Background In July 2002, the Joint Commission on Accreditationof Healthcare Organizations implemented standardized performancemeasures that were designed to track the performance of accreditedhospitals and encourage improvement in the quality of healthcare.
Methods We examined hospitals' performance on 18 standardizedindicators of the quality of care for acute myocardial infarction,heart failure, and pneumonia. One measure assessed a clinicaloutcome (death in the hospital after acute myocardial infarction),and the other 17 measures assessed processes of care. Data werecollected over a two-year period in more than 3000 accreditedhospitals. All participating hospitals received quarterly feedbackin the form of comparative reports throughout the study.
Results Descriptive analysis revealed a significant improvement(P<0.01) in the performance of U.S. hospitals on 15 of 18measures, and no measure showed a significant deterioration.The magnitude of improvement ranged from 3 percent to 33 percentduring the eight quarters studied. For 16 of the 17 process-of-caremeasures, hospitals with a low level of performance at baselinehad greater improvements over the subsequent two years thanhospitals with a high level of performance at baseline.
Conclusions Over a two-year period, we observed consistent improvementin measures reflecting the process of care for acute myocardialinfarction, heart failure, and pneumonia. Both quantitativeand qualitative research are needed to explore the reasons forthese improvements.
Source Information
From the Joint Commission on Accreditation of Healthcare Organizations, Division of Research, Oakbrook Terrace, Ill.
Address reprint requests to Dr. Williams at the Joint Commission on Accreditation of Healthcare Organizations, 1 Renaissance Blvd., Oakbrook Terrace, IL 60181, or at swilliams{at}jcaho.org.
Quality of Care in U.S. Hospitals
Robbins R. A., Klotz S. A., Bender B. S., Saver B. G., Williams S. C., Loeb J. M., Jha A. K., Epstein A. M.
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N Engl J Med 2005;
353:1860-1861, Oct 27, 2005.
Correspondence
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