When hospitals are in the midst of unannounced accreditation inspections, their patients’ risk of dying seems slightly lower than at other times, according to a new study from Harvard T.H. Chan School of Public Health and Harvard Medical School.
The study looked at patients’ risk of dying within 30 days of admission. Using data from nearly 2,000 hospitals from 2008–2012, the researchers compared health records from Medicare patients treated during accreditation inspections with those of patients treated three weeks before or three weeks after such inspections.
Across all the hospitals, patients treated during an inspection week had, on average, a 1.5 percent lower risk of dying within 30 days of admission than patients treated in the weeks either before or after the inspection. The decrease was more pronounced at major teaching hospitals.
The decrease in patient deaths during accreditation visits may stem from people’s tendency to perform better when they know they’re being watched and evaluated, the authors said.
“We’ve all seen how traffic slows when drivers see a police officer ahead of them on the road,” said Dr. Michael Barnett, assistant professor of health policy and management at Harvard Chan School and lead author of the study, in a March 20 Harvard Medical School news article. “We believe the same dynamic may be at play here, and physicians and staff find ways to step up the overall quality of care when they know they are being observed.”
The researchers said that finding a way to harness people’s impulse to perform well while being watched could boost patient safety.