Questions About The Joint Commission, Competition, and Healthcare Quality
Mark Graban
I help organizations and leaders drive continuous improvement and spark innovation through Lean management, building a culture of learning from mistakes, and fostering psychological safety. 3 Shingo Book Awards.
I wrote a "tweetstorm" thread with questions about The Joint Commission, competition, "customer satisfaction," and healthcare quality.
Those tweets are also posted below. They are based on this NPR article and some discussions I've had recently with healthcare quality and patient safety advocates.
Quotes from the article:
“With little competition until now, the Joint Commission has tended to be viewed adversarially by hospital insiders”
"As soon as [Joint Commission] surveyors left the building and hit the parking lot, it was always back to business as usual"
"There was nothing to sustain quality improvements after [Joint Commission] surveys."
None of that surprises me in the least.
My thoughts and questions:
I had always thought competition was a good thing. The Joint Commission's market was opened to competition 10 years ago.
When TJC had a monopoly, maybe their ideal could be to be "tough, but fair" because they had a unique Congressional mandate.
But now TJC has to worry about "customer satisfaction" and retaining customers, does that give incentive for them to "go easy" on hospitals?
I wonder how many hospitals left TJC for DNV or other competitor because they thought TJC was too tough or "unfair"?
Does competition in this outsourced accreditation-that's-not-regulation game really help improve healthcare quality?
Did The Joint Commission monopoly really improve healthcare quality (TJC claims it did / does)?
Your thoughts? Leave a comment below.
Read the tweets and share or comment there, if you prefer.
Mark Graban(@MarkGraban) is a consultant, author, and speaker in the “Lean healthcare” methodology. Mark is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen. Mark is also editor of the book Practicing Lean.
He is also the VP of improvement and innovation services for the technology company KaiNexus and is a board member for the Louise M. Batz Patient Safety Foundation. Mark blogs most days at www.LeanBlog.org.
Business Owner at J. R Pain Management
7 年Healthcare is a circus. Very overpriced compared to quality. No guarantee of payment to providers. Outsourced accreditation is ineffective because of high cost and many only hire people to answer phones when dues need to be collected or inspections are done. Providers are not at fault but caught in a system that does not work.
Trusted Advisor for Operational Excellence | Training, Coaching, Leading Organizations to Achieve Greatness
7 年Seems it's more about the tone and priorities set by leadership. If senior leaders make quality a top priority, then accreditation services can be integrated into the overall system for quality and another good source of potential improvement information. If the leadership system rewards reactionary actions and minimal standards, the TJC will be perceived as a necessary evil and the organization will get no benefit from it.
Dual Directorship of Physical Medicine and Regional Dialysis Service Lines; Corporate Team Leader for Acute Care Rehabilitation Directors
7 年In the earlier part of my career, I dreaded Joint Commission visits. Decades of experience later, I learned to appreciate the value of their standards and anticipated surveys...but only if leadership expects "readiness" to become actual culture. In current hospital settings, I think the Disease Specific Certifications, such as joint replacement and stroke, are of the most value to an organization's outcomes. Therein lies the only competitive benefit of Joint Commission accreditation, in my opinion.
ADMIN OFFICER at ARINAWAN MANUFACTURING CORPORATION
7 年https://MyPayMyLife.com/?ref=7648
CEO/CTO of Infinitus Medical Technologies - A #Veteran Owned Medical Device Company
7 年It's a ridiculous costly bureaucratic burden. Hospitals literally spend billions for compliance, only to abandon it all after the inspection. There is NO consensus, as they pay these idiotic mock surveyors who make stuff up as they go, just to feel relevant. The institution then creates a knee jerk reaction policy with no damn consensus. The burden of more and more regulatory BS, crap that really has no evidence base merit, then keeps providers from doing their actual jobs. There needs to be a cross functional congress of various provider organizations that adopts cohesive and responsible regulations and standards so every one is on the same page. It's all a joke!