Healthcare executives' opinion of the Joint Commission on Accreditation of Healthcare Organizations slipped last year, according to the results of the JCAHO's latest opinion poll of executives of accredited facilities.
"This year's results contain few surprises or changes from the 1992 results," said Dennis O'Leary, M.D., the JCAHO's president, in a written statement. "What we sense from these responses is positive anticipation of the new survey process and other features of the Agenda for Change in 1994 and future years.
"Against that backdrop it is remarkable and encouraging to see that over half of the respondents still rate the Joint Commission as continuing to improve."
Dr. O'Leary declined to be questioned about the apparent decline in executives' rating of the organization.
Some 66% of the surveyed hospital executives said the JCAHO's performance had improved over the past five years. That's down from 75% in 1992 (See chart). Last year, 8% of the polled hospital executives said the JCAHO's performance worsened over the past five years. That's up from 3% in 1992.
The JCAHO conducted the poll last October. The Oakbrook Terrace, Ill.-based accrediting agency released the results May 20, one week after the JCAHO's board meeting in Chicago.
The latest results were released at a time when the JCAHO was coming under increasing criticism from some hospitals, hospital systems and hospital trade groups (May 9, p. 6).
The poll is based on a survey of chief executive officers from 1,253 healthcare facilities that were surveyed by the JCAHO between June 1, 1992, and May 31, 1993. Of the respondents, 709, or about 57%, were hospital executives. The other executives represented home-care programs, long-term-care facilities, mental health providers and ambulatory-care centers.
The poll is the fifth annual survey conducted by the JCAHO, which expanded the poll in 1992 and 1993 to include executives from four types of facilities other than hospitals that seek accreditation from the JCAHO.
Executives from three of the four facilities also gave the JCAHO lower marks last year. They were asked whether the JCAHO's performance had improved over the past five years:
Some 40% of the long-term-care CEOs agreed, compared with 58% in 1992.
Some 48% of the mental health CEOs agreed, compared with 56% in 1992.
About 43% of the home-care CEOs agreed, compared with 47% in 1992.
Fifty-two percent of the ambulatory-care CEOs agreed, compared with 42% in 1992.
"We fully acknowledge that there are areas needing improvement. That is why there has been an Agenda for Change," Dr. O'Leary said. "As (it) unfolds, we expect most of the difficult and prickly problems we have had in the past to diminish significantly."
The Agenda for Change is the moniker of the JCAHO's overhaul of the organization's accreditation process, under way now for eight years. The overhaul has three prongs: the development of more relevant accreditation standards, the improvement of the accreditation survey process itself, and the creation of a mandated clinical indicator monitoring system for accredited hospitals.