Report Highlights Top Evidence-based Hospitals

A Joint Commission report highlights several hundred of the nation's top-performing hospitals in terms of the rate at which they use evidence-based procedures.

The nation’s leading hospital accreditation board, the Joint Commission, has released a report listing several hundred of the nation’s top-performing hospitals in terms of the rate at which they used evidence-based procedures in 2010. The list includes 405 hospitals, or 14% of those accredited by the Joint Commission that report the relevant data.

The rankings looked at 22 accountability measures of treatment of heart attack, heart failure, pneumonia, surgery, and children’s asthma. Among the standards included were whether heart attack patients were given aspirin upon admission and whether surgical patients were given antibiotics within an hour. In order to be included in the list of top-performing hospitals, an institution had to receive at least a 95% composite score on all accountability measures for which it reported data, regardless of the number of patients or cases in each, and at least a 95% score on each accountability measure, excluding those with fewer than 30 patients or cases. The report is part of an effort to increase attention to the importance of following evidence-based treatment guidelines. Beginning in 2012, the Joint Commission will withhold accreditation from hospitals that have a composite score under 85%—a bar that 121 hospitals would not pass based on their 2010 performance.

Overall, the report found progress in the rate of evidence-based treatments across all reporting hospitals. In 2002, hospitals used the treatments 81.8% of the time in 957,000 opportunities; in 2010, they used them 96.6% of the time in 12.3 million opportunities. The portion of hospitals that use evidence-based treatments over 90% of the time has dramatically increased as well, from 20.4% in 2002 to 91.7% in 2010. However, there is still room for improvement. For example, just 60.5% of hospitals provided fibrinolytic therapy to heart attack patients within 30 minutes over 90% of the time, and just 77.2% of hospitals provided antibiotics to intensive care unit pneumonia patients over 90% of the time.

A New York Times article on the report points out that many of the nation’s most renowned hospitals, such as Johns Hopkins in Baltimore, the Mayo Clinic in Minnesota, and the Cleveland Clinic failed to make the list, as did all 17 listed in U.S. News & World Report’s “Best Hospitals Honor Roll,” which places great emphasis on institutions’ reputation among physicians. The Times also points out that smaller and rural hospitals are heavily represented on the list, which also includes 20 Veterans Affairs medical centers.

Sources

Joint Commission Annual Report Names Top Performing Hospitals [The Joint Commission Press Release]

Improving America’s Hospitals: The Joint Commission’s Annual Report on Quality and Safety 2011 [The Joint Commission]

Report Finds Improved Performance by Hospitals [New York Times]