In a news conference announcing the Joint Commission's latest list of top performers in quality and safety, President Dr. Mark Chassin contrasted his organization's list with others that assign individual quality ratings or letter grades to hospitals.
Chassin called such efforts “misguided” because, he argued, hospitals' performance in one area has not been shown to correlate with performance in another. “Hospitals are good at some things and not others,” he said.
The Joint Commission recognized 620 hospitals (PDF)
as top performers, up 53% from 405 hospitals last year. The designation is based on hospitals' performance during 2011 across 45 accountability measures in areas such as pneumonia care, heart-failure care and inpatient psychiatric services.
To make the list, hospitals had to receive a composite score of 95% or above on all of the accountability measures it reported to the Oakbrook Terrace, Ill.-based organization. Additionally, top-performing hospitals needed to meet or exceed the 95% performance mark on each of the accountability measures they reported.
"A 95% score means a hospital provided an evidence-based practice 95 times out of 100 opportunities to provide the practice," the Joint Commission said in its annual report on quality and safety. "Each accountability measure represents an evidence-based practice—for example, giving aspirin at arrival for heart-attack patients, giving antibiotics one hour before surgery and providing a home management plan for children with asthma."
Approximately 18% of the 3,300 hospitals that submit data to the Joint Commission achieved the top-performer designation for performance in 2011, the Joint Commission said in the report. And 244 hospitals made the list both last year and this year. Another 583 hospitals fell short of the 95% threshold on just one measure, the organization said.
"These hospitals are leading the way in quality improvement, as American hospitals continue to make strides," Chassin said in the report.
Overall performance on accountability measures has improved since 2002, when the organization began collecting such data, the Joint Commission said. For instance, performance on a heart-attack-care composite measure has increased to 98.5% in 2011, up from 88.6% in 2002. And performance on a composite measure of pneumonia care is 96.2% for 2011, up from 72.4% in 2002.
As it did last year, the report sparked questions about notable hospitals, such as the Cleveland (Ohio) Clinic and Johns Hopkins Medicine, Baltimore, that were missing from the top-performers list. Chassin says their absence may be due to quality reporting burdens and other obstacles faced by large academic medical centers.
“I think we'll see more academic medical centers stepping up to the plate,” he said. “I would hope and expect that we would see some of them on the list next year.”