A third of Joint Commission-accredited hospitals achieved “top performer” status in a 2013 report on quality and safety. Hospitals chose among measure sets that included heart attacks, heart failure, stroke and venous thromboembolism (VTE).
To be eligible, hospitals selected and reported on four of nine accountability measure sets using 2012 data: heart attack, heart failure, pneumonia, surgical care, pediatric asthma care, inpatient psychiatric services, VTE, stroke and immunization. To be a top performer, they had to report a cumulative performance of 95 percent or higher for all reported measures; hit 95 percent or higher on each reported measure where there were at least 30 denominator cases; and have at least one core measure set that had a composite rate of 95 percent or above, and within that measure set all applicable individual accountability measures had a performance rate of 95 percent or more.
A total of 1,099 hospitals met the criteria and another 673 hospitals landed just short by missing 95 percent performance on only one measure. “These 673 hospitals are ‘on track’ to potentially achieve Top Performer status next year,” according to the report. “In last year’s report, there were 583 on-track hospitals; this year, 253, or 43 percent, of those on-track hospitals attained Top Performer status.”
The report highlighted heart attack and stroke measures as bright spots. The heart attack score of 98.8 percent was an increase of 10.2 percentage points from 2002. The composite included aspirin at arrival; aspirin at discharge; ACE inhibitor or ARB at discharge; beta-blocker at discharge; fibrinolytic therapy within 30 minutes; PCI within 90 minutes; and statin prescribed at discharge.
Stroke care increased from 92.7 percent in 2010 to 96.2 percent in 2012. The composite included anticoagulation therapy for atrial fibrillation/flutter; antithrombotic therapy by the end of hospital day two; patient assessed for rehabilitation; patient discharged on antithrombotic therapy; patient discharged on statin medication; stroke education; thrombolytic therapy; and VTE medicine/treatment.
The VTE score totaled 91 percent for 2012, up from 82.7 percent in 2010. Heart failure results were 97.1 percent, up from 95.5 percent in 2010.
Next year the Joint Commission will require hospitals to select six core measures. The change will go into effect on Jan. 1, 2014.
A complete list of the top-performing hospitals and their measure sets is available here.