The Joint Commission on Accreditation of Healthcare Organizations has devised a five-star rating system for public disclosure of hospital accreditation results.
The star rating is JCAHO's effort to make complex quality information easy for laypersons to understand.The effort has gone through several revisions since the commission decided last year to nail down a form for relaying hospital-specific evaluations to healthcare consumers.
But some state hospital association executives who saw the final form at a recent JCAHO-convened assembly are giving the disclosure scheme somewhat less than a five-star rating.
Days after that gathering, the commission's Task Force on Confidentiality and Disclosure Issues unanimously approved the two-pronged disclosure and explanation process, said commission spokeswoman Alice Brown.
The proposal now goes to the commission's board for approval in late September. Ms. Brown said the JCAHO staff anticipates the procedure will be rolled out at the end of October, around the time of the annual commission-sponsored forum on quality in Chicago.
Central to the disclosure process is the rating system for individual hospital performance, which covers more than two dozen star-rated areas (See chart). The areas are grouped into the commission's categories of patient care, organizational management, staff performance, physical atmosphere and department requirements.
The disclosure also will include a seven-page text explaining the notion of standards, taking readers through the accreditation process and providing background on what each star-rated area assesses in reaching an evaluation, according to a draft obtained by MODERN HEALTHCARE.
But the proposal isn't sitting well with some of the first to see it. Particularly, the symbols chosen for the ratings are striking a nerve.
"We certainly have concerns about the emotional attachment to star-rating systems," said Mark Milner, vice president of professional services at the Florida Hospital Association. "It lends credence to an evaluation process that shouldn't be a part of it."
"The stars oversimplify accreditation survey results to the point of being meaningless," said Donna Nowakowski, senior director for quality management at the Illinois Hospital Association.
Mr. Milner and Ms. Nowakowski were among 35 representatives from state hospital associations across the country who attended the JCAHO's annual state association forum July 20-22 at the JCAHO's headquarters in Oakbrook Terrace, Ill.
A number of state executives at the meeting told MODERN HEALTHCARE they were concerned about how consumers may equate the star-rating system with those used by critics to rate restaurants, hotels and movies. The number of stars awarded often are indications of quality and cost.
How hospitals achieve certain stars is a complicated process, Ms. Nowakowski said. And losing or gaining a star could have nothing to do the quality of patient care, she said.
Mr. Milner said he encouraged the JCAHO to include explanatory materials with the public release of data that describe the subjectivity of the JCAHO's survey process and note the fact that hospitals voluntarily seek accreditation.