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Groups Call for Transparency in Hospital Accreditation Survey Findings

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   September 21, 2011

Nearly 60 patient advocacy groups including Consumers Union, several physicians, and one former Boston hospital CEO are pushing to make findings from the Joint Commission, and all hospital accreditation survey findings, open to the public.

"We believe it is in the public's interest to have all accreditation survey findings of the Joint Commission, and other bodies accessible to the public," the coalition said in a Sept. 2 letter to Sen. Tom Harkin, D-IA, Chairman of the U.S. Senate Committee on Health, Education, Labor & Pensions.

Currently, such information cannot be accessed by the public, they wrote, because of a provision in the Social Security Act, which they want repealed.

However, in some states, hospitals can opt to have accreditation surveys performed by state agencies, and those reports are available to the public, such as in Harkin's Iowa, whose Division of Health Facilities conducts accreditation surveys. "The present situation creates a double standard," the coalition wrote.

The letter was signed by Kevin T. Kavanagh, MD, of Health Watch USA, of Somerset KY, Lisa McGiffert, director of Consumers Union Safe Patient Project, Carl Flatley of the Sepsis Alliance, Harvey Frey, MD, of the Health Administration Responsibility Project and Helen Haskell of Mothers Against Medical Error.

It was also sent to HHS Secretary Kathleen Sebelius; Mark Chassin, MD, president of the Joint Commission; Thomas Hamilton, director of the Centers for Medicare & Medicaid Survey and Certification Group and Carolyn Clancy, director of the Agency for Healthcare Research and Quality.

"We believe that the public has a right to information irrespective of the entity that conducts the surveys."

They added that public services such as public health and education, restaurant inspections and school performance are transparent. "Hospitals should be held to the same standard. Their performance should no longer be shielded from the public."

In addition, the groups wrote, the Joint Commission, "and any accrediting body of healthcare facilities should be made subject to the federal Freedom of Information At as a condition of their authority" to perform accreditation surveys and complaint investigations.

A spokeswoman for the Joint Commission said she was unable respond to request for comment.

A second letter, signed by some of the same patient advocacy groups including McGiffert of the Consumers Union Safe Patient Project and Lori Nerbonne, of New Hampshire Patient Voices, asks Joint Commission president Mark Chassin to dramatically improve the complaint process that provokes the agency's accreditation inspections.

They told Chassin they are concerned that the complaint process "does not rise to the standard that the commission sets for hospitals in handling adverse events in their facilities: namely that they are patient-centered and transparent."

Patient advocacy groups and patients harmed have "shared stories (that) reflect a common theme: delayed complaint responses and investigations, the need for transparency and improved communication, and no clear way to offer rebuttal to what may very well be incomplete information provided by the offending hospital or facility during the complaint investigation."

The letter lists 11 steps the commission should take to improve the complaint process. They include:

1. A clear, concise and easily accessible link on the commission's homepage for filing patient complaints.

2. The complainant should be informed various parts of the process and the result of an inspection without having to request it, and information on filing a grievance.

3. The complaint investigation should be completed in a defined time frame

4. The complainant should receive period updates and information throughout the investigation until it is completed.

5. In the event of a patient death, the Joint Commission should cross-reference causes of death and contributing factors on the death certificate with information gathered during the investigation.

6. The discovery of any evidence of illegal activity be revealed to the complainant, including falsification of medical records.

7. Rebuttals to findings from the initial complaint process should be accepted as long as the initial complaint was filed within the three-year time limit.

8. The complainant can remain anonymous because healthcare professionals may fear retaliation.

9. The complainant should have the opportunity to provide feedback through an evaluation form after the investigation process is completed.

10. The Joint Commission commit to continuous improvement in the patient complaint process.

11. To enhance transparency, the joint commission consider adding complaint data, such as the number of complaints, the number resolved, and the average time to resolution, to its annual report.

"We are asking for compassionate, open, honest disclosure and transparency throughout the complaint process," the group's letter said.

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