Joint Commission Safety Goals and Accreditation, do they relate to quality of care>?

Swerlick, Robert A rswerli at EMORY.EDU
Sat Dec 22 16:37:02 UTC 2018


I agree with Jason. The inability to consistently measure diagnostic accuracy and misdiagnosis represents a significant bottleneck. This organization has been grappling with this since I have been a member. An organization such as TJC cannot make diagnostic error a priority without having some sort of metric which can be tracked.

Perhaps this is ground where a patient reported tool could make some headway. Perhaps we could simply ask patients whether they know what diagnosis (diagnoses) they carry and whether these have changed over time?

Robert A. Swerlick, MD
Alicia Leizman Stonecipher Chair of Dermatology
Professor and Chairman, Department of Dermatology
Emory University School of Medicine
404-727-3669
________________________________
From: Jason Maude <jason.maude at ISABELHEALTHCARE.COM>
Sent: Friday, December 21, 2018 5:20 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Joint Commission Safety Goals and Accreditation, do they relate to quality of care>?


Ruth

That’s a great question but will bring us back to the issue of having a measure of diagnosis. Unless we have a measure then TJC are unlikely to focus on diagnosis. As the previous posts have shown, we do not seem to have support/consensus for any measures that have been suggested. I see this as a major hurdle we need to overcome if diagnosis is going to get the attention it deserves from institutions like TJC.



Regards

Jason



Jason Maude

Founder and CEO Isabel Healthcare
Tel: +44 1428 644886
Tel: +1 703 879 1890
www.isabelhealthcare.com<http://www.isabelhealthcare.com/>





From: Ruth Ryan <ruth at RYAN-GRAHAM.COM>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>, Ruth Ryan <ruth at RYAN-GRAHAM.COM>
Date: Friday, 21 December 2018 at 19:14
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG" <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: [IMPROVEDX] Joint Commission Safety Goals and Accreditation, do they relate to quality of care>?



Hello All,



The Joint Commission or TJC has been much in the news of late, e.g., Wall Street Journal (Hospital Watchdog Gives Seal of Approval, Even After Problems Emerge 9.6.17), AMA News (Trump administration weighing possible financial conflicts in hospital accreditation process, 12.19.18), and now this article by Ashish Jha:

Accreditation, Quality, and Making Hospital Care Better. The JAMA Forum December 18, 2018 Ashish K. Jha, MD, MPH.

JAMA. 2018;320(23):2410-2411. doi:10.1001/jama.2018.18810.

referring to this new study:

Lam MB, Jha, A et al. Association between patient outcomes and accreditation in US hospitals: Association between patient outcomes and accreditation in US hospitals: observational study

Jha concludes from this recent comparative study that accreditation by TJC, the states or any other body is not associated with improved outcomes or patient experience.



He states, “The problem, it seems, is that accrediting organizations are not focusing on what actually matters to patients. The criticism that these organizations spend enormous amounts of energy requiring hospitals to focus on things like signs in the hallway or how documentation is done appears to have some merit. We need to reexamine the standards required for accreditation to ensure that they are promoting what’s actually important: the health, safety, and optimal experience of patients.”



Diagnosis is largely unaddressed by the patient safety goals and measures of either TJC  or CMS.  How can we who are advocates of improving diagnosis participate in this discussion of changing the quality measures used by accrediting bodies?



Ruth



Ruth Ryan RN, MSW, CPHRM

Telephone (504) 256-8797

Email ruth at ryan-graham.com<mailto:ruth at ryan-graham.com>

Save the Date: Diagnostic Error in Medicine Conference, November 10-13, 2019, Washington, D.C.

Save the Date: Australasian Diagnostic Error in Medicine Conference, April 28-30, 2019, Melbourne, Australia













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