Maintaining efficiency, effectiveness and quality, when delivering health services to the customers, is an extremely important aspect of any hospital. Several countries have undertaken this aspect extremely seriously and even Acts and laws have come up to ensure the quality and effectiveness of the service and processes of the hospitals. For this purpose, several accreditation agencies and awards were established, so as to provide a guidance and impetus to the hospitals to maintain their quality and standards. The best result from gaining accreditation, apart from gaining efficiency in processes, is the public confidence, which grows towards the accredited organisation. For the past few years, we have been using JCAHO as our accreditation. However, in recent times, the hospital has been facing flak for the number of deaths due to medical errors. It is, therefore, considered to be a proper time to change the accrediting agency and guidelines by way of which we function.
In view of our requirements, for our hospital, I would suggest using such an accreditation agency or awards, which has guidelines including the alliance with Centres for Medicare and Medicaid Services (CMS), since our hospital functions in compliance with CMS. Keeping this in mind, I have shortlisted three accreditation agencies and awards, any of which can be adopted for future purposes. I have placed the agencies in a manner of ranking, where the first agency/award is the one best suited.
Baldrige -- Established by President Ronald Reagan himself, Baldrige Award has laid down certain guidelines and postulates which help achieve total efficiency and quality in hospital management. The Baldrige principles are mainly focussed on these postulates: systems perspective, visionary leadership, innovation oriented, fact reporting, organisational learning, Corporate and social responsibility, maintaining ethics and focussing on delivering results (The National Institute of Standards and Technology [NIST], 2015). While the overall expanse of the pointers covered by Baldrige principles makes it an extremely tempting alternative, the only point not covered by this one is cost-effectiveness. Where cost is not an issue, Baldrige Principles makes for the best accreditation service available.
NCQA (the National Committee for Quality Assurance) -- NCQA has recently been one of the most prestigious accreditation systems. It provides several programs such as Accountable Care Organisation (ACO) Accreditation program that helps an organisation (hospital) imbibe standards which help in providing high-quality care to its patients (NCQA.org, n.d.a). Some of the postulates of NCQA are: Patient-centred primary care, quality improvement, access to providers, patient rights and responsibilities, care management and coordination, structure and operations, performance reporting etc. The best advantage that we might get by adopting the NCQA accreditation system is the ability to reduce our operation cost while achieving effectiveness at the same time (NCQA.org, n.d.b). Secondly, our present accreditation system, JCAHO, is very similar to NCQA and hence, we will not have to make any drastic changes while adopting this technique.
Healthgrades -- More recent of the accreditations available, Healthgrades focuses its accreditation based on the risk-treatment done by the hospitals and the concerning mortality rate. Healthgrades focuses its data evaluation based on the last three years' reports released by Medicare (Graham, 2008). Since it does not cover the evaluation of doctors or other personnel involved in the process, nor provides any help in bringing about changes to the hospital processes, its rating does not provide a complete outlook to the buyer (grbj.com, 2013). Nevertheless, several people consider its rating and accreditation seriously because of its end result-orientation considerations. While it is true that Healthgrades does not consider the interim processes and individual performances of the hospital and the personnel, it evaluates the risk-taking factors of the hospital and the mortality rates based on these risk-evaluations. Thus, the more specialty-focussed a hospital, better its ranking will be.
The chart below explains the various focal points covered by each of the three above mentioned accreditation service. The points taken into consideration involve all three -- the employees, the patients and the third-party payers -- the three main pointers which will help us decide on the final accreditation to adopt after JCAHO.
Conclusion
Hence, it may be deduced that in order to bring a complete change in outlook, even at a certain cost, Baldrige Principles make for the best option. However, if cost-effectiveness is of concern, the second best option NCQA would be best suited for our needs.
References
Graham, J. (2008). HealthGrades Posts 2009 Hospital Rankings. Chicago Tribune. Retrieved from http://newsblogs.chicagotribune.com/triage/2008/10/healthgrades-po.html
Grand Rapids Business Journal (GRBJ). (2013). Street Talk: Hospital Ratings — Something’s Better Than Nothing. GRBJ.com. Retrieved from http://www.grbj.com/articles/77669-street-talk-hospital-ratings-somethings-better-than-nothing
National Committee for Quality Assurance. (n.d.a) About NCQA. NCQA.org. Retrieved from http://www.ncqa.org/AboutNCQA.aspx
National Committee for Quality Assurance. (n.d.b) Why NCQA Accreditation? NCQA.org. Retrieved from http://www.ncqa.org/Programs/Accreditation/AccountableCareOrganizationACO.aspx
National Institute of Standards and Technology (NIST). (2015). About the Baldrige Excellence Framework (Health Care). Nist.gov. Retrieved from http://www.nist.gov/baldrige/publications/hc_about.cfm
