Raising the Bar for Health Care

The Joint Commission
Written by Claire Suttles

Founded in 1951, The Joint Commission is America’s oldest and largest standards-setting and accrediting body in health care. For over half a century the independent, not-for-profit body has helped ensure that the nation’s health care organizations provide safe and effective care of the highest quality and value.
Based in Oakbrook Terrace, Illinois, with a second office in Washington, DC, The Joint Commission is governed by a 32-member Board of Commissioners that includes administrators, physicians, nurses, employers, a labor representative, quality experts, a consumer advocate and educators.

The Joint Commission accredits and certifies more than 20,500 health care organizations and programs in the United States; its Gold Seal of Approval is a nationwide symbol of quality, demonstrating that an organization meets key standards. These standards deal with specific functions in patient, individual, or resident care and are developed with input from health care professionals, providers, subject matter experts, consumers, government agencies, and employees.

Joint Commission standards go beyond the mandatory standards that government sets for health care. “Joint Commission accreditation raises the bar for delivering quality care and ensuring patient safety,” says Joint Commission COO Mark Pelletier, RN, M.S. “We go beyond the basics.” The organization maintains a strong focus on patient rights, advocating important elements such as patient participation in his or her own care and consideration for a patient’s religious beliefs.

Joint Commission standards also help health care organizations prepare for the unexpected, ensuring that patients stay safe when disaster strikes. The emergency management response seen throughout New York City’s health care system during Hurricane Sandy is a prime example. “When Sandy hit, had any of those organizations not had the Joint Commission standards in place, the [negative] results would have been far greater than what they were,” Mr. Pelletier says. “The fact that they were able to evacuate hospitals with minimum disruption is a result of the standards that we require of our accredited organizations to prepare for all types of hazards and to coordinate emergency planning activities and drills with the other agencies in their community.”

Health care organizations that choose to be accredited by The Joint Commission must prove that they meet the organization’s rigorous standards. To do so, laboratories undergo an onsite survey by a Joint Commission survey team every two years, while other health care organizations must be carefully surveyed every three years. The Joint Commission accredits a wide range of health care organizations including hospitals (general, children’s, psychiatric, rehabilitation, and critical access), home care (medical equipment services, pharmacy, and hospice services), nursing homes and rehabilitation centers, behavioral health care and addiction services, ambulatory care, and independent or freestanding clinical laboratories. Standards are specific to each accreditation program, so they are specially tailored to individual industries. Furthermore, Joint Commission surveyors are drawn from a variety of health care industries and only survey those organizations that match their area of expertise.

Accreditation benefits health care organizations in a wide variety of ways. First and foremost, patient safety and quality of care efforts are organized and strengthened. Community confidence in an organization is also strengthened, and this confidence can give an organization a competitive edge in the marketplace over non-accredited competitors. Joint Commission accreditation may also reduce liability insurance costs by enhancing risk management efforts. “Our focus is risk reduction,” says Mr. Pelletier. “Our surveyors go in to help those organizations identify where they are at risk and also help them in finding solutions to resolve those areas of risk.”

In some markets, accreditation has actually become a prerequisite to eligibility for insurance reimbursement and participation in managed care plans or contract bidding. “Insurance companies recognize the high quality and safety standards that we have,” Mr. Pelletier points out. Likewise, Joint Commission accreditation qualifies some health care organizations for Medicare and Medicaid certification. In some states, Joint Commission accreditation may also fulfill regulatory requirements, making an organization compliant without it having to undergo additional surveys or inspections for the state. The accreditation also helps to attract the best and brightest health care workers, since top notch employees are more likely to want to work for an organization that meets the highest standards.

In addition to earning Joint Commission accreditation, health care organizations can earn certification for specific programs or services. “The [certification] takes those programs to the next level,” Mr. Pelletier says. A wide variety of programs and services, either within a medical center or in the community, can be certified, from prenatal, stroke or diabetes care to heart disease care. Benefits of certification include a more consistent approach to care, an increase in consumer confidence, a competitive edge over non-certified programs, and a fulfillment of regulatory requirements in some states. As with accreditation, in some markets certification has become a prerequisite for insurance reimbursement, participation for managed care plans, and contract bidding.

The Joint Commission works hard to ensure that the public has access to information regarding the performance of accredited organizations. Launched back in 1996, the Quality Check® website makes it easy for consumers to check up on how a health care organization is doing. The comprehensive website allows consumers to search for accredited and certified organizations by city and state, name, or zip code, or to find organizations by type of service provided within a certain geographic area. Consumers can also download free hospital performance measures or quickly print a list of Joint Commission certified programs. The Joint Commission’s Quality Reports® provide an overview of how well an accredited organization or certified program complies with Joint Commission standards.

In 2008, The Joint Commission launched the Joint Commission Center for Transforming Healthcare, taking the next step toward ensuring safe, quality care. Participants, which include some of the nation’s leading hospitals, utilize a systemic approach to analyze specific breakdowns in care and the underlying causes behind these breakdowns. Targeted solutions are then developed and shared with the 20,500+ organizations that The Joint Commission accredits and certifies.

Some of the identified breakdowns in care may surprise you. “The first one that we worked on was hand hygiene – how do we get people to wash their hands, believe it or not.” Health care-associated infections have become “a huge issue” both domestically and internationally, and simply getting health care workers to wash their hands between patients can make a world of difference when it comes to prevention.

The Center has also been working on improving handoff communications. When patients are moved from one caregiver to another, “often there is not that communication between care providers, so patients are at risk at that period of time,” Mr. Pelletier explains. Most recently, the Center developed targeted solutions to help combat falls in the hospital. Currently, the team is working on decreasing hospital transmission of C. diff, an intestinal infection that can lead to severe complications and death. The Center for Transforming Health care has become a key player in the drive to transform health care into a high reliability industry, and The Joint Commission reports that hospitals have made significant advances in quality since its establishment.

Looking ahead, Mr. Pelletier predicts that technology is going to play an increasing role in health care in a variety of ways, from robotic surgery to telehealth. “For example, I just heard from an organization in a small, rural area that had no dermatologist. Now, because of the resolution that they can get from cameras, they have a dermatologist that is actually assessing and providing diagnoses and treatment to patients from a distant site.” Obviously, the ongoing potential for supplying health care to regions lacking in certain specialists is huge. Technological breakthroughs are also dramatically decreasing the number of patients that require an inpatient admission. “Most of it is being done on an outpatient basis,” Mr. Pelletier reports.

The Joint Commission is committed to staying ahead of rapidly evolving technology to ensure that health care organizations continue to meet important standards. “We are going to continue to focus on the tough issues and helping organizations [find] solutions to those problems,” says Mr. Pelletier. “We will help organizations assess where they are in that journey [to] commit zero harm to patients and to put in those safeguards in place that protect patients and improve quality.”



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