Several powerful hospital associations are revving up their plans to exert greater control over hospital accreditation.
Meanwhile, the Joint Commission on Accreditation of Healthcare Organizations has been busy during the past several weeks stamping out fires with a number of other hospital groups.
For example, the JCAHO last week unveiled a special task force to address key accreditation issues facing small and rural hospitals. Many such hospitals have been particularly critical of the cost of JCAHO surveys.
Regardless, senior executives of the American Hospital Association are planning a late November retreat for the seven AHA representatives on the JCAHO's 28-member board of commissioners.
The recent controversy over the Joint Commission's planned use of a star rating system to release accreditation data exposed a communications gap between AHA senior management and the AHA's representatives on the JCAHO board.
The board was expected to approve the star system at its meeting last month, but a groundswell of opposition from individual hospitals and state associations prompted the AHA to intervene (Sept. 26, p. 10). The board later approved a numerical system for releasing such data.
"The field was upset with us," said Richard Wade, the AHA's senior vice president for communications. "They felt we had not paid close enough attention to Joint Commission issues."
The purpose of the upcoming retreat is to better coordinate communication between the AHA and its JCAHO commissioners, and to increase AHA staff support of their work, he said.
Mr. Wade disputed speculation that the seven AHA commissioners were going to be schooled on past and future policy positions at the retreat.
"The commissioners have not done anything to merit being taken to the woodshed," Mr. Wade said. "We have a terrific set of commissioners."
Mr. Wade said the AHA representatives have been and will continue to be permitted to act independently on the JCAHO board.
In Los Angeles, the governing board of the 230-member Hospital Council of Southern California approved a resolution on Sept. 28 that calls on the statewide California Association of Hospitals and Healthcare Systems to investigate an alternative to the JCAHO for private accreditation services.
At deadline, CAHHS executives were not available for comment.
In addition, the Southern California council, at a Nov. 2 meeting, will consider a proposal by its professional service committee to restructure the accreditation system, said Jon Gilwee, its vice president for government relations. He declined to release the details of the plan.
If the proposal is approved internally, it will go before the council's governing board on Nov. 22, he said.
In Columbus, Ohio, JCAHO President Dennis O'Leary, M.D., met with three groups of Ohio hospital executives at three separate meetings Oct. 5-6.
Like associations in many other states, the Ohio group is responding to the concerns of its 200 members.
The concerns include the value vs. costs of accreditation; the variability in accreditation standards, standards interpretation and accreditation surveyors; and the usefulness of the JCAHO's clinical indicator program.
The Ohio forum with Dr. O'Leary, for example, followed a Sept. 16 meeting of the OHA's board of trustees, which passed a resolution expressing its "extreme reservations" about the JCAHO's ability to perform as a credible quality review body. The board said it is considering a recommendation that Ohio hospitals drop the JCAHO.
"Our conversations with Dr. O'Leary were frank, candid and constructive, but we're going to stay the course," said OHA President Jim Castle.
The OHA intends to monitor the JCAHO's performance over the next 12 months and explore alternatives to private accreditation through the JCAHO.
And finally, the JCAHO worked to resolve its differences with a group of powerful Roman Catholic hospital systems at a Sept. 9 meeting at JCAHO headquarters in Oakbrook Terrace, Ill.
In May, MODERN HEALTHCARE disclosed that the systems, through a joint task force on quality issues, were preparing to pressure the JCAHO into making improvements (May 9, p. 6).
However, the systems later denied that they intended to play hardball with the JCAHO (June 27, p. 88).
Jan Commens, director of quality and utilization management at the Daughters of Charity National Health System in St. Louis, described the Sept. 9 meeting as "useful." She said the systems were satisfied with the response to their concerns.