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Hospitals see lower mortality rates during unannounced on-site inspections

Authors said that the impact on public health could be significant if the changes that take place during inspection weeks were sustained.

Jeff Lagasse, Associate Editor

When hospitals receive on-site inspections from The Joint Commission, they experience noticeably lower mortality rates, especially in major teaching hospitals, according to a study published in the Journal of the American Medical Association.

The study was conducted to determine whether hospitals, who receive accreditation from The Joint Commission, change certain practices during on-site inspections that could impact the mortality rate. Among hospitals overall, there was a modest decline in mortality rates of about 1.5 percent during weeks when the inspections occurred.

Among major teaching hospitals, the mortality rate dipped by 5.9 percent during inspection weeks. While still modest, the authors said that the impact on public health could be significant if the changes that take place during inspection weeks were sustained throughout the year.

[Also: Higher mortality rates associated with routine handoffs of hospital patients]

They hypothesized that the largest teaching hospitals may have a greater change in their mortality rates because their size allows them to better mobilize staff resources. They also have reputations at stake, the authors said, which may be another factor.

There may be several reasons why there's a link between onsite inspections and lower mortality rates, though the authors caution that more research is needed to determine those factors definitely. The most likely reason, they said, is heightened scrutiny during inspections, which could raise awareness of any operational deficiencies that exist.

For example, focusing more on paper documentation could lead to more carefully documented encounters and better communication during inspection weeks. Or the presence of inspectors could improve compliance with hand hygiene and infection control protocols, thereby reducing hospital-acquired infection rates.

Until the causes are examined more in-depth, the authors suggest that health systems pay attention to which aspects of their normal day-to-day operations change the most when they're being inspected, and to sustain these changes in an effort to improve patient safety.

Twitter: @JELagasse

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