Hospital care in the United States has improved considerably, especially in the treatment and care for patients with pneumonia, children's asthma care and heart attack, says a new report issued by the Joint Commission, titled Improving America's Hospitals: The Joint Commission's Report on Quality and Safety 2010."
According to the report, the heart attack result in 2009 was 97.7%, compared to 88.6% in 2002. A 97.7% score means the hospitals provided an evidence-based heart attack treatment, including aspirin on arrival and beta-blockers on leaving hospitals 977 times out of 1,000. The report measured hospital care improvement during the period 2002 through 2009 - an eight-year period. The Joint Commission drew data from over 3,000 accredited hospitals across the USA.
Mark R. Chassin, M.D., M.P.P., M.P.H., president, The Joint Commission, said:
It is very encouraging that this year's report shows high rates of performance on these critical process measures and high levels of consistent excellence among hospitals on many measures. 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 America's hospitals.
The report found:
- The use of evidence-based treatments has improved considerably, from an average of 81.8% composite performance on 957,000 chances to carry out care processes related to accountability measure in 2002, to 94.5% in 2009 - a 13.6% improvement in 8 years.
- Hospital care improvement for childhood asthma (inpatient care) rose from 70.1% in 2007 to 88.1% in 2009 - an improvement of 18% in just two years.
- Pneumonia hospital care rose from 72.4% in 2002, to 92.9% in 2009 - a 20.5% percentage point increase in eight years.
- Hospital surgical care went up from 77.4% in 2004, to 95.8% in 2009.
In the following two measures, which were introduced in 2005, hospitals did not perform so well in 2009:
- Just 55.2% of hospitals attained 90% or more compliance in providing heart attack patients with fibrinolytic therapy within 30 minutes of arriving in hospital.
- Only 67.5% of hospitals attained 90% compliance or better in administering antibiotics to pneumonia patients in intensive care within 24 hours of being hospitalized.
The Joint Commission uses the following criteria for accountability measures:
- Research: Compelling scientific evidence shows that performing the evidence-based care process improves health outcomes (either directly or by reducing risk of adverse outcomes).
- Proximity: Carrying out the care process is closely linked to the patient outcome; there are comparatively few clinical processes that happen after the one that is measured and before the improved outcome occurs.
- Accuracy: The measure accurately gauges whether the care process has really been provided; i.e., the measure should be capable of indicating whether the process has been delivered with sufficient effectiveness to make improved outcomes probable.
- No Adverse Effects: The implementation of the measure will not induce unintended adverse consequences; or the risk is at most minimal.
Written by Christian Nordqvist