The Healthcare Association of New York State and its 210 hospital members are conducting their own review of hospitals' accreditation and licensure needs, MODERN HEALTHCARE has learned.
The disclosure follows by a week confirmation that the American Hospital Association has launched a comprehensive review of hospitals' future accreditation needs under a reformed healthcare delivery system (April 18, p. 3).
Both reviews come at a time of growing hospital dissatisfaction with the Joint Commission on Accreditation of Healthcare Organizations, which accredits 5,300 hospitals nationwide. Some hospitals and state hospital associations have questioned the cost and usefulness of JCAHO's clinical indicator program, the soundness of JCAHO's public disclosure policies and the quality of the Oakbrook Terrace, Ill.-based agency's accreditation services (March 14, p. 30).
Carolyn F. Scanlan, HANYS' executive vice president, said the group is participating in the AHA's analysis of accreditation. But, she said, HANYS decided to supplement that with its own analysis because of the large and unique data demands placed on New York hospitals by the state's highly regulated healthcare system.
The goal of the analysis is to sort through all the demands on New York hospitals for quality-related data from JCAHO, the state, the business sector and the federal government, Ms. Scanlan said. HANYS then would help hospitals determine what data sets are most useful to the hospitals and to payers, she said.
That information would help hospitals improve their data-collection systems and eliminate duplicative or less useful requests for data, she said.
Cathy Barry-Ipema, JCAHO's communications director, said JCAHO applauds HANYS' effort, saying JCAHO always supports an analysis of the accreditation process.
JCAHO accredits 94% of all New York hospitals, although the state stopped accepting accreditation in lieu of state inspections for licensure in 1988. The state doesn't recognize accreditation as a substitute for licensure inspections, but it still reimburses hospitals for their accreditation survey costs, a health department spokeswoman said.
HANYS has formed a committee of several dozen executives, nurses, physicians and quality-assurance experts from member hospitals to examine three issues: the service and performance of accrediting agencies such as JCAHO, the data demands of the New York state regulatory structure and hospitals' information systems needs regarding quality data.
The committee will have its first meeting early next month and is scheduled to present its findings to the HANYS board in September.
In addition to the committee's work, HANYS will conduct a detailed survey of its members on the same three topics. The survey is scheduled to be sent to New York hospitals by month's end.
Like the AHA's effort, the HANYS' project asks hospitals to set aside their personal views of specific organizations such as JCAHO and the state health department to focus on how accreditation and regulation could work better.
"We're not trying to prejudge what anyone is doing," Ms. Scanlan said.
However, she did say the association is "not moving rapidly" on becoming a "quality partner" in JCAHO's clinical indicator program, or IMSystem.
JCAHO has solicited hospital associations to become partners in the IMSystem. As such, associations would market it to members in exchange for member discounts on JCAHO consulting and educational services. To date, associations in Connecticut and Oklahoma have signed up.
And, the HANYS analysis continues a long history in New York of debating the value of JCAHO accreditation.
In October 1988, the Wall Street Journal published an expose on serious quality problems at accredited hospitals, many of which were located in New York. Two months later, the New York Health Department stopped accepting accreditation in lieu of state inspections for licensure purposes.
In January 1989, then-New York State Health Commissioner David Axelrod, M.D., threatened to stop reimbursing hospitals for the cost of JCAHO accreditation surveys because of what he said was a tenuous link between accreditation and improvements in care by New York hospitals.
Four months later, JCAHO retaliated by releasing for the first time hospital compliance rates with key accreditation standards. The report showed that New York hospitals failed key standards at a higher rate than hospitals nationally despite the use of state inspections.