Hospital quality of care improves, but weak spots persist

The quality of care in U.S. hospital is up, according to a report released Wednesday by the Joint Commission. Still, while hospitals achieved 90 percent or better performance on many individual process of care measures, there's room for improvement. Two measures introduced in 2005 where hospitals did not perform as well included:

  • Providing fibrinolytic therapy within 30 minutes of a heart attack patient's arrival. Only 55.2 percent of hospitals achieved 90 percent compliance or better.
  • Providing antibiotics to ICU pneumonia patients within 24 hours of arrival. Only 67.5 percent of hospitals achieved 90 percent compliance or better.

The one measure that did not show year over year improvement was the surgical care measure for beta-blocker patients who received beta-blocker perioperatively.

For the first time, the report focused on accountability measures--that link evidence-based care to patient outcomes--to show how performance measures affect patient outcomes. The Joint Commission will add accountability measures to its hospital accreditation standards for 2012. Some of the more encouraging findings demonstrated improvements across broader categories or composite measures.

Quality of care related to heart attack, pneumonia, surgical care and children's asthma care patients improved. The 2009 heart attack care result was up to 97.7 percent, from 88.6 percent in 2002. A 97.7 percent score means that hospitals provided evidence-based heart attack treatment 977 times in every 1,000 opportunities. The recommended care includes a composite of actions including aspirin at arrival and at discharge.

For 2009, hospitals gave recommended pneumonia care 92.9 percent of the time, up from 72.4 percent in 2002. Substantial improvement also was evident in the surgical care result. The score rose to 95.8 percent, up from 77.4 percent in 2004. Recommended steps include stopping antibiotics within 24 hours, appropriate hair removal, and prescribing and receiving VTE medicine/treatment.

The findings are based on data from more than 3,000 hospitals accredited by the Joint Commission.

To learn more:
- read the Joint Commission press release
- here's the report
- check out the Seattle Post-Intelligencer article
- read the Associated Press story

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