Responding to an outcry from rural Tennessee hospital administrators, Dennis O'Leary, M.D., president of the Joint Commission on Accreditation of Healthcare Organizations, will pay a personal visit to the Tennessee Hospital Association's small and rural hospital constituency group this month.
"Small and rural hospitals expressed concern about the high cost of Joint Commission fees and the cost of compliance with commission standards," the Tennessee Hospital Association said in announcing the June 23 visit.
"Dr. O'Leary will be here...to explain the future directions of JCAHO."
Last year, Dr. O'Leary paid a similar visit to the Arkansas Hospital Association, which had threatened to orchestrate a mass withdrawal of its hospital membership from the JCAHO's accreditation program. The association subsequently backed off, but a February survey by the association of its membership found that many felt their concerns hadn't been addressed.
"I hope this isn't just a public relations visit with nothing substantial behind it," said Phil Campbell, administrator of 72-bed Woods Memorial Hospital District in Etowah, Tenn.
He's been lobbying the JCAHO to revise its mission statement to reflect a concern for cost in addition to quality improvement (May 23, p. 12).
Mr. Campbell said he welcomed Dr. O'Leary's visit, but, he added, "It won't mean anything unless they change their mission statement."
Mr. Campbell isn't alone in his push for improvements at the JCAHO, which has come under increasing fire from hospitals and hospital organizations that are questioning the quality of the organization's services and the wisdom of some of its policies.
"We're actually thinking about dropping the JCAHO," said J.B. Wright, administrator of 165-bed La Follette (Tenn.) Medical Center. "Really, it's (accreditation) just for prestige. The state and feds will do it (certification inspection) for nothing."
Mr. Wright said La Follette's last survey fee was $70,000. Annual hospital revenues are about $18 million.
"We have to cut costs to stay in business," he said. "There's no evidence that the Joint Commission is cutting its costs."
"We have the same concerns as other hospitals," said Robert Foster, administrator of 91-bed Jefferson Memorial Hospital in Jefferson City, Tenn. "I think it's a great thing that Dr. O'Leary is coming down. We just need to have a better dialogue with the JCAHO."