If you saw the recent Dateline Show on medical errors and were as appalled as
I was at Dr. O'Leary's responses about the responsibility of the Joint
Commission and Patient Safety read this...........


<A
HREF="http://www.modernhealthcare.com/currentissue/editorial.php3?type=editori

al&db=mh99up&published=20011210">- Modern Healthcare - Your Source for Weekly
Healthcare Business News</A>


Time for a sentinel event at the JCAHO: An ineffective O'Leary should quit
post to pave way for needed changes
By: David Burda Editor


If there were accreditation standards for maintaining the status quo and
covering your backside, the Joint Commission on Accreditation of Healthcare
Organizations and its president, Dennis O'Leary, M.D., would exceed them with
commendation. After 15 years of doing very little to make hospitals and other
healthcare facilities safer for patients, the time has come for O'Leary to
step down.

The JCAHO must put someone in charge who would place patient care ahead of
his or her job preservation and the protection of the self-interests of the
Joint Commission's sponsoring organizations, including the American Hospital
Association and the American Medical Association.

Since 1986, O'Leary skillfully has kept the nation's largest voluntary
healthcare accrediting agency one step ahead of HHS and consumer
organizations but not so far ahead as to draw the ire of hospitals and
physicians. He has turned a cottage operation with a little more than $28
million in annual revenue and a few floors in the John Hancock building in
downtown Chicago to a massive organization with $111 million in annual
revenue and a sprawling corporate office complex in the upscale Chicago
suburb of Oakbrook Terrace, Ill.

The only people who seem to have really figured out what the JCAHO is doing
are the commissioners of DuPage County, Ill., and the local school district
board, who successfully challenged the Joint Commission's property-tax
exemption for its headquarters building. The DuPage County Circuit Court
ruled that the organization operated more like a for-profit business than a
tax-exempt public charity.

O'Leary and the Joint Commission have tried but repeatedly failed at
initiatives designed to judge hospitals and other healthcare providers based
on their performance-how well they take care of sick people. The projects
always are announced with much fanfare and heady names such as ``Agenda for
Change,'' ``IMSystem,'' ``Orion Project'' and ``Oryx.'' And they're
invariably scrapped, watered down or delayed.

That's the apparent strategy: Hide behind some mind-bending jargon, act like
you're doing something but really do nothing. That way, the Joint Commission
keeps its ``deemed status'' relationship with Medicare, which means any
accredited hospital automatically qualifies for the program, and avoids
alienating hospitals and other providers that pay its hefty accreditation
survey fees. Keep executive salaries growing, and hire and fire at will
dozens of well-meaning staff members depending on which way the healthcare
quality-improvement winds blow.

Consequently, O'Leary has turned the Joint Commission into little more than
an ambulance chaser. Modern Healthcare was the first to disclose the
organization's public relations strategy of showing up at a hospital after a
horrible patient tragedy. Surveyors conduct a detailed inspection of the
hospital after the so-called ``sentinel event,'' demanding a ``root-cause
analysis'' to find out what went wrong. And when the local newspapers and TV
stations go away, the hospital often maintains its previous accreditation
status.

Last year, after 49 years in operation, the Joint Commission issued its
first-ever patient-safety and medical-error reduction standards. They came 19
months after the Institute of Medicine issued its eye-popping report on
patient deaths caused by medical errors. Earlier this year, the JCAHO said it
was going to overhaul its hospital accreditation standards. That announcement
came three months after a second IOM report called for an overhaul of the
healthcare delivery system to improve patient care. Hmmm. There may be a
pattern here.

So, what does the Joint Commission really do? Not much, if improving patient
care is the yardstick. Having a hospital pretty itself up every three years
for the surveyor visit is like the college kid who cleans his dorm room only
before his parents visit: His room is cleaner, but he doesn't become a better
student.

Now it's time to clean house at the JCAHO. Patients deserve better. HHS
should demand better. And hospitals, physicians and other healthcare
providers should know better.

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