The Joint Commission's defense
In a news conference Wednesday, Joint Commission President Mark Chassin, MD, described how the Commission's list distinguishes itself from the pack of quality lists that preceded his.
"This report is not a ranking of hospitals, nor is it based on unscientific data such as reputation, nor from measures derived from data created for hospital billing," he said. "We also do not attempt to give a single hospital grade that's intended somehow to reflect its overall quality of care."
"In our view those attempts are misguided. The fact is that hospitals may do some things well and other things not as well...This report focuses on 45 uniformly excellent measures of quality that assess evidenced based care processes that are closely linked to positive patient outcomes."
Chassin acknowledged that at a big hospital, it is more difficult to get a high score, "because [there are] more patients, they're often collecting data on more measures, and the operations are more complicated.
"But on the other hand," he continued, "they have more resources to devote to improvement. And I think we're going to see more academic medical centers stepping up to the plate."
Chassin added that a number of smaller hospitals that are affiliated with big academic medical centers "did make the list," such as two small Mayo Clinic hospitals in New Prague and Fairmont. "So they have got their own local examples of how to do it.
He defended the Commission's list as one that shows how hospitals performed on "16 million opportunities to provide the right care to patients," using "the very best measures of quality that exist."
What I'd really like to see next is a hospital scorecard that zeroes in on "appropriateness" measures. These would tell whether patients admitted for surgery, or pneumonia care, or testing, were there because they really needed to be, and that the care they got was the right care. This list could include in a safety component and maybe an outcome or two as well. I wouldn't quibble.
Maybe such a list will come from somewhere in October.