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How do we know we are the nation's premier medical center?

If you had to choose metrics by which to compare all American hospitals, what would they be? Survival rate, certainly. Cleanliness. Fire safety. What about quality and readability of signage in the corridors? How about average number of years of experience among nurses? Presumably, there is a mathematical way to score, weigh, and combine all of these factors - and thousands of others - into a single value by which all institutions providing health care may be ranked. Meeting this analytical challenge and providing useful feedback in improving a hospital's quality of care is the stated objective of The Joint Commission. The Joint Commission is the accrediting organization that sets the industry standard for North American hospitals, both military and civilian. Sometime in the next two months - and we will not know precisely when until they arrive - a team of surveyors representing The Joint Commission will walk through our doors, into our clinics, and into our records and processes and inspect us from top to bottom. All hospitals go through this, and it is the way we measure how we are doing in the industry.

The original Minimum Standards for Hospitals as set forth by the American College of Surgeons (ACS) in 1917 fit onto a single page. They required, for example, that a hospital in a cold climate be heated. Today's Joint Commission standards fill many volumes, and are as specific as requiring, for example, that printed pamphlets made available at individual clinics present health care information ".in a manner that is culturally sensitive" and "relevant to the patient's level of literacy." It is an evaluation of the highest order, and its requirements are so demanding, and the accreditation so important, that we employ full time staff whose year-round job it is to track how closely we adhere to Joint Commission standards.

What about hand-hygiene? Availability of parking? What about the verification and maintenance of health care provider credentials? It is not unusual for a Joint Commission surveyor to contact every signatory on an individual patient's chart to confirm a chain of referral and care, to remove ceiling panels to check for penetrations in a physical firewall, or to initiate an impromptu and candid interview with a random staff member as they walk down the corridor. Surveyors include nurses, physicians, engineers, administrators, pharmacists, and behavioral health specialists. They are thorough, they are particular, and they possess the power to close a hospital or to validate months and months of hard work, such as we have done to affect our recent transition.

How do we know we're an industry leader?

I like to think we know it in our hearts: that we look around at our colleagues and the care we provide, and that we're proud of our clinic, our department, our hospital. But while we can say it (and we do, in brochures and in press releases, and frequently in this column), and perhaps repeat it to ourselves, mantra-like, to get us through certain tasks, ultimately laying claim to such superlatives as "premier" requires that we be measured against others who would attempt the same level of care. That is the purpose of our partnership with The Joint Commission. Over the years, the relationship between accrediting bodies and the hospitals they inspect, including ours, has evolved into a cooperative process. We would not be premier if the lessons learned from these surveys, and the surveys of our peers did not help us improve the safety and quality of the care we provide.

Active engagement in the identification and meeting of industry standards is one of the things that makes us world-class.

Commander sends

Rear Adm. Alton L. Stocks

Medical Corps

United States Navy