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

Peggy Zuckerman peggyzuckerman at GMAIL.COM
Sat Dec 22 18:10:51 UTC 2018


I think that it would be fairly easy to create a survey among patients in a
series of disease groups, and ask them what the original diagnosis was, and
if that diagnosis was accurate as to their current disease situation, if
the diagnosis was eventually changed, and how quickly that diagnosis was
reached..  These patients will need to be seen as more 'activated' and/or
engaged patients, so not reflective of all patients, but can give a sense
of the diversity of misdiagnosis or especially long-delayed diagnosis.  No
doubt there are physician groups who also recgonize that a certain
percentage of their patients are late to a proper diagnosis, and could make
some analysis of that.  After all, the patient who is finally diagnosed
properly is unlikely to s pend any more time with the doctor who was unable
to make a correct diagnosis, but the second opinion doctor or specialist is
in a position to do so.

I would also look to the impact that the "science of safety" evolution, who
had this similar challenge, but seemed always to forcus on the data that
was avallable in some small areas, so that there was clarity as to the
problem and thereby, a test of some solutions.

Since my favorite disease area is kidney cancer, I am painfully aware of
the sheer number of patients who experience a long delay in getting the
"it's kidney cancer" diagnosis, and moreover, often do  NOT understand the
subtype of their cancer nor the complete extent of disease.  We in patient
forums are often the first to alert those patients that they must
understand the subtype, and may have metastatic growth, still yet to be
found.  The surgeon who tells the patient he 'got it all', but has not
thoroughly imaged the lungs and bones, lacks plans to monitor the patient
appropriately, or fails to recommend an oncologist folllow the patient is a
big part of the kidney cancer treatment delay.  No doubt this occurs in
other solid tumors.

Sincerely,


Peggy Zuckerman
www.peggyRCC.com


On Sat, Dec 22, 2018 at 9:18 AM Swerlick, Robert A <rswerli at emory.edu>
wrote:

> 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
>
>
>
>
>
> *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
>
> 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
>
>
>
>
>
>
>
>
>
>
>
>
> ------------------------------
>
>
>
> To unsubscribe from IMPROVEDX: click the following link:
>
> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
>
> or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
>
>
>
> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in
> Medicine
>
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/
>
> ------------------------------
>
>
> To unsubscribe from IMPROVEDX: click the following link:
>
> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
>
> or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
>
>
>
> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in
> Medicine
>
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/
>
>
> ------------------------------
>
> This e-mail message (including any attachments) is for the sole use of
> the intended recipient(s) and may contain confidential and privileged
> information. If the reader of this message is not the intended
> recipient, you are hereby notified that any dissemination, distribution
> or copying of this message (including any attachments) is strictly
> prohibited.
>
> If you have received this message in error, please contact
> the sender by reply e-mail message and destroy all copies of the
> original message (including attachments).
>
> ------------------------------
>
>
> To unsubscribe from IMPROVEDX: click the following link:
>
> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
> or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
>
> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in
> Medicine
>
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/






Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


HTML Version:
URL: <../attachments/20181222/2f80767d/attachment.html>


More information about the Test mailing list