Journal of Healthcare Management - September/October 2014 - (Page 323)

Pressure and Performance: Buffering Capacity and the Cyclical Impact of Accreditation Inspections on Risk-Adjusted Mortality Tyler J. Towers, PhD, lieutenant commander, Medical Service Corps, United States Navy, Falls Church, Virginia,1 and Jonathan Clark, PhD, assistant professor, Health Policy and Administration, The Pennsylvania State University, University Park E X E C U T I V E S U M M A R Y The Joint Commission's move toward unannounced site visits in 2006 clearly underscores its goal to ensure more consistent compliance with its standards among accredited hospitals between site visits. As Joint Commission standards are intended to inform a host of practices associated with preventing adverse patient outcomes, and accreditation is intended to signal a satisfactory level of adoption of these practices, there should be no significant fluctuation in patient outcomes if hospital compliance remains sufficiently consistent before, during, and after an accreditation site visit, ceteris paribus. However, prior research on the implementation of practices in healthcare organizations (especially those practices related to quality improvement) points to the likelihood of inconsistency in the use of such practices, even after they have been "adopted." This inconsistency may emerge from shifts in manager attention patterns that may be driven by (1) resource constraints that preclude managers from dedicating consistent and perpetual attention to any given program or initiative and (2) accreditation pressures that are predictably cyclical even when site visits are, technically, unannounced. If these shifts in organizational attention patterns are sufficiently salient, we might expect to see patient outcomes ebb and flow with accreditation site visits. In this study, we explore this possibility by examining monthly patterns in risk-adjusted mortality rates around accreditation site visits. As shifts in organizational attention may be linked to resource constraints, we also explore the role of slack resources in shielding healthcare organizations from the ebbs and flows of external pressures, a capability we term buffering capacity. For more information about the concepts in this article, contact Dr. Towers at Tyler.Towers@med.navy.mil. 323

Table of Contents for the Digital Edition of Journal of Healthcare Management - September/October 2014

Journal of Healthcare Management - September/October 2014
Interview With Delvecchio S. Finley, FACHE, CEO of Harbor-UCLA Medical Center
Hospital Consolidation: “Safety in Numbers” Strategy Prevails in Preparation for a Value- Based Marketplace
Leveraging Women’s Leadership Talent in Healthcare
Pressure and Performance: Buffering Capacity and the Cyclical Impact of Accreditation Inspections on Risk-Adjusted Mortality
Development and Field Testing of a Self- Assessment Guide for Computer-Based Provider Order Entry
Good to Great: Using 360-Degree Feedback to Improve Physician Emotional Intelligence
Career Inflection Points of Women Who Successfully Achieved the Hospital CEO Position

Journal of Healthcare Management - September/October 2014