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Joint Commission 'Best' List Draws Skepticism from C-Suite

Cheryl Clark, for HealthLeaders Media, September 22, 2011

Instead, many hospitals that made the cut are smaller, and many are in rural areas.

That could be because, as one cynical healthcare executive observed last week, they don't have nearly as many patients. It's a lot easier to get a 95% or better score when checking off the boxes when you have only 100 beds, than when you have 1,000. 

And the score does not measure outcomes, such as whether a hospital's patients are more likely to die within 30 days after they came through the door, fall, have a surgical object left inside them or require readmission.

The other big concern these executives express is that this list puts on a pedestal those hospitals that may be merely "teaching to the test," not measuring what ultimately matters to the patient, which is – again – the outcome. Did the patient get better? 

Chris Van Gorder, American College of Healthcare Executives' immediate past president and CEO of Scripps Health, whose 312-bed flagship Scripps Memorial in La Jolla made the list, is one who isn't jumping with joy.

"I'm pleased to see that Scripps La Jolla made the cut but frankly, I looked at some of the others who did and I don't think all are very good hospitals – the type of hospital where I would refer a friend or loved one," he says.

"But I'm not going to lose any sleep over this list -- being on it or not on it."

Officials with Premier healthcare alliance, a large hospital quality and purchasing group, also have concerns about TJC's list.

“The uncertainty in the methodology of these types of rating programs is an example of the problem with our healthcare system," said Blair Childs, Premier's senior VP of Public Affairs. "There is no true, consistent way to measure top performance in healthcare. Each of these top 'lists' use different measures, different scoring systems, etc. They say they have the best way, but the true best way to define top performance is to utilize measures that providers themselves developed and agreed upon, and then make that information and outcomes transparent for all to see and learn from. This is what we do in our QUEST program and the results have been tremendous.”

Joanne Conroy, MD, chief healthcare officer for the Association of American Medical Colleges – most of whose teaching hospital members did not make the list – has concerns about The Joint Commission's methodology.

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4 comments on "Joint Commission 'Best' List Draws Skepticism from C-Suite"


C.L.Jones (9/23/2011 at 9:46 AM)
There are many elements of disconnect here. First-it's like comparing apples to oranges when comparing these two unique and different rankings and trying to make the same conclusion. The JC is trying to use bsic and core measures to rank basic standards of care. USNWR is a publication,informative however, and not a peer reviewed medical science based journal. There are some interesting survey and measure techinque in the USNWR methodology- that fortunately have improved over the years- but have a lot of opinion based information, from research companies owned by physicians of these major "report" headliners. Bottom line- consumer beware.

Daniel Fell (9/22/2011 at 11:40 PM)
Sadly, it's the patient attempting to make informed decisions about his or her healthcare who is faced with how best to interpret another set of conflicting quality measures. While the lack of standards surely helps some hospitals to compete in the marketplace, long-term it continues to erode consumer confidence and trust. The industry doesn't need more healthcare ratings, rankings and awards - it needs more consensus on which ones matter.

mila michaels (9/22/2011 at 3:29 PM)
Not surprising C Van Gorder is perplexed. Scripps boasts the highest number of fines in San Diego county by the state licensing board. TJC has again proven that a true and unbiased rating shouldn't be bought.