Joint Commission Posts Accountability Measures FAQ

On July 19th, the Joint Commission posted its FAQ concerning it's recently announced accountability measures. It can be found here. The following are excerpts from the FAQ:

Accountability Measures - Frequently Asked Questions

What are “Accountability Measures?”
Accountability measures are quality measures that meet four criteria that produce the greatest positive impact on patient outcomes when hospitals demonstrate improvement on them.

The criteria for classifying accountability measures include:

Research: Strong scientific evidence exists demonstrating that compliance with a given process of care improves health care outcomes (either directly or by reducing the risk of adverse outcomes).
Proximity: The process being measured is closely connected to the outcome it impacts; there are relatively few clinical processes that occur after the one that is measured and before the improved outcome occurs.
Accuracy: The measure accurately assesses whether the evidence-based process has actually been provided. That is, the measure should be capable of judging whether the process has been delivered with sufficient effectiveness to make improved outcomes likely. If it is not, then the measure is a poor measure of quality, likely to be subject to workarounds that induce unproductive work instead of work that directly improves quality of care.
Adverse Effects: The measure construct is designed to minimize or eliminate unintended adverse effects.
These criteria are based on The Joint Commission’s experience implementing and evaluating the outcomes of quality measures for more than a decade. The criteria provide a more rational approach to the process of collecting and reporting quality data.

Why is The Joint Commission reclassifying the core measures as accountability measures and how will this help hospitals?
The Joint Commission wants to help hospitals improve performance on accountability measures in an effort to promote excellence in the delivery of care and maximize health outcomes, and in anticipation of the Centers for Medicare & Medicaid Services incentive payments that become effective in 2013. The Joint Commission will eliminate measures that do not work well, include performance on accountability measures in accreditation standards and include only accountability measures in the ORYX program.

Why not remove non-accountability measures from use?
Measures that do not meet the accountability measures criteria can still prove to be a valuable source of information to hospitals. These measures are also currently used by other initiatives as standardized performance measures for assessing and reporting on hospital performance.

How will The Joint Commission utilize accountability measures in future accreditation activities?
The Joint Commission currently is considering a variety of innovative approaches to integrating hospital performance on the accountability measures into its survey and accreditation activities. To promote improved performance on accountability measures, and help hospitals prepare for the increasing reliance on attaining high performance on quality measures. The Joint Commission will be engaging accredited hospitals through focus groups and online surveys over the next few months.

Where can I locate additional information on accountability measures?
Additional information on accountability measures can be found in the June 23, 2010 special issue of Joint Commission Online and the June 23, 2010 on-line issue of the New England Journal of Medicine, “Accountability Measures: Using Measurement to Promote Quality Improvement.” Additional information will be posted on The Joint Commission’s Web site and in the August 2010 issue of Joint Commission Perspectives.

Will The Joint Commission continue to categorize measures as accountable and non-accountable measures?
In the future, The Joint Commission will only adopt accountability measures for use in its ORYX initiative.