Quality and Performance Evaluation in Healthcare Organizations - 77700

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The Joint Commission (previously known as ‘The Joint Commission on Accreditation of Health Care Organizations [ JCAHO] and now known as simply “The Joint Commission”, is an independent, non-profit organization, which carries out quality checks and accredits / renews the validity of the accreditation of existing Health Care Organizations.  The Joint Commission is the largest regulatory authority in healthcare in North America and has the responsibility of updating the accreditation more than 20,500 health care organizations and programs in the United States.

“The Joint Commission’s accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standard’s.”  (Facts about the Joint Commission, 16th July 2014)

The parameter of “Accountability”

The Joint commission has adopted ‘accountability ‘as a measure of effective care taken by care providers. Depending upon the initial complaint, the joint commission has classified several health complaints as either ‘accountable’ or “not accountable”. Accountable events are a measure of care taken by the health provider in relation to the initial complaint and they are such that the benefit of the healthcare service being provided to the patient can be compared and thereby measured. The criteria of an accountability measure which are four in number are as follows

1.  Research: the presence of clear data which shows that the care taken has led to positive health outcomes either directly or indirectly (reducing the possibility of adverse health related events).

2.  Proximity: Identification of which care process has showed positive results on the patient’s health. Therefore, a huge number of care procedures should not be carried ouyt  as then identifying the care method responsible becomes very hard.

3.  Accuracy: Accuracy in administering the care process as regards the method and quantity of administering.

4.  No adverse or side effects: The care administered does not enhance even in the slightest way, any possibility of inducement of any other condition which may be harmful to the development of the patient.

A few examples of accountability effects and non-accountability effects are as below.                 





Heart Attack Care

Heart Attack Care

Aspirin at arrival, Aspirin at discharge

ACEI or ARB at discharge

               Beta blocker at discharge              

Fibrinolysis therapy after 30 minutes

PCI therapy within


Smoking cessation advice

                     Heart Failure Care

Heart Failure Care

ACEI or ARB at discharge




Smoking cessation advice

Discharge Instructions

LVS assessment


                   Pneumonia Care

Pneumonia Care

Pneumococcal Vaccination

Blood Culture in ICU

Blood Culture in ED

Antibiotics to ICU patients within 24 hours

Antibiotics to non-ICU patients within 24 hours.

Influenza Vaccination



Antibiotics within six hours of arrival.

Smoking cessation advice



            Therefore as can be seen, the Joint commission initially tested the accountability for a few key parameters and found the system of measure to be a success. The graph formed below shows this.

The graph for pneumonia is also given below.


In conclusion, we would like to say that the accountability method introduced by the Joint commission works well and no elaborate procedures are required t