Accreditation's New Player

If DNV hopes to be the nation's leader in hospital accreditation, it has some catching up to do. About 4,250 hospitals—roughly 80% of the accreditation market in the United States—are accredited by The Joint Commission. When asked about the arrival of DNV, the Oak Terrace, IL-based company issued a written statement saying it "never shies away from competition."

"Eight out of 10 hospitals choose The Joint Commission, as do more than 10,000 other healthcare organizations, because The Joint Commission accreditation provides the best guidance for improving safety and quality of patient care—and therefore best serves the needs of both patients and providers," the statement continued. The American Osteopathic Association is the third private company with Medicare deeming authority and accredits more than 200 hospitals in 31 states.

However incrementally, DNV is making inroads. Atrium Medical Center in Middletown, OH, uses both The Joint Commission and DNV, but Robyn Myers, director of quality management and accreditation at the 250-staffed-bed acute care hospital, says the organization may consider dropping one of the two deeming authorities. Myers says Atrium was attracted to ISO about seven years ago because the process considers all aspects of hospital operations. "Our goal was to make sure that all of our processes were streamlined and connected and there were no gaps for patient care," Myers says.

St. Elizabeth Medical Center in Utica, NY, in December dropped its longstanding affiliation with The Joint Commission in favor of DNV. "It was both a practical and a philosophical issue for us," says Albert D'Accurzio, MD, vice president of medical affairs at the 201-staffed-bed hospital. "If we wanted to maintain ISO certification and use The Joint Commission for our CMS accreditation, we would have undergone two different surveys by two different organizations. This is a simpler process."

"We also found the DNV approach to surveys more appealing to us," D'Accurzio says. "It's a more collaborative relationship, we found, and the surveyors often provide helpful advice in terms of how to best comply with the survey requirements."

Additionally, D'Accurzio says he prefers the annual audits with DNV to three-year surveys with The Joint Commission. "Organizationally, that helps us to stay more in a continual compliance mode." D'Accurzio says the annual audits don't require more work "because we've aligned our system to the ISO standard and we are doing it already, anyway. I don't view it as more work to get ready for it, because we don't have to get ready for it. We are operating the way we operate."