The upside of surprise Joint Commission surveys: Lower patient death rates

Patients are less likely to die within 30 days of admission if they happen to be treated at hospitals at the same time The Joint Commission arrives for a surprise inspection.

The reason for the better mortality rates during the unannounced on-site surveys compared to weeks before and after the surveys may be due to the fact that clinicians are aware they are under scrutiny and are therefore more vigilant, according to the new study published Monday in JAMA Internal Medicine.

Researchers from Harvard Medical School and Harvard T.H. Chan School of Public Health analyzed Medicare admissions at 1,984 surveyed hospitals from 2008 through 2012 in the three week period before the survey, during the survey and three weeks after the survey. Approximately 245,000 patients were admitted during Joint Commission surveys, and more than 1,462,000 in the three weeks before and after the surveys. The research team compared outcomes between surveys and surrounding weeks, adjusting for sociodemographic and clinical characteristics, and conducted a subanalysis for major teaching hospitals.

Across all hospitals, patients who were treated during an inspection week had a 1.5% lower risk of dying, on average, within 30 days of admissions compared to the patients treated in the three weeks before or after an inspection. And there was a 5.9% decrease in deaths during the survey periods at major teaching hospitals.

Although the difference in mortality risks may be small, every drop is a move in the positive direction.

“This study highlights that there is potential for us to learn what is going on during those weeks that is associated with better patient outcomes,” Vineet Arora, a researcher at University of Chicago Medicine who wasn’t involved in the study, told Reuters. “The question is whether it is due to a concerted effort on the part of the hospitals to follow safe practices or whether there is something else going on.”