Hospital Accreditation Type and Patient Safety Outcomes: A National Comparison

Hospital accreditation is widely viewed as a mechanism to promote patient safety and quality improvement. However, the extent to which different accrediting bodies are associated with variation in performance outcomes remains unclear. The authors in this study assessed whether the performance on publicly reported patient safety outcomes in US acute care hospitals with 250 or more licensed beds, accredited by The Joint Commission (TJC) or Det Norske Veritas Healthcare, significantly differs.

The authors used a retrospective, cross-sectional study design. They merged hospital accreditation and bed count data with publicly available Centers for Medicare & Medicaid Services performance data and included, in total, 1043 hospitals. The authors analyzed 24 outcome measures, including timely and effective care, complications, infections, mortality, readmissions, and the Overall Star Rating. The authors used Welch's independent 2-sample t tests to compare patient safety outcomes between TJC- and Det Norske Veritas-accredited hospitals and the 1-sample t tests to assess each group's performance relative to national benchmarks.

The accreditation groups for 23 of the 24 measures analyzed did not show statistically significant differences. Heart failure mortality was significantly lower in TJC-accredited hospitals (P < .05). Both groups outperformed national benchmarks on several infection-related measures, including catheter-associated urinary tract infections, central line-associated bloodstream infections, and Clostridioides difficile rates.

Findings show that hospital accreditation type is not strongly associated with differences in patient safety outcomes. Although accreditation remains important for compliance and accountability, broader organizational, operational, and cultural factors may play a greater role in driving safety performance.