* Room for improvement exists for most of the quality measures.
A 90% compliance level was achieved for only four of 22 quality-related measures tracked during 2006. In addition, certain treatments are not being performed consistently for some measures in place since 2002. For example, two measures introduced in 2002 that relate to prescribing of ACE inhibitors at discharge for patients with heart failure or with heart attack show the most room for improvement, with hospitals offering these treatments only 64 and 56% of the time, respectively.
* Hospitals continue to be challenged in meeting certain patient safety requirements.
Non-compliance rates for six of the 16 National Patient Safety Goal requirements range between 16 and 37%. While some of this performance can be explained by more searching during on-site evaluations by Joint Commission survey teams, a number of hospitals appear to be struggling with the re-design of patient care processes- such as the reconciliation of medication lists when patients move from one care site to another- that the goal requirements are seeking.
* Significant variability exists in the performance of hospitals by state, as well as between the highest- and lowest-performing hospitals.

For example, on the measure of providing pneumococcal vaccination, performance ranged from 55.5% to 91%. On specific measures of surgical care, the difference between the highest state rate and the lowest state rate ranged as high as 80%.

Joint Commission data also show that some hospitals perform better than others in treating particular conditions. To view hospital-specific performance on specific measures, go to Quality Check® at http://www.qualitycheck.org/.

In 2008, The Joint Commission plans to add measures to the pneumonia and surgical care measure sets, and to introduce new measure sets for hospital outpatient care and hospital-based inpatient psychiatric care. In addition, The Joint Commission will begin to publicly report hospital performance data that are gathered by the Centers for Medicare and Medicaid Services, such as the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) results. The Joint Commission offers a comprehensive guide to hospital performance measurement at the Quality Check website.



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