Joint Commission Announces 'Top Performers'
He noted that hospitals appear to have the most difficulty getting to 95% reliability in these critical measures:
- Removing urinary catheters after surgery
- Appropriately administrating antibiotics to patients not in the ICU
- Giving beta-blockers to patients peri-operatively
- Giving an angiotensin-converting-enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB) to heart failure patients at discharge
Other troublesome measures remain in surgical care, such as giving venous thromboembolism prevention medication and stopping antibiotics within 24 hours after the procedure.
For nearly all measures, however, the commission said fewer hospitals failed to meet the thresholds in 2012 than failed in 2011 or in 2010.
The nearly 50 measures by which hospitals can choose to be evaluated are process measures. These are not measures of hospital safety, such as assessed by the Leapfrog Group's twice-annual A to F report card.
And on that point, Chassin noted, "It is true that the 40 measures that go into the determination of the top performer distinction don't cover every condition treated in hospitals. But they do address many common conditions." And, he said, "taken all together, the data on these 40 measures represents 18.3 million opportunities [hospitals had] to provide the right test, drug, or treatment to the patient."
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