status from the Centers for Medicare & Medicaid Services (CMS), some 320 of the 5,800 registered facilities have opted to use the OH-based company rather than The Joint Commission (TJC).You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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