Hospital Accrediting Organization Names “Top Performing” Hospitals In NC

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.

Joint Commission's 'Top Performing Hospitals' in North Carolina

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.

How budget cuts are affecting UNC Health Sciences Library

Walk into the Health Sciences Library at UNC Chapel Hill and you can’t help but miss this display in the window of the main entrance:

Window display in the Health Services Library at UNC Chapel Hill

In case you can’t read it in the photo, the text says:

The HSL budget was CUT by 12.7%
The HSL will CANCEL 34 journals.
35 journals will be RENEWED. 4 decisions will be DELAYED.
We will also cut:
Books
Hiring
Databases
Equipment
Operating Costs, etc.

The journal cancellation program has been underway for 3 years now and library administrators have solicited user feedback in deciding which journals to cut, in part by comparing usage to cost.

According Jake Wiltshire, development and communications head for the Health Sciences Library, no one’s lost a job yet.  Instead, HSL administrators cut vacant positions. Some services (IT, admin) were picked up by a newly ‘convergent’ library system. He says hours have been cut some, but what’s more significant is there are fewer librarians to assist students during those hours the library is open. 

The HSL also got some money from the University provost to keep open, longer.  “Without it,” Wiltshire says “we would have been closed weekends.”

“We regularly get requests for extended hours, especially from medical students,” he says. Wiltshire points out many of the health sciences schools built their facilities without study areas, relying on the fact the HSL would be there to provide those medical students with places to study – along with nursing, public health and dental students, among others.

But Wiltshire says one of his biggest concerns is access to journals for health care professionals at UNC Hospitals. They use the HSL to do real time research while caring for patients. And those are the people who might be likely to look for an article in a more obscure journal – one that’s been cut because of the budget.

“They need that up-to-date information at the point of care. We’re less equipped to support them,” he says.

Correction: when this post was originally written, the HSL was identified as the Health Services Library, not by it’s correct name as the Health Sciences Library.  D’oh!

Reboot

As some of you might know, I left North Carolina Public Radio – WUNC at the end of June.

After taking off two months to attend to some family business and rest a little, I’m back blogging and tweeting as I create the infrastructure for an exciting new venture.

The plan: In January 2012, I will launch North Carolina Health News, a website and news service dedicated to covering health care in North Carolina.

Hey, no one else is doing it!  The health reporting staff at the N&O is all but gone, there’s only one person at the Charlotte Observer and there are only a handful of full time health reporters left in the entire state. But health care is an important part of NC’s economy, jobs landscape, research base and health care affects everyone at at some time or another. Some talented and experienced health reporters are committed to coming on board, so we think we’ll have something worth reading (and listening to).

In the meantime, I’ll be writing occasional reported stories and posting them here. I’m also lending a hand at the Raleigh Public Record and writing some stories about health care in our capitol city.

Let’s hear it for high-quality, local journalism!!