Joint Commission Apes Newt, Takes on IHI

Not content with handing out demerits for bad behavior, the Joint Commission has launched an effort to help those who misbehave change their ways.

As detailed in the Wall Street Journal’s Health Blog, the mission of the Joint Commission’s new Center for Transforming Healthcare will be, in the Journal’s words, “to work on new collaborative programs with leading hospitals and health care systems to find a cause of the most deadly breakdowns in patient care, and put a stop to them.”If the name of the new group sounds familiar, you could be confusing it with Newt Gingrich’s Center for Health Transformation. That center was launched by the former House Speaker to tout the benefits of health information technology and a changed reimbursement system and then show how those benefits could work in practice through demonstration projects. Of course, with the advent of the Obama administration, the for-profit center has changed its mission just a tad from Newt-the-Wonk’s, “Paper Kills” to Newt-the-Republican-Attack-Dog’s “Democrats kill.”  Visitors to the Center’s site can now find helpful op-eds with titles like “Healthcare Rationing” and “Listen to Barney Frank or listen to America?”

On the other hand, if the mission of the Joint Commission’s Center for Transforming Healthcare sounds familiar, it could be because assembling a group of hospitals in voluntary collaboratives aimed at solving a specific quality problem through systemic process improvement sounds very similar to what goes on over at the Institute for Healthcare Improvement. The non-profit IHI, of course, is led by the charismatic Donald Berwick, MD, MPP. The Joint Commission’s Center, as it happens, is not led by some lower-level staffer but is directly overseen by Joint Commission president Mark Chassin, MD, MPP, MPH, also a charismatic leader, if a very different personality than Berwick.By the way, while Chassin has an extra diploma, Berwick was appointed by the Queen in 2005 as an honorary (all that’s allowed to Americans) Knight Commander of the Most Excellent Order of the British Empire.Apart from honor, however, there’s the small matter of money. The Joint Commission kicked in $10 million of its own money to start the new center and raised additional funds from the American Hospital Association, GE Healthcare and Johnson & Johnson, among others, according to the Journal. Over five years, the aim is to raise a total of $100 million. IHI reported fiscal 2007 revenues of $43 million, according to its latest tax filing.As a long-time advocate for quality improvement, I’m delighted to see QI flourishing. And there is certainly room for the Joint Commission, IHI and others. But as a Chicagoan, I’m a bit disappointed in the fiscal inefficiency of the effort. For far less than just one million dollars in twenty- and ten-dollar bills, along with the encouragement of a bunch of large men with colorful nicknames who live not far from the Joint Commission’s neighborhood, I’m sure we could encourage doctors who wanted continued use of their fingers to wash their hands very, very carefully.But that wouldn’t be a very collaborative process, would it?

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7 replies »

  1. I was suggested this blog via my cousin. I’m now not certain whether or not this submit is written by him as no one else recognise such distinctive approximately my problem. You are incredible! Thanks!

  2. I found it very interesting that JC once again failed to look at programs that have been making an impact on Hand Hygiene compliance, have been validated, published in peer review journals but instead believe they are the only ones that will find the majic answer to solve the compliance issue. Until the US adopts the culture of our European colleagues who mandate and require adherence to guidelines rather than “recommend” we will not make any impact other that the impact of being the big spenders and duplicating efforts. I encourage JC and IHI to visit http://www.hhreports.com and build on this foundation.

  3. Michael Thank you for such pointing out something so important while at the same time giving all of us a respite from the heavy dialogue. Humor goes along way in teaching. I think we could use more of it.
    While truly noble, the idea that with yet another organization we will now help hospitals improve overlooks the fact that true change has to be a product of commitment and accountability. In many ways we enable this performance. I see it on the frontline everyday with Leaders. It is not that these ideas are not in the hospitals. There is just complete variance within the same hospital, let alone between hospitals. One critical question to me is how do we give the consumer more power because they are the ones everyday, every shift who see the variance. I have tried to address this issue of managing by best practices versus managing to outcomes and the role of the consumer at http://www.healthcareletter.com/ Thanks again.

  4. The causes of the deadly breakdowns in healthcare ARE the Joint Commission and the government.

  5. I am amazed at how this kind of balderdash is written, or worse, believed!
    Don’t you folks know that the Joint Commission is a corrupt, manipulative, corrupt and unpoliced front for big money interests.
    The sooner people look behind their flowery prose and get in touch with who they really are and what they are doing, nothing will change.
    The JC has broken the law which empowered them in 1965. The are the street thugs who essentially are in the protection racket. No accreditation, no hospitals.
    Their motives are financial and political. Though given the power to sanction hospitals and other organizations they accredit, they have suspended the credentials of less than 1/10th of 1% in all the accreditations they have ever given.
    The JC has a Sentinel Alert program. My butt! Have a look at how many posting of Sentinel Alerts have been made by the JC in the last several years. Over 16,000 active accreditations and less than 12 reported events!
    Will some one wake up and smell the coffee. These guys are street thugs dressed in business suits. The are a major part of the problem. They have nothing to do with any solution. They want to collect their protection money, make nice, nice and go away until their next check becomes due.
    The have held the medical system in check since 1965, at the start of Medicare. Now they are going for it internationally by accredited (read: selling hospital accreditation) so that the insurance mafia can send American patients overseas for cheaper care. This move will drive down domestic prices so that they and their colleagues in the insurance cartel can pocket even more, while shoving all of this down the throats of doctors (read: providers) and to hell with the patients!

  6. Agreed. While there is always room for improvement and learning…
    …the fundamental problem is not that hospitals don’t know how to do systemic, collaborative process improvement (pardon my double negative)
    — but that they don’t have the right economic incentives to make it happen.