It's a start. Action taken by the Joint Commission board last month shows organizational responsiveness to the concerns of healthcare executives. That's welcome news, considering that for months the accrediting group has downplayed the existence of operational deficiencies.
But the JCAHO still faces credibility problems. American Hospital Association executives, meeting in Washington last week, were reminded that members have heard promises of change before. Shirley Klens, a Lock Haven (Pa.) Hospital trustee, said she participated in a JCAHO user committee about three years ago and "thought we had these problems solved. But now we seem to be back to the same old things."
The letter on this page from Ohio hospital CEO Jerrold A. Maki illustrates the level of administrator discontent.
That said, it's apparent JCAHO leaders have embarked on a promising path of reconciliation with healthcare executives.
The "Orion Project," recommended by a work group of executives from small and rural hospitals, is a downpayment on needed change. The plan, which will be tested in eastern Pennsylvania in the next 90 days, makes accreditation an ongoing coaching process with a local focus, an approach that makes sense as healthcare becomes more regionalized.
Other improvements are planned in day-to-day operations, standards-writing and review practices.
Nobody has yet tackled the big issues relating to control of JCAHO and whether it wears too many hats. But resolving such sweeping issues will require extensive study.
With the spotlight now shining on JCAHO accreditation problems, the AHA must continue to play a key leadership role. State hospital associations can be effective advocates for their members, but ongoing national oversight is needed. AHA board members should set a timetable for desired changes and establish ways to monitor progress. With major Medicare and Medicaid cuts facing providers, however, the association must maintain the impetus for change without diverting itself from essential advocacy and market-transformation concerns.