Fourteen North Carolina hospitals have been labeled as ‘top performing’ by the Joint Commission, the nation’s leading hospital accreditation organization.
The hospitals represent all parts of the state, large community and small, urban and rural. Absent are major medical centers associated with medical schools in the state: Duke, UNC Hospitals, Wake Forest Baptist and Pitt Memorial Hospitals.
Almost all hospitals in the country now follow a series of 28 procedures and practices that researchers and Joint Commission accreditors have identified as being the best practices to reduce patient complications and adverse outcomes. Examples include simple interventions such as giving aspirin to a patient after a heart attack or giving antibiotics before surgical procedures. In the past, researchers found these simple practices were practiced inconsistently, often leading to patient injury.
Tracking the use of these practices has become a standard way of approximating hospital quality.
The Joint Commission defines a hospital as ‘top performing’ when it falls into the top 14 percent of hospitals following what accreditors call a ‘core’ of 22 such procedures and practices. Hospital adherence to these practices has risen sharply in recent years, first after Medicare started publishing hospitals’ performance on the Hospital Compare website and more recently when Medicare announced it would start reducing payment to hospitals not performing enough of the practices.
In a 2010 article published in the New England Journal of Medicine, Joint Commission head Marc Chassin wrote:
Because … virtually all U.S. hospitals participate in them, it is not possible to know how many of these improvements would have occurred in the absence of standardized measurement, Joint Commission accreditation requirements, public reporting, or the threat of Medicare payment penalties.