“Nearly 3600 deaths could be avoided each year, or 10 deaths per day, if care patterns that are observed during hospital inspection weeks were the same year-round,” Jena adds.
It’s possible that during inspection periods, doctors and nurses pay closer attention to things that the inspectors check like hand-washing to prevent the spread of infections. But there were not fewer infections or adverse safety events during inspection weeks than at other times, Jena says.
Another possibility is that shifts in how doctors and nurses make diagnoses and treatment decisions during inspection weeks might lead to better outcomes, Jena says.
One limitation of the study is that researchers weren’t able to identify what might have caused the lower mortality rates during inspection periods.
Patients admitted during inspection weeks might also be different from patients seen at other times in ways the study didn’t capture, notes Dr. Vineet Arora, a researcher at University of Chicago Medicine who wasn’t involved in the study.
Hospitals might also respond to the arrival of inspectors with heightened vigilance that translates into better quality care, Arora says by email. For example, checking prescriptions before people leave the hospital might improve mortality rates by reducing medication errors.
“A modest reduction in mortality is certainly still a positive thing,” Arora says.
“This study highlights that there is potential for us to learn what is going on during those weeks that is associated with better patient outcomes,” Arora adds. “The question is whether it is due to a concerted effort on the part of the hospitals to follow safe practices or whether there is something else going on.”
- Barnett ML, Olenski AR, Jena AB. Patient mortality during unannounced accreditation surveys at U.S. hospitals. JAMA Intern Med. 2017 Mar 20. doi:10.1001/jamainternmed.2016.9685