The Joint Commission released on Wednesday its second annual Top Performers on Key Quality Measures. The list features 620 hospitals out of 3,300 eligible that got above 95 percent compliance on all 43 quality measures and in key subject areas.
Doctors and Trinity were both recognized for getting above 95 percent for all measures in heart attack, heart failure, pneumonia, and surgical care. Many of those are considered “process” measures that look at what a health care provider did, such as giving an antibiotic to a patient before surgery to help prevent infection at the surgical site, rather than outcomes. But those make a real difference for patients, said Doug Welch, the CEO of Doctors.
“We’ve definitely seen better outcomes on our infection rates by following those measures,” he said. That, in turn, has an impact on patient care by reducing complications that can prolong hospital stays.
“People definitely heal better at home,” Welch said. “The more we do to get them home, the better.”
At Trinity, quality review is done “every day, every patient,” CEO Jason Studley said. Every morning, the hospital convenes a “safety huddle” where quality reviewers look at not only what was done but also for potential ways patients might be harmed, he said.
“We’re always being proactive, making sure we have the highest quality and safety instituted,” Studley said.
Trinity’s parent company, Community Health Systems, has been a big help in reaching those quality goals, he said.
“They provided us with a lot of resources, a lot of education, things that we can actually tailor to our individual hospitals,” Studley said.
That’s probably a big reason Community Health had 50 of its hospitals on the Top Performers list, he said. HCA had 96 hospitals on the list, including Doctors.
The Joint Commission list tends to include more for-profit hospitals, such as Trinity and Doctors, said Dr. Mark Chassin, the president of the commission.
“They really do focus their efforts on getting to extraordinarily high levels of performance,” he said. “In some instances, they use financial incentives, but the other important mechanism they use is they share with each other very intensively what works.”
There might be also be motivation coming from the Medicare program, which looks at many of the same quality care areas and is starting to base payment on meeting those criteria, Studley said.
“From a for-profit standpoint, it actually impacts us quite a bit,” he said.
The list did not include many of the more prestigious academic medical centers in the country, such as Johns Hopkins and Mayo Clinic, although it did include some smaller affiliate hospitals of those health systems.
Size could be a disadvantage to making the list, Chassin said.
“It is more difficult because there are more patients, they are often collecting data on more measures and the operations are more complicated so it is more difficult to achieve this kind of consistent excellence across all of the measures they report to us,” he said.
He predicted some would make the list next year.