Accredited hospitals in the United States are providing higher-quality, evidence-based care for heart attacks, pneumonia, surgical care and children’s asthma, according to a new report by The Joint Commission.
"Improving America’s Hospitals: The Joint Commission’s Report on Quality and Safety 2010" presents evidence of improvement and explains how it relates to these medical conditions and procedures.
“It is very encouraging that this year’s report shows high rates of performance on these critical process measures and high levels of consistent excellence among hospitals on many measures,” said Mark R. Chassin, MD, president of The Joint Commission. “Hospitals devote enormous resources and energy to using these performance measures to drive improvement in their clinical processes.”
The fifth annual report shows continual improvement over an eight-year period on accountability measures – quality measures that meet four criteria designed to identify measures that produce the greatest positive impact on patient outcomes.
For example, the 2009 heart attack care result is 97.7 percent, up from 88.6 percent in 2002. A 97.7 percent score means that hospitals provided an evidence-based heart attack treatment such as aspirin at arrival and beta-blockers at discharge 977 times for every 1,000 opportunities to do so.
The data, drawn from more than 3,000 accredited hospitals, shows significant progress in consistently using evidence-based treatments, Chassin said. In 2002, hospitals achieved 81.8 percent composite performance on 957,000 opportunities to perform care processes related to accountability measures. In 2009, hospitals achieved 95.4 percent composite performance on 12.5 million opportunities – an improvement of 13.6 percent.
Hospital performance on measures of quality relating to inpatient care for childhood asthma has increased dramatically in the two years since being introduced. The 2009 children’s asthma care result is 88.1 percent, up from 70.7 percent in 2007.
The 2009 pneumonia care result is 92.9 percent, up from 72.4 percent in 2002 – an improvement of 20.5 percent. The surgical care result improved to 95.8 percent in 2009 from 77.4 percent in 2004.
Although hospitals achieved 90 percent or better performance on most individual process of care measures, the report contends that more improvement is needed. For example, hospitals finished 2009 with relatively low performance on two measures introduced in 2005: providing fibrinolytic therapy within 30 minutes of arrival to heart attack patients (only 55.2 percent of hospitals achieved 90 percent compliance or better); and providing antibiotics to intensive care unit pneumonia patients within 24 hours of arrival (only 67.5 percent of hospitals achieved 90 percent compliance or better).
Chassin said the report, which focuses on accountability measures for the first time, is an effort to demonstrate the impact that performance measures have on improving patient outcomes. He said doing so will strengthen the partnerships hospitals have with physicians, nurses, pharmacists and other clinicians.
The Joint Commission intends to include specific expectations for performance on accountability measures in hospital accreditation standards by 2012.