Quality Standards Comparison - Essay Example

Running head: QUALITY STANDARDS COMPARISON Quality Standards Comparison Insert Insert Insert 15 September Quality Standards ComparisonCenters for Medicare & Medicaid Services (CMS) process of care measures provide information about how hospitals give recommended treatments known to get the best results for patients with medical conditions such as heart attack, heart failure, pneumonia, asthma (children only), and patients having surgery. CMS gets data for these conditions from hospitals that voluntarily submit them from the patients’ medical records.

The data sets are mainly from two categories of patients’ i.e. Patients with Medicare, and the patients enrolled in health plans. The CMS hospital process of care measures includes the following guidelines: the seven measures related to heart attack care; the four measures related to heart failure care; the six measures related to pneumonia care; nine measures related to surgical care improvement project; and the three measures related to asthma care for children only (HHS, 2011). The measures are regularly updated and are based on scientific evidence relating to treatments that are known to produce the best outcomes for the mentioned conditions.

The CMS standards and the joint commission (TJC) standards are quite similar in that they both include measures for the above mentioned medical conditions. They share unity of purpose in that they are both intended to provide information on recommended measures for best results in treatments of some medical conditions and surgical operations care. Another similarity is that TJC provides the information for CMS reports information on children’s asthma care measures and the two organizations worked jointly to come up with the measures for acute myocardial infarction and heart failure (HHS, 2011).

TJC standards are wide in scope than the CMS standards in that in addition to the five mentioned measure sets they include measures for hospital based inpatient psychiatric services, hospital outpatient department measures and perinatal care (TJC, 2010). Additionally, CMS relies on information from claims and enrollment data for patients in original Medicare and does not rely on information from people in Medicare advantage plans or people without Medicare while TJC relies on information from a wide variety of stakeholders including people having no any Medicare (HHS, 2011).

Thus due to differences in data sources the quality of information recommended by the two bodies’ measures may be different in some scope such as relevance, and applicability. Based on this analysis I would recommend that health care settings to adopt TJC standards as supplementary to CMS standards as they will offer a wide scope that even includes psychiatric and long-term care hospitals. CMS confers deeming authority to organizations such as TJC. Organizations with deeming authority are the accrediting authorities that approve each accredited health care organization as meeting the Medicare and Medicaid certification requirements (Premier Inc, 2011).

Another obligation of CMS is to conduct random validation surveys and compliant investigations of organizations with deemed status. Further, the organizations are obliged to provide CMS with a listing of, and related documentation for, organizations receiving conditional accreditation, preliminary non-accreditation, and non-accreditation (Premier Inc, 2011). In essence these programs enable hospitals to evaluate and manage quality improvement efforts. The major shortcoming of these programs is that the overly prescriptive language from CMS leads to duplication of work or unnecessary requirements as was the case for TJC in 2009 when the CMS requirements were already covered in existing elements of performance or were addressed in the survey process (Premier Inc, 2011).

ReferencesHHS, (2011). What is the Hospital Process of Care Measures? U.S. Department of Health Services. Retrieved from http://www.hospitalcompare.hhs.gov/staticpages/for-consumers/poc/process-of-care.aspxPremier Inc, (2011). CMS Deemed Status and national accreditation organizations. Retrieved from http://premierinc.com/quality-safety/tools-services/safety/topics/guidelines/cms-guidelines-4-infection.jspTJC, (2010). Core Measure Sets. Retrieved from http://www.jointcommission.org/core_measure_set/