By Sandra Basu
WASHINGTON — A group of federal medical facilities has earned accolades this fall for “exemplary” performance in using evidence-based care processes.
Dubbed “top performers,” 19 VAMCs and four Army facilities from around the country were included in The Joint Commission’s Top Performers on Key Quality Measures™ program, which is detailed in the 2012 The Joint Commission’s Annual Report on Quality and Safety. Making the Top Performers list is “no easy feat,” wrote Mark Chassin, The Joint Commission president, in an opening letter included with the report.
“These hospitals are leading the way in quality improvement, as American hospitals as a whole continue to make strides. While all hospitals achieving improvements deserve congratulations, those making the list … have achieved an exemplary level of performance,” he wrote.
The 2012 report reviewed the performance of more than 3,300 Joint Commission- accredited hospitals on 45 accountability measures of evidence-based care processes closely linked to positive patient outcomes. When it came to achieving the distinction of Top Performers on Key Quality Measures, 620 hospitals from around the country made the cut.
“We at VA are very pleased with The Joint Commission recognition. We are proud of the medical facilities that made this list, proving VA’s commitment to providing the high-quality care our veterans have earned through their service,” said Secretary of Veterans Affairs Eric K. Shinseki in a written statement. “This achievement demonstrates the hard work that each and every VA medical staff member undertakes to serve veterans.”
VA Undersecretary for Health Robert Petzel, MD, said in a statement that he “fully expects to see more VA medical facilities making this list next year.”
As far as Army facilities go, Col. Karen Grace, MEDCOM Quality Management Division, told U.S. Medicine that Army Medicine “is proud of the achievement” of its hospitals, which were cited as Top Performers in the “area of surgical and venous thromboembolism (VTE) care measures.”
|The 19 VA medical centers that made the Top Performers list:
*denotes a Top Performer rating for a second year
|Tuscaloosa VA Medical Center – Tuscaloosa, AL
VA Long Beach Health Care System – Long Beach, CA
Grand Junction Veterans Affairs Medical Center Grand Junction, CO
VA Medical Center * – Wilmington, DE
Boise VA Medical Center * – Boise, ID
Jesse Brown VA Medical Center * – Chicago, IL
Robley Rex Medical Center – Louisville. KY.
Oscar G. Johnson VA Medical Center * – Iron Mountain, MI
Aleda E. Lutz VA Medical Center * – Saginaw, MI
VA Gulf Coast Veterans Health Care System * – Biloxi, MS
Samuel S. Stratton VA Medical Center – Albany, NY
VA Hudson Valley Health Care System – Montrose, NY
Portland VA Medical Center – Portland, OR
Erie VA Medical Center * – Erie, MI
William Jennings Bryan Dorn VA Medical Center * – Columbia, SC
Memphis VA Medical Center – Memphis, TN
VA Medical Center – White River Junction, VT
VA Medical Center – Spokane, WA
VA Medical Center – Huntington, WV
|The four Army facilities to make the list were|
|• Bayne-Jones Army Community Hospital at Fort Polk, LA
• Weed Army Community Hospital at Fort Irwin, CA
• Irwin Army Community Hospital at Fort Riley, KS and
• Keller Army Community Hospital in West Point, NY
The report explained that the Top Performers on Key Quality Measures program “is designed to inspire better performance on accountability measures and to serve as an incentive for all hospitals to improve and be the best they can be.” Last year was the first time the list was issued.
To be recognized as a Top Performer, hospitals had to meet two 95% performance thresholds on 2011 accountability measure data. First, the hospital had to achieve performance of 95% or above on a single, composite score that includes all the accountability measures for which it reports data to The Joint Commission, including measures that had fewer than 30 eligible cases or patients.
Secondly, the hospital had to meet or exceed a 95% performance score on every accountability measure for which it reports data to The Joint Commission, excluding any measures with fewer than 30 eligible cases or patients.
Determining top performers was based on the hospital’s performance related to accountability measures for heart attack care, heart failure care, pneumonia care, surgical care and children’s asthma care, In addition, three new accountability measure sets were used for the first time this year: stroke, VTE and inpatient psychiatric services.
The report explained that “each accountability measure represents an evidence-based practice — for example, giving aspirin at arrival for heart attack patients, giving antibiotics one hour before surgery and providing a home-management plan for children with asthma.” A “95% score means a hospital provided an evidence-based practice 95 times out of 100 opportunities to provide the practice,” the report said.
Chassin said the report is neither a “ranking of hospitals,” nor based on unscientific data such as the hospital’s reputation.
“Hospitals want to be on the list because it provides strong evidence that they are achieving a high level of excellence on some of the very best measures of quality that exists,” he said.
Chassin said that achieving top-performer status is no guarantee that a hospital will not experience a preventable adverse event. In addition, he said that making the top performance list does not mean that a hospital is performing at the same level in areas that were not evaluated. “Making the list means no more, but no less than meeting the specific criteria as outlined that defined outstanding performance of a specific group of excellent measures of quality care,” he said.
With a long history of point of care testing at both of its predecessor organizations, the Walter Reed National Military Medical Center (WRNMMC) laboratory services staff were keenly aware of the advantages of using portable testing devices to obtain rapid patient assessments.
Legislation that would streamline VA’s community care programs into one program and expand VA’s caregiver program to veterans of all eras was signed into law earlier this month..