Becker's Clinical Quality & Infection Control

28 QUALITY IMPROVEMENT & MEASUREMENT Patient Safety Issues Rarely Spur Joint Commission to Withdraw Seal of Approval By Mackenzie Bean T he Joint Commission seldom revokes its seal of approval for hospitals who do not comply with Medicare regulations, according to e Wall Street Journal. Investigators analyzed hundreds of Joint Commission inspection reports from 2014 through 2016. About 350 Joint Commission-accredited hospitals violated Medicare requirements in 2014. More than one-third of those facilities had additional violations in 2014, 2015 and 2016. e Joint Commission, which serves as the accrediting agency for nearly 80 percent of U.S. hospitals, withdrew accreditation for just 1 percent of facilities not in compliance in 2014. More than 30 hospitals maintained accreditation, despite CMS identifying violations severe enough to cause — or likely to cause — serious patient injuries or deaths. e research suggests hundreds of hospitals with patient safety issues could promote accreditation status and bear e Joint Commission's "Gold Seal of Approval." "It's clearly a failed system and time for a change," Ashish Jha, MD, a practicing internist and health policy researcher at the Harvard T.H. Chan School of Public Health in Boston, told WSJ. "[e inves- tigation] shows accreditation is basically meaningless — it doesn't mean a hospital is safe." Joint Commission CEO Mark Chassin, MD, told WSJ the organization generally avoids revoking accreditation. He said the group's mission is to "work closely with healthcare organizations to help them im- prove the care they provide," not punish them for safety incidents. n Study: Online Physician Ratings Not Indicative of Care Quality By Mackenzie Bean O nline physician ratings are a poor indicator of clinical performance, according to a study published in the Journal of the American Medical Informatics Association. For the study, researchers analyzed online ratings, specialty-specific performance scores and peer review scores for 78 physicians representing eight medical and surgical specialties. Researchers pulled online ratings from the five most popu- lar ratings websites: Healthgrades, Vitals, Yelp, RateMDs and UCompareHealth. Performance scores included metrics on 30-day readmissions, length of stay and adjusted cost of care. Peer review scores included ratings from both fellow physi- cians and administrators. Researchers found no significant association between a physician's average online rating score and specialty-specific performance scores or peer review scores. The online ratings did not correlate to any score metrics addressing clinical quality or value-based care. Of physicians who ranked the lowest for performance scores, only 5 percent to 32 percent also ranked among the lowest in online ratings. "When you're trying to choose a restaurant online, it's OK if you get a bad recom- mendation, but the stakes are high here," study coauthor Timothy Daskivich, MD, a urologic oncologist with Cedars-Sinai Medical Center in Los Angeles, told Reu- ters. "Online rating companies should be clear about what their ratings measure and don't measure so patients understand the scores." n CMS: Poor Board Governance Hurt Quality at Sonoma West Medical Center By Emily Rappleye T he lack of board oversight at Sebastopol, Calif.-based Sonoma West Medical Center jeopardized management, operations, patient safety and the financial status of the facility, according to a CMS report naming 13 deficiencies at the hospital, the Sonoma West Times & News reports. Among the deficiencies named was the failure to ensure a corrective action plan was in place to eradicate black mold in the hospital's sterilization area, according to the report. The hospital has suspended surgical procedures since June due to the mold. CNO Barbara Vogelsang told Sonoma West Times & News none of the issues cited by CMS were life-threatening, but due to the fact the hospital had no quality manager, some of the "back burner" issues were never addressed, creating po- tentially dangerous conditions. CMS said the deficiencies found in the hospital stemmed from the lack of oversight by the governing board. SWMC has cycled through nine CEOs and management teams since October 2015 and its board has experienced a similar frequency of turnover, according to the Sonoma West Times & News report. Following the CMS report, which was issued July 19, according to another report from the Sonoma West Times & News, SWMC appointed an interim quality control officer, created a quality assurance program, updated its infection control proce- dures and created compositional bylaws for its board, according to the report. SWMC expects to hear back from CMS this week on its progress. n

• Cover