Strategic opportunities in the oversight of the U.S. hospital accreditation system

Moffett, Maurice L.; Morgan, Robert O.; Ashton, Carol M.

doi:10.1016/j.healthpol.2005.03.005

Cited by 8 publications

(2 citation statements)

References 13 publications

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“…However, hospitals pay for Joint Commission surveys, and more than 70 percent of the Joint Commission's revenue comes directly from the organizations it is supposed to inspect (American Federation of Teachers 2006). The Joint Commission have switched to unannounced inspections for all hospitals during the 3‐year cycle, but these have been criticized for being superficial and failing to detect significant hospital safety and performance problems—identification of poor care patterns are not distinguishable by the Full Survey score or by the accreditation decision (United States Government Accountability Office 2004; Moffett, Morgan, and Ashton 2005). …”

Section: Us Approachmentioning

confidence: 99%

Intelligent Information: A National System for Monitoring Clinical Performance

Bottle

Aylin

2007

Health Services Research

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Objective. To use statistical process control charts to monitor in‐hospital outcomes at the hospital level for a wide range of procedures and diagnoses. Data Sources. Routine English hospital admissions data. Study Design. Retrospective analysis using risk‐adjusted log‐likelihood cumulative sum (CUSUM) charts, comparing each hospital with the national average and its peers for in‐hospital mortality, length of stay, and emergency readmission within 28 days. Data Collection. Data were derived from the Department of Health administrative hospital admissions database, with monthly uploads from the clearing service. Principal Findings. The tool is currently being used by nearly 100 hospitals and also a number of primary care trusts responsible for purchasing hospital care. It monitors around 80 percent of admissions and in‐hospital deaths. Case‐mix adjustment gives values for the area under the receiver operating characteristic curve between 0.60 and 0.86 for mortality, but the values were poorer for readmission. Conclusions. CUSUMs are a promising management tool for managers and clinicians for driving improvement in hospital performance for a range of outcomes, and interactive presentation via a web‐based front end has been well received by users. Our methods act as a focus for intelligently directed clinical audit with the real potential to improve outcomes, but wider availability and prospective monitoring are required to fully assess the method's utility.

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Section: Us Approachmentioning

confidence: 99%

Intelligent Information: A National System for Monitoring Clinical Performance

Bottle

Aylin

2007

Health Services Research

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“…While practice change occurs within clinical settings, the responsibility for ensuring implementation often falls on higher levels of the health-care organization, where non-compliance may affect funding, accreditation, quality measures, hiring, and reputation. 1 Therefore, improving the efficiency and effectiveness of organizational policy is of broad interest to managers of health systems.…”

Section: Introductionmentioning

confidence: 99%

Randomized Policy Evaluation of the Veterans Health Administration Stratification Tool for Opioid Risk Mitigation (STORM)

et al. 2022

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BACKGROUND:The Veterans Health Administration (VHA) developed a dashboard Stratification Tool for Opioid Risk Mitigation (STROM) to guide clinical practice interventions. VHA released a policy mandating that high-risk patients of an adverse event based on the STORM dashboard are to be reviewed by an interdisciplinary team of clinicians. AIM: Randomized program evaluation to evaluate if patients in the oversight arm had a lower risk of opioidrelated serious adverse events (SAEs) or death compared to those in the non-oversight arm. SETTING AND PARTICIPANTS: One-hundred and forty VHA facilities (aka medical centers) were randomly assigned to two groups: oversight and non-oversight arms. VHA patients who were prescribed opioids between April 18, 2018, and November 8, 2019, were included in the cohort. PROGRAM DESCRIPTION: We hypothesized that patients cared for by VHA facilities that received the policy with the oversight accountability language would achieve lower opioid-related SAEs or death. PROGRAM EVALUATION: We did not observe a relationship between the oversight arm and opioid-related SAEs or death. Patients in the non-oversight arm had a significantly higher chance of receiving a case review compared to those in the oversight arm. DISCUSSION: Even though our findings were unexpected, the STORM policy overall was likely successful in focusing the provider's attention on very high-risk patients.

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Design and evaluation of hospital-based business intelligence system (HBIS): A foundation for design science research methodology

Kao

Masud

et al. 2016

Computers in Human Behavior

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Strategic opportunities in the oversight of the U.S. hospital accreditation system

Cited by 8 publications

References 13 publications

Intelligent Information: A National System for Monitoring Clinical Performance

Intelligent Information: A National System for Monitoring Clinical Performance

Randomized Policy Evaluation of the Veterans Health Administration Stratification Tool for Opioid Risk Mitigation (STORM)

Design and evaluation of hospital-based business intelligence system (HBIS): A foundation for design science research methodology

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