The number of hospitals that made the Joint Commission's “Top Performer” list increased again this year, even with the addition of new measures.
A total of 1,224 U.S. hospitals made the annual list, which recognizes accredited facilities for outcomes on key quality measures reported the previous year. The list released Thursday reflects more than one-third of the hospitals accredited by the organization.
“The nationwide implementation of evidence-based quality improvement processes is working,” said Dr. Mark Chassin, president and CEO of the Oakbrook Terrace, Ill.-based accrediting organization. “Achieving these criteria is not easy. This represents real progress.”
The report summarizes how more than 3,300 U.S. hospitals fared on 46 accountability measures for evidence-based care processes linked to positive patient outcomes. The measures focused on care for 10 specific treatment areas: heart attack, heart failure, pneumonia, surgical care, pediatric asthma, inpatient psychiatric services, venous thromboembolisms, stroke, perinatal care and immunizations.
To become a 2014 Joint Commission top performer, hospitals had to: achieve cumulative performance of 95% or above across all reported accountability measures; achieve performance of 95% or above on every reported accountability measure for which there were at least 30 denominator cases; and have at least one core measure set with a composite rate of 95% or above.
Nearly 37% of the hospitals accredited by the organization met the standards, an 11% increase over 2013, and triple the number of qualifying hospitals since 2010.
There were also increases in the number of academic medical centers and public hospitals recognized. A total of 138 government-owned hospitals and 35 academic medical centers were top performers. The disproportionately small representation of large institutions, including academic medical centers, had raised questions in previous years. Only four academic medical centers made the list in 2011.
The increase, Chassin said, reflects “priority setting” at those institutions. While the majority of annual top performers typically are smaller hospitals, Chassin said the list shows that more academic medical centers have increased their efforts to achieve consistent excellence. “I always knew they could do it,” he said.
The Joint Commission's report also recognized 44 hospitals for voluntarily collecting and reporting data on more core measure sets than required.
Additionally, last year was the first year the commission included a measure for perinatal care in its overall assessment, which 180 hospitals voluntarily reported. More measures will be added in future years, Chassin said. Though he did not list specifics, he said there may be a decline in the number and percentage of hospitals attaining top-performer status. “It will be more difficult for them to achieve it,” he said. Chassin made a similar prediction last year, but the number of hospitals making the top-performer list still grew.
Though the Joint Commission says it sees extraordinary progress on performance for an increasing number of quality measures, there is still work to be done to reduce hospital performance variations from measure to measure.
“The evidence is very clear that variations in quality within individual hospitals are quite strong and very consistent,” Chassin said. Hospital leaders should consider their organizational culture as they attempt to improve organizational performance across a wide array of quality and safety areas, he said.
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