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Relationship Between Performance Measurement and Accreditation: Implications for Quality of Care and Patient Safety

Peter Pronovost, MD, PhD

Michele Donithan, MHS

Scott Zeger, PhD

Chunliu Zhan, MD, PhD

Laura Morlock, PhD

Gregg S. Meyer, MD, MSc

This study examined the association between the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accreditation scores and the Agency for Healthcare Research and Quality’s Inpatient Quality Indicators and Patient Safety Indicators (IQIs/PSIs). JCAHO accreditation data from 1997 to 1999 were matched with institutional IQI/PSI performance from 24 states in the Healthcare Cost and Utilization Project. Most institutions scored high on JCAHO measures despite IQI/PSI performance variation with no significant relationship between them. Principal component analysis found 1 factor each of the IQIs/PSIs that explained the majority of variance on the IQIs/PSIs. Worse performance on the PSI factor was associated with worse performance on JCAHO scores (P = .02). No significant relationships existed between JCAHO categorical accreditation decisions and IQI/PSI performance. Few relationships exist between JCAHO scores and IQI/PSI performance. There is a need to continuously reevaluate all measurement tools to ensure they are providing the public with reliable, consistent information about health care quality and safety.

Key Words: safety • quality of health care/statistics and numerical data • medical error • inpatients • hospitals

American Journal of Medical Quality, Vol. 20, No. 5, 239-252 (2005)
DOI: 10.1177/1062860605277076


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