Issue link: https://beckershealthcare.uberflip.com/i/824946
8 PATIENT SAFETY CMS Wants to Make Accrediting Organization Surveys Public By Heather Punke C MS may require national accrediting organizations to make provider and supplier survey reports and plans of corrections available online. Right now, accrediting bodies like the Joint Commission do not make their survey find- ings publicly available, but CMS does. e agency included the proposal in its 2018 Medicare Inpatient Prospective Payment Sys- tem proposed rule released April 14. "Access to survey reports and PoCs will enable healthcare consumers, in addition to Medi- care beneficiaries, to make a more informed decision regarding where to receive health- care thus encouraging healthcare providers to improve the quality of care and services they provide," according to CMS' fact sheet on its IPPS proposed rule. Additionally, CMS expressed concerns about accrediting bodies' capabilities to identify and cite safety deficiencies in their surveys. Ac- cording to a ProPublica report, state officials visited 103 hospitals in 2014 that had been reviewed by an accrediting organization in the prior 60 days. State officials found 41 se- rious deficiencies during those visits, but the accrediting organization missed 39 of them. e Joint Commission told ProPublica it is re- viewing CMS' proposal and declined to com- ment further. Nancy Foster, the American Hospital Asso- ciation's vice president of quality and patient safety told ProPublica AHA supports trans- parency but the organization is "concerned that sharing a detailed report may not be the most useful or effective strategy for informing the public." She instead advocated for a short- er "accurate summary" of inspection reports to be made public. n Hospital Patient Mortality Drops During Joint Commission Surveys, Study Finds By Heather Punke P atients admitted to the hospital during an unan- nounced Joint Commission survey have lower 30-day mortality rates than those patients admitted three weeks before or after the unannounced survey, according to a study published March 20 in JAMA Internal Medicine. The Joint Commission drops by unannounced to accredit- ed hospitals every 18 to 36 months to examine the hospi- tals' patient safety protocols, which often puts hospital staff on high-alert and on their best behavior. "The stakes for performance during a TJC survey are high: loss of accreditation or a citation in the review process can adversely affect a hospital's reputation and presage public censure or closure," the study reads. To measure the effect these unannounced inspections have on patient safety, researchers from Boston-based Harvard Medical School and the Harvard T.H. Chan School of Pub- lic Health analyzed Medicare admissions at 1,984 surveyed hospitals from 2008 through 2012 in the period three weeks before to three weeks after the surveys. They adjusted for pa- tients' sociodemographic and clinical characteristics. Across all hospitals, patients admitted during an inspection week had, on average, a 1.5 percent lower risk of dying within 30 days of admission compared to patients treated in the three weeks before or after a survey. At teaching hos- pitals, the decrease in mortality during survey weeks was more significant — 5.9 percent. The study's authors said the most probable reason for the decrease in mortality during survey weeks is the "height- ened scrutiny during visits" and the physical presence of surveyors, similar to how the Hawthorne effect contrib- utes to better hand hygiene compliance. "These changes suggest that some aspect of predictable behavior change associated with TJC surveys might im- prove the quality of inpatient care," the study authors con- cluded. While 1.5 percent isn't a large drop, "even changes of this magnitude throughout the year could theoretically have a significant public health impact," they wrote. In a statement to Becker's, The Joint Commission said it "supports the authors' call for healthcare organizations to examine what they do differently during the weeks the or- ganization is undergoing its on-site accreditation survey to achieve optimal patient safety and outcomes, and strive to replicate those actions throughout the year." The statement continues, "This is consistent with The Joint Commission's emphasis on a strategy of 'continuous read- iness' among healthcare organizations: behaviors and an adherence to accreditation and certification requirements that ensure readiness for a Joint Commission survey at any time, which provides for consistent, highly reliable health- care to patients every day." n