March 2nd, 2010

Joint Commission: Transparency Obscured?

The Joint Commission*  has been sent a letter by the Association for Health Care Journalists (AHCJ) calling for better informing the public via their website exactly what they know about a hospital’s quality of patient care. Of concern to AHCJ is the Quality Check® website, which consumers can use to locate and compare healthcare organizations in their area.

The AHCJ’s Right-to-Know committee identified the following specific issues with the site

  • Hospitals with any level of accreditation are given “The Gold Seal of Approval” – even those whose accreditation is conditional or at risk of being denied.
  • It’s difficult to find out which hospitals in a given region have less-than-full accreditation. To check on a hospital’s accreditation status, one has to open each individual profile. The Joint Commission once had a mechanism to sort hospitals by accreditation status, but that has been taken down.
  • After a hospital loses accreditation, its past Accreditation Quality Reports are eventually removed from the site, leaving only the facility’s name with no historical record.
  • There is no easy way to do a side-by-side comparison of more than six facilities simultaneously.

That ‘Gold Seal of Approval’ is misleading (5 stars anyone?) if it does not differentiate between those organizations who have Accreditation with Commendation (‘more than satisfactory compliance… in all performance areas on a complete accreditation survey’) and those with Preliminary Denial of Accreditation (‘when there is justification to deny accreditation to the organization as evidenced by an Immediate Threat to Health or Safety situation; or the organization failed to resolve the requirements of a Conditional Accreditation, or it was in significant noncompliance with Joint Commission standards.’) (Source: Glossary)

I poked around the original jcaho.org website in the WayBackMachine and the March 01, 2000 records reflected the ability to sort both accreditation and current status data as shown below.

That particular formatting as a preliminary search page is so last decade (and as Iris points out, no one sees beyond a single search box anymore) but the need to have these fields somewhere, perhaps in Advanced Search, is not… and they aren’t listed there. The WayBackMachine shows an apparent QualityCheck® website redesign between the data records of October 27, 2003 (there) and December 18, 2003 (no longer there). Why were they removed? Surely it’s not part of JCAHO’s 2002 decision to make their recommendations “more easily understood by consumers.” (Measuring Researching and Monitoring the Quality of Health Care – Accreditation)

From a medical librarian/archival perspective, the outright removal of past reports is troubling and I’m interested in seeing specific examples there too.

(hat tip to Pia at Covering Health)
*also referred to as The Organization Previously Known as the Joint Commission on Accreditation of Healthcare Organizations; also JCAHO, pronounced ‘JAY-co’ with varying levels of resigned frustration depending on who you’re talking with at a hospital.

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