A couple of notes on recent news:
* Sometimes it seems as if the Joint Commission on Accreditation of Healthcare Organizations is heading up iceberg-scouting on the Titanic.
In the past few weeks, the industry has witnessed two more examples of the Joint Commission's rushing to the barn after the door has swung open. In the first case, the Joint Commission said it would investigate quality problems at Puget Sound Hospital in Tacoma, Wash., after state health authorities ordered the facility closed because of evidence of rodent and insect infestation.
In the second case, the JCAHO said it would probe the kidnapping of an infant from Loyola University Medical Center in Maywood, Ill. The child was found dead shortly after the abduction.
These and numerous other incidents suggest that the Joint Commission has difficulty grasping the idea of prevention. Accreditation surveys ought to help stop errors before they occur. Sending in a squad of surveyors to find deficiencies that should have been spotted the first time risks the credibility of the JCAHO and the hospital industry.
In fairness to the Joint Commission, it should be noted that a lot of hospitals haven't exactly embraced the idea of rigorous, thorough and surprise surveys. Hospital executives also need a forward-looking perspective. If the industry hopes to maintain self-policing on quality, the JCAHO will have to get to the scene before chalk outlines are on the floor.
* Speaking of forward looks, Medicare is getting fewer these days, at least from residents of Capitol Hill. With a booming economy and the threat of the program's imminent demise greatly diminished, some influential healthcare policy voices in Congress are scaling down their reform proposals (May 15, p. 8).
The Founding Fathers designed a government with checks, balances and roadblocks to thwart the passions of the moment from stampeding officials into ill-advised action. The downside of this admirable and phenomenally successful arrangement is that it often takes a crisis to get anything done.
This country needs to re-examine and rethink Medicare as well as its whole system of financing healthcare. The only thing short of a crisis that could spur such developments is articulate, intelligent and unselfish leadership. We can't get that from most politicians. How about from healthcare executives?