Thursday, September 10, 2009

Transforming at the Joint Commission

Here's an announcement from Mark Chassin at the Joint Commission. I recall that Mark set forth some of these themes several months ago, and it is great to see that he and his folks are implementing them:

Today, I am excited to announce the launch of the Joint Commission Center for Transforming Healthcare, which was created to address the most pressing safety and quality problems in health care. The Joint Commission is using a new approach to systematically measure the magnitude of serious quality and safety problems, pinpoint their underlying causes, and develop and test targeted, long-lasting solutions. And, we aim to provide these proven effective solutions to you as an additional benefit of accreditation. The Center is well on its way to completing its first initiative - developing solutions to improve hand hygiene and reduce preventable health care-associated infections.

I know you are searching for - and are eager to implement - highly effective, sustainable solutions that are relevant to your most difficult quality and safety problems. This new approach is required to achieve the level of consistent excellence that is sought by you, by patients and their families, by physicians and other clinicians, and by other public and private stakeholders. I strongly believe that the Center for Transforming Healthcare will live up to its name - transforming the delivery of health care so that all people always experience the safest, highest quality and best-value health care.

The Center is developing solutions by using the same Robust Process Improvement(TM) (RPI) methods - including Lean Six Sigma and change management - that other industries have long relied on to improve quality, safety and efficiency. You may recall that the Joint Commission deployed RPI internally in 2008, and we are aggressively using these proven methodologies to improve our systems and processes for the benefit of customers. Likewise, the Center's participants - volunteer hospitals and health systems throughout the country - have substantial, real-life expertise using RPI in the health care environment. They are using a proven systematic approach to analyze specific breakdowns in care, discover their underlying causes, and develop targeted solutions that solve these complex problems. In addition, the Center is engaging industry to create new products that will amplify and sustain the impact of its solutions.

The Joint Commission has led the way nationally and internationally to identify the highest priority health care quality and safety problems and to address them. Our National Patient Safety Goals, core measures, and state-of-the-art accreditation standards have helped health care organizations focus their efforts to gain the greatest improvements in safety and quality. And you and your colleagues have focused your efforts and made great progress - often with scarce resources and limited help. Now, the Joint Commission Center for Transforming Healthcare aims to provide you with specific guidance on exactly how to improve and sustain quality and safety using Center-developed, proven effective solutions that will be customized for differences among health care organizations. Importantly, the Center's solutions are designed so that your organization will not require any expertise in RPI methods in order to use them.

Ultimately, the Center will provide knowledge and practices that will help transform health care into a high-reliability industry, with rates of adverse events and breakdowns in routine safety processes comparable to air travel or nuclear energy. To accomplish this goal, the solutions that are developed and tested by the Center must make their way into health care organizations across the nation. The Joint Commission is uniquely positioned to facilitate this process. As the Center's solutions are proven effective, the Joint Commission will speed their distribution to our accredited health care organizations and, in the future, we may consider them for possible inclusion in our standards or National Patient Safety Goals.

The Joint Commission is successfully obtaining outside funding for the Center's vital work, so we can deliver these solutions to accredited health care organizations to the extent feasible at no additional cost. In addition to the hand hygiene project, the Center is also developing solutions for hand-off communications and safeguards to prevent wrong site surgery and will work on additional projects for the range of health care settings we serve. To learn more about these projects, visit the Center's Web site and make it a regular resource for your organization.

The Center for Transforming Healthcare is already creating excitement about its new approach to solving problems that we all face every day. I know you will find value in these and other solutions emanating from the Center. Together, we can make a difference and transform health care for patients everywhere.


Mark R. Chassin, M.D., M.P.P., M.P.H.
The Joint Commission


Anonymous said...

Unfortunately, I look upon this "advertisement" with somewhat of a jaundiced eye. The JC has often proven to be behind the curve on the issue of quality/patient safety, passing a hospital on inspection only to swoop in and find all sorts of problems later, after someone else has discovered a big one. I know they have been trying to move from paperwork-based inspections to a more clinical and outcome-based approach. However, I do not see anything new or startling in this announcement. Other quality organizations are well along in this effort. I would hope that, rather than duplicating effort just to put their own stamp on it, the JC will data mine what is already out there and simply make it available so struggling hospitals don't have to reinvent the wheel. (It seems that this is their intent.)
They also need to train their M.D. inspectors better in these tools. I was not impressed with those I encountered, although my experience is about 5 years out of date now.


Anonymous said...

The Joint Commission has been asleep at the wheel a long time. Every high profile medical mishap seems to come just months after a visit from the Joint Commission.

Isn't that poor performance just one reason why they are about to lose their monopoly on hospital accreditation?

Paul, I don't expect you to criticize them, given your position, but I've heard nothing about complaints about the Joint Commission's heavy handedness and ineffectiveness.

So they have a new initiative. Shouldn't they have pushed to have this solved decades ago? Why does the Joint Commission suddenly have the answer? Because they are throwing around Lean and Six Sigma buzzwords??

I don't get it.

Engineer on Medicare said...

"The Center is developing solutions by using the same Robust Process Improvement(TM) (RPI) methods - including Lean Six Sigma and change . . . "

They have most of the right buzz words. I'm surprised they didn't mention ISO 9000.

The primary beneficiaries of most of these "buzz word processes" are the consultants who sell the "enterprise training" and then the assessment and certification, for which they collect big bucks. There is a serious conflict of interest if the accreditation organization is also going to sell services to train the organization that they are then going to examine.

Accreditation by itself means nothing. All depends on the leadership culture, training of staff, and diligence of executing the processes. I saw one case where a large metal fabricator was caught shipping non-compliant parts for jet engines before the paint was dry on their new ISO 9000sign.

Anonymous said...

Here's an interesting take on this from the Happy Hospitalist: