Report Shows Improvements on Pneumonia, Surgical Care But Not on Antibiotic Prophylaxis


Accredited hospitals in the United States are providing higher-quality, evidence-based care for pneumonia and surgery, among other conditions according to "Improving Americas Hospitals: The Joint Commissions Report on Quality and Safety 2010." The report presents scientific evidence of improvement and how it relates to common medical conditions and procedures.

"It is very encouraging that this years report shows high rates of performance on these critical process measures and high levels of consistent excellence among hospitals on many measures," says Mark R. Chassin, MD, MPP, MPH, president of the Joint Commission. "Hospitals devote enormous resources and energy to using these performance measures to drive improvement in their clinical processes. This report demonstrates that these efforts are resulting in consistently improving patient care in Americas hospitals."

The fifth annual report shows continual improvement over an eight-year period on accountability measures quality measures that meet four criteria designed to identify measures that produce the greatest positive impact on patient outcomes. For example, the 2009 heart attack care result is 97.7 percent, up from 88.6 percent in 2002. A 97.7 percent score means that hospitals provided an evidence-based heart attack treatment such as aspirin at arrival and beta-blockers at discharge 977 times for every 1,000 opportunities to do so.

The data, drawn from more than 3,000 accredited hospitals, show:

- Significant progress in consistently using evidence-based treatments. In 2002, hospitals achieved 81.8 percent composite performance on 957,000 opportunities to perform care processes related to accountability measures. In 2009, hospitals achieved 95.4 percent composite performance on 12.5 million opportunities an improvement of 13.6 percentage points.

- The 2009 pneumonia care result is 92.9 percent, up from 72.4 percent in 2002 an improvement of 20.5 percentage points.

- The surgical care result improved to 95.8 percent in 2009 from 77.4 percent in 2004.

Although hospitals achieved 90 percent or better performance on most individual process of care measures, the report contends that more improvement is needed. For example, hospitals finished 2009 with relatively low performance on providing antibiotics to intensive care unit pneumonia patients within 24 hours of arrival only 67.5 percent of hospitals achieved 90 percent compliance or better. This measure was introduced in 2005:

The report, which focuses on accountability measures for the first time, is an effort to clearly demonstrate the impact that performance measures have on improving patient outcomes. Doing so will strengthen the partnerships hospitals have with physicians, nurses, pharmacists and other clinicians who are engaged in the hard work of improving the processes of care. Specific expectations for performance on accountability measures will be included in hospital accreditation standards by 2012.

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