Costs and Benefits of JCI Accreditation

Accreditation
The Cost and Benefits of
© Copyright, Joint Commission International

The Cost and Benefits
of Accreditation
Costs of
Accreditation

JCI: Fact or Fiction?
Fiction  Preparing for JCI accreditation costs a
minimum of $250,000 USD.
Fiction  To achieve JCI accreditation, you must

use JCI consulting.
Fact  The current average fee for a hospital full

survey is ~$50,000 USD, not including
travel and hotel for the surveyors
Fiction  Your facility must be new to be able to

meet the standards.
3
Client name/ Presentation Name/ 12pt - 3
The Survey Costs
– Survey costs will be different for
each organization.
– Larger and more complex
organizations require more
surveyors and a longer survey.

4
Very large/highly
complex
Size and Complexity
Most Expensive Survey: 88K
1 SD above average: 60K
Average:50K
1 SD below average: 33K The survey fee for

uncomplex
Small and
most hospitals are

likely to fall into this
Cheapest Survey: 11K
range.
0 USD 20,000 40,000 60,000 80,000 100,000

USD USD USD USD USD 5
Cost
The Survey Cost
– The current average survey fee is
about $50,000 USD.
– Does not include airfare, lodging, and
miscellaneous expenses.
– This fee covers the cost of your
initial survey.

– We do not charge annual maintenance
fees during the years between your
survey.
6
The Expense of JCI
Accreditation Preparation
– JCI Accreditation does not need to be

expensive.
– Much of your preparation will involve
developing new policies and processes
that meet the standards.

– Many organizations have everything they
need to meet the standards right now.
7
Preparation for JCI
– The costs to prepare will vary by:
– Region
– Organizational complexity
– Current preparedness level
– To help you estimate your costs, we can share
what other organizations have done.

8
Preparation Routes:
Expensive
– Hire Quality Director and Quality
Department
– Hire outside consultants
– Hire architect and contractors to
renovate your building

– Conduct/convene education
programs
– Minimal internal staff work
9
Preparation Routes:
Moderate Expense
– Hire Quality Director
– Hire outside consultants (Baseline,
Tech Assistance, Mock Survey)
– Moderate amount of internal staff
work

10
Preparation Routes:
Inexpensive
– Hire minimal outside consulting
(Mock Survey only)
– High amount of internal staff work

11
Preparation Routes:
Minimal Cost
– Very high amount of internal staff
work
– Slower progress
– Staff frustration

12
JCI Consulting Costs
– If you choose to have JCI Consulting
assist you, we will work with you to
estimate your costs prior to
beginning work.
– To do this, we will need to:
– Understand your organization’s size

and complexity.
– Discuss the areas that you think will be
your largest challenges.
13
Summary of Costs
– Expenses vary depending on your:
– Size
– Complexity
– Accreditation Survey Fee: about $50,000
USD
– Once every three years
– Preparation Expenses:

– Depends on how many standards you meet
when you start
– Depends on the route you choose
14
The Costs and Benefits of
Accreditation
What we require What you get
• Meet our standards • Safety
• Be surveyed • Efficiency
• Continuously improve • Visibility
• Resources

Each organization must decide if
the costs are worth the benefits.
15
Accreditation
What we require What you get
• Meet our standards • Safety
• Be surveyed • Efficiency
• Continuously improve • Visibility
• Resources
• At this point, you should have a sense of

how you will meet our requirements.
• What have similar organizations have
gained from JCI Accreditation?
16
of Accreditation
Benefits of
Accreditation:

Safety
Safety
– Improving safety and the quality of
care is JCI’s core mission.
– Measuring safety is difficult.
– Qualitative and quantitative studies
by our accredited organizations

report marked and sustained
increases in safety outcomes.

Independent Studies
Numerous studies point to the value of
accreditation:
 Journal of Healthcare Management: “Accreditation
Improves Patient Safety”1
 Health Affairs: “Accreditation requirements influenced
hospitals’ efforts toward implementing patient safety
initiatives; “Hospital leaders ranked Joint Commission
as most important driver of patient safety”2

 Hospital Topics: “Accreditation is effective in driving
efforts to reduce errors”3
Client name/ Presentation Name/ 12pt - 19 19

Safety: Needle Stick Injuries in
a Jordanian Hospital
Needle Stick Injuries
Needle Stick Injuries per Employee
0.08
0.07
0.06
at Risk
0.05
0.04
0.03

0.02
0.01
0.00
-1 +1 +2
Years Before/After Accreditation Survey
20 to JCI and Accreditation

Introduction
Safety: Medication Errors
in an Indian Hospital
Medication Errors
50
45
40
Medication Errors
35
30
25
20
15

10 Upper Control Limit
5
0
-5 -4 -3 -2 -1 -4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Months Before/After Accreditation Survey
21
of Accreditation
Benefits of
Accreditation:

Efficiency
Efficiency and Cost Savings
– For many organizations, the financial
costs of accreditation are a serious
concern.
– A recent study illustrates that the
quality improvement activities and

patient safety techniques that
accreditation preparation requires
can lead to significant cost savings.
23
Brandeis Value and Impact
Study
– A Brandeis University study
examined this question.
– Three study hospitals matched with
three control hospitals
– Designed to control for the changes

within a country that may influence
standards compliance

Value and Impact Study
– Analysis suggests significant findings on
some of their study metrics:
Metric Savings
•Reduced rate of return •$34,000 per year
to ICU within 24 hours

•Staff turnover •$53,000 per year

25
Efficiency: Survey Results
from a Hospital in UAE
Satisfaction Before and After Accreditation
90
80
70
60
50
Percent
40
Before

30 After
20
10
0
Patient Human Doctors
“Delight” Resources
26
of Accreditation
Benefits of
Accreditation:

Visibility
Visibility and Marketing
– JCI is globally recognized as the
preeminent international
accrediting body.
– JCI accreditation is
increasingly seen as the

mark of an organization’s
commitment to quality
and patient safety.


JCI and Medical Travel
– Many organizations pursue some form

of distinction in order to increase their
medical traveler population.
– JCI does not take a position on medical
travel.
– Neither endorse or discourage

– Per our mission, our goal is to ensure that
every patient that enters an accredited
hospital receives the highest quality and
safest care possible.

30
The Business Case for JCI
As the most globally recognized and respected symbol of
quality and patient safety, JCI Accreditation helps
patients and organizations answer these critical business
questions.
Critical Business Questions
•How can we demonstrate an international level of safety

and quality?
•How can we differentiate our organization from our

competitors?
•How can we attract patients?
Attracting patients
requires that we know
how to talk to them about
accreditation.
31
Remember: Most patients
have a very limited
understanding of how health
care works.
If they assume that health care is
generally safe…..

Introduction to JCI and Accreditation
…then explaining that Accreditation shows
your commitment to improving
performance on standards like IPSG.4….

…may not be very reassuring.
Therefore, it’s very important to think about
how your explain your accreditation
achievement to patients.

Many organizations struggle with this, so
we have developed tools to help.
JCI’s most effective tool
to help you reach patients

Goals
1) Help our accredited

organizations educate patients
about the value and meaning of
JCI Gold Seal accreditation


• This website
explains JCI
Accreditation in
terms patients

can easily
understand.

• It also provides a
simple overview
of the health
care system in

countries where
we accredit
organizations.
Goals
1) Help our accredited

organizations educate patients
about the value and meaning of
JCI Gold Seal accreditation

2) Promote JCI-accredited health
organizations to patients




Google Maps lets
patients find your
hospital in an
interactive map.

Hospitals list their
specialties.

Hospitals list
contact
information.
Hospitals

provide an
overview of
their
organization

Hospitals
can even
provide a
PDF of
useful
information
about their
hospital.


The website uses an automated translation
function to translate the site into 80 languages.


Getting listed on World
Hospital Search
– All JCI accredited organizations are
listed on WorldHospitalSearch.org.
– To list your free “expanded” profile, your
Accreditation Coordinator should
contact Gia Riney at

Griney@jcrinc.com.

of Accreditation
Benefits of
Accreditation:

Resources
Resources
– As a JCI accredited hospital, you
have access to a number of valuable
resources.
– Two of the most helpful are:
– The Targeted Solutions Tool (TST)
– The JCI Library of Measures

– Both are stored on JCI Direct
Connect, JCI’s extranet site for
accredited organizations
52
The Targeted Solutions Tool ®

Persistent Health Care
Problems
– There are some problems that all
health care organizations have had
difficulty solving.
– Our web-based Targeted Solutions
Tool ® helps address persistent

health care problems
– Current offering: hand hygiene
– Free to accredited organizations
54
Targeted Solutions Tool ®
– Tool guides organizations through
process of:
– Collecting data to measure your actual
performance
– Identifying barriers to excellent
performance (root causes)
– Selecting targeted solutions to address
your specific root causes

– Sustaining improvements
– No special training needed
– Data analysis conducted by the tool
55
The TST Process
– The TST guides and supports you
through the process of data
collection, analysis, and
improvement….

56
Getting Started
Setting Up Projects
Measurement
Analysis

57

Solutions
Downloadable
implementation
guides

58
With TST®, Hand Hygiene
Improves Significantly
100%
90%
80%
70%
60%
50%
40%

30%
Improvement
Improvement
20%
Baseline
Baseline
10%
Post
Post
0%
US Organizations Non-US Organizations
59
News

60
The Library of Measures

Measurement
– JCI believes it is important for health care
organizations to measure clinical
performance in order to drive
improvement.
1. Identify opportunities for improvement
2. Determine whether or not the clinical
guidelines that an organization has selected
are being effectively adopted and

implemented
– We have developed a Library of Measures
to help you do this.

Is the LOM Required?
– APR.7 requires that organizations select

and use measures as part of their
quality improvement system.
– Your measures and measurement
approach must be well-defined and

evidence-based.
– You do not need to select our Library of
Measures.

The Library of Measures
– The Library of Measures program has two

main components:
1. 36 process and outcome measures into a
library of measures
– Measures based on the scientific evidence of the
National Hospital Inpatient Quality Measures.

2. A standardized approach to evaluate these
measures
Introduction to64
JCI and Accreditation
The Measure Sets
1. Acute Myocardial Infarction (AMI)
2. Heart Failure (HF)
3. Stroke (STK)
4. Children’s Asthma Care (CAC)
5. Hospital-Based Inpatient Psychiatric Service (HBIPS)
6. Nursing-Sensitive Care (NSC)
7. Perinatal Care (PC)

8. Pneumonia (PN)
9. Surgical Care Improvement Project (SCIP)
10. Venous Thromboembolism (VTE)
Introduction to65
Selecting Your Measures
– You should select the measures that

are most useful for you to track in order
to drive improvement
– Ideally, select your measures based
upon your:

– High-volume activities
– Risk points
– Previously identified quality issues
Introduction to66
Collecting Useful Data
– JCI wants you to use the data you

collect to drive improvement in your
organization.
– Therefore, the quality and integrity of
the data you collect is critically

important.
– Consistency in data collection produces
comparable results that can be used to
drive improvement.
Introduction to67
Measure Specifications
 Getting everyone to collect data correctly

and consistently is difficult.
 JCI has developed Measure

Specifications in order to help you collect
consistent and accurate information.
Introduction to68
Submitting Data?
– This data should be used by your

organization to identify and drive
improvements.
– Organizations do not submit their
Library of Measures data to JCI.

Introduction to69
Other LOM Resources
• To support our accredited organizations,

the Library of Measures web page also
contains many resources to help you
select, develop and implement measure
data collection:
– Sampling methodology
– Measure calculation

– Validation methodology
– Data abstraction tools
– Data element dictionary
– Initial eligible population criteria- ICD codes
Introduction to70
Accreditation
What we What you
require get
• Meet our • Safety
standards • Efficiency

• Be surveyed • Visibility
• Continuously • Resources
improve
71 to JCI and Accreditation

Introduction
Questions?

Introduction to72

Costs and Benefits of JCI Accreditation

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Costs and Benefits of JCI Accreditation

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Accreditation

The Cost and Benefits of

© Copyright, Joint Commission International

© Copyright, Joint Commission International

Fiction  To achieve JCI accreditation, you must

Fact  The current average fee for a hospital full

© Copyright, Joint Commission International

Fiction  Your facility must be new to be able to

© Copyright, Joint Commission International

Most Expensive Survey: 88K

1 SD above average: 60K

1 SD below average: 33K The survey fee for

most hospitals are

0 USD 20,000 40,000 60,000 80,000 100,000

© Copyright, Joint Commission International

– JCI Accreditation does not need to be

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

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Client name/ Presentation Name/ 12pt - 18

© Copyright, Joint Commission International

Client name/ Presentation Name/ 12pt - 19 19

© Copyright, Joint Commission International

20 to JCI and Accreditation

© Copyright, Joint Commission International

© Copyright, Joint Commission International

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Client name/ Presentation Name/ 12pt - 24

© Copyright, Joint Commission International

Client name/ Presentation Name/ 12pt - 25

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

Client name/ Presentation Name/ 12pt - 28

© Copyright, Joint Commission International

– Many organizations pursue some form

© Copyright, Joint Commission International

Client name/ Presentation Name/ 12pt - 30

•How can we demonstrate an international level of safety

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

1) Help our accredited

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

Introduction to JCI and Accreditation

© Copyright, Joint Commission International

1) Help our accredited

© Copyright, Joint Commission International

Introduction to JCI and Accreditation

© Copyright, Joint Commission International