The Role of the Joint Commission in Providing Quality Healthcare

According to the American Hospital Association, there are 5,723 registered hospitals in the whole of United States, registered in the sense that these “hospitals that meet AHA’s criteria for registration as a hospital facility” (American Hospital Association, 2014). Out of these “registered” hospitals, the Joint Commission has more than “3,300 accredited hospitals, which is almost 60 percent of all registered hospitals in the nation (The Joint Commission, 2013).  While majority are reporting to the Joint Commission – membership is voluntary –, my initial observation was that although all Kaiser hospitals are apparently members, there were only two hospitals from the City of Los Angeles that were listed in the State of California.  The more popular hospitals USC (University of Southern California) Medical Center, Cedars Sinai, Children’s Hospital, and Good Samaritan were not listed, even the Huntington Memorial Hospital in Pasadena.  The latter hospitals of course don’t necessarily have to be “evaluated” as they exemplify the epitome of first rate world class medical institutions, known as pioneers and leaders and implementers of cutting edge technology in the field of medicine.  In San Gabriel Valley’s stretch of Alhambra, Monterey Park all the way to Rowland Heights, where doctors of Asian descent – doctors of Indian descent dominate the medical field – have based themselves, only one hospital in Rosemead is a member.

The reason I cited the top hospitals in Los Angeles is that they could be great contributors to The Joint Commission, and their models can be replicated by other institutions. They could also share their techniques and expertise to improve health care for all hospitals and other facilities in America, if not the whole world.  At any rate, from the Executive Report of the President of CEO of The Joint Commission, at least one third or 1,099 of the 3,300 accredited hospitals were reported to have improved their facilities in 2013, which is exemplary.  Moreover, The Joint Commission said “more than 200 core measure solutions have been posted by hospitals (in the Core Measure Solution Exchange ) that have dramatically improved and sustained their performance (The Joint Commission, 2013).” The Joint Commission was also proud to announce that more hospitals were “top performers” for 2013, while others “have reached or have nearly reached Top Performer distinction” that allowed President and CEO Mark R. Chassin to declare that “we are approaching a tipping point in hospital performance (The Joint Commission, 2013).”  Dr. Chassin added that more than 673 others are on their way to becoming top performers. The report said the 1,099 hospitals earned a grade of 95 percent or better across the board for core measures for heart attack care, heart failure care, pneumonia care, surgical care, children’s asthma care, inpatient psychiatric services, venous thromboembolism (VTE) care, stroke care, perinatal care, immunization, etc.

A closer look, however, may show a slow progress in the delivery of quality health care as The Joint Commission was founded way back in 1951. “Evaluating and accrediting more than 20,000 health care organizations and programs in the United States (History: The Joint Commission, 2014)” which is the main function of The Joint Commission, however seems to be a gargantuan task given the enormity of the industry and the costs involved in running a medical facility where patients are treated first before they get to pay.  The report also indicated that it was only in 2002 when member hospitals began providing core measures data to The Joint Commission, which raises more questions.  It is worthy to mention that while a some monitoring agencies rely on volunteered data from their members, The Joint Commission “worked closely with clinicians, health care providers, hospital associations, performance measurement experts, and health care consumers across the nation to identify the quality measures. This collaborative process identified measures that reflect the best ‘evidence-based’ treatments” for patients (The Joint Commission, 2013) and therefore allowing both healthcare workers and patients alike the freedom to provide information based on their own experiences. On the other hand, the improvement in the member’s performances show that The Joint Commission is policing their own members to keep the industry at a high level of standard.  Such methods also prevent the spread of disease and epidemics, including reducing infection incidents in hospital themselves (like the use of sanitizers).

Hospital Standards

While The Joint Commission incidentally requires payment for us to view their standards, the “comment on standard” page indicated the areas where these have been set: ambulatory health care, behavioral health care, critical access hospital, disease specific care, hospital, healthcare staffing services, laboratory, long term care, home care and office based surgery.  According to the Joint Commission, their standards “focus on important patient, individual, or resident care and organization functions that are essential to providing safe, high quality care (Standards: The Joint Commission, 2014).” To be more specific, The Joint Commission expected evidence-based treatments such giving aspirin at arrival for heart attack patients, giving antibiotics one hour before surgery, and providing a home management plan for children with asthma and transmitting continuing care plans for psychiatric patients for its members, etc.

Some of the Standards as listed require that the organization:

·         Manages safety and security risks

·         Manages risks related to hazardous materials and waste

·         Manages medical equipment risks

·         Inspects, tests, and maintains medical equipment

·         Manages its space during demolition, renovation, or new construction

·         Verifies staff qualifications

·         Staff participates in ongoing education and training

·         Safely administers medications

·         Provides for diagnostic testing

·         Plans the patient’s care

·         Collects data to monitor its performance

·         Compiles and analyzes data 

Comment:  While it’s worthy to note that The Joint Commission has set its own standards, there are healthcare accreditation organizations that may have a different set of standards.  Moreover, since members of The Joint Commission apparently come from their own organization that it’s supposed to monitor, there have been reports where the practice of advising hospitals when the inspections occur at their facility have been highly criticized, according to Wikipedia based on reports from the Washington Post and Boston Globe (Wikipedia, 2014).  Hopefully, these have been rectified or eliminated if not reduced.

Requirements for a hospital seeking accreditation by The Joint Commission:

·         As posted by the Joint Commission, any hospital wishing to be accredited by the agency must meet the following requirements:

·         Located in the U.S. or its territories

·         Must conduct its own assessments and improves services where needed subject to review by clinicians

·         Must identify its services

·         Must meet The Joint Commission standards

·         Must meet minimum parameters as required 

The Joint Commission-accredited hospitals near my area (Norwalk, California):

·         Kaiser in the cities of Downey, Anaheim

·         Presbyterian Intercommunity Hospital in Whittier

·         Garden Grove Hospital and Medical Center in Garden Grove

·         Miller's Children Hospital in Long Beach

·         The Huntington Beach Hospital in Hungtington Beach

·         Centinela Hospital Medical Center in Inglewood

·         La Palma Intercommunity Hospital in La Palma

·         Children's Hospital of Orange County in Orange

·         Providence Little Company of Mary Medical Center in Torrance

Bibliography

American Hospital Association. (2014, January). Fast Facts on US Hospitals. Retrieved April 1, 2014, from www.aha.org: http://www.aha.org/research/rc/stat-studies/fast-facts.shtml

History: The Joint Commission. (2014). History of The Joint Commission. Retrieved April 1, 2014, from www.jointcomission.org: http://www.jointcommission.org/about_us/history.aspx

Standards: The Joint Commission. (2014). Facts About Commission Standards. Retrieved April 1, 2014, from www.jointcommission.org: http://www.jointcommission.org/assets/1/6/Standards1.PDF

The Joint Commission. (2013). Improving America’s Hospitals: The Joint Commission’s Annual Report on Quality and Safety . The Joint Commission.

Wikipedia. (2014, February 24). Joint Commission. Retrieved April 1, 2014, from Wikipedia: http://en.wikipedia.org/wiki/Joint_Commission