A message from Peter L. Slavin, MD
March 20, 2007

Like many other members of the hospital community, I was surprised and dismayed to read the story on page 1 of Saturday's Boston Globe about the MGH's recent Joint Commission survey. The sensational headline and the tone of the story misrepresented the results of our survey as well as the accreditation process itself.

Mindful that the Joint Commission would arrive unannounced at the MGH at some point in 2006, we communicated frequently during the past year to educate and remind staff about the various quality and safety standards that would be evaluated and to enhance our rates of compliance in some important areas. We felt we were prepared for the survey, recognizing we would likely fall short on some of the standards but knowing that our compliance rates were heading in the right direction.

We had our survey in December, and the Joint Commission's comments in the wake of that review reaffirmed for us that while we were doing many things well, there were some important areas that needed to improve. We communicated this information openly, broadly and frankly, using the Joint Commission's preliminary comments to emphasize the importance of universal and consistent compliance in certain areas. When we got the call from the Globe several weeks ago asking about our survey, we answered as many questions as we could in the absence of our final report.

But the Globe was determined to do the story before our final results were available, relying largely on our internal communications. We learned late last Friday afternoon that we would be receiving our final report from the Joint Commission this week and that it would include 10 Requirements for Improvement (RFIs). We contacted the Globe and provided this information to the reporter. While the Globe did include this total in the story, the article provided little context, and as a result, the clear implication was that the MGH was somehow an outlier - different and worse than other hospitals. In fact, we understand that our results are similar to those received by most other academic medical centers in the region and across the country. Being open and honest somehow has led to us being singled out has having, according to the Globe, "numerous quality of care problems" during a "surprise inspection" - a lead sentence that could be written for just about every hospital surveyed in the past year. This story is unfair to our hospital and our staff and is misleading to our patients and the public.

After reading the article in the paper Saturday, I e-mailed Globe Health/Science editor Gideon Gil and reporter Liz Kowalczyk. I have included that e-mail below.

Liz and Gideon,
I was extremely disappointed in today's Globe headline and article about the recent JCAHO survey at MGH. As you may know, JCAHO surveys can result in three outcomes for a hospital: denial of accreditation, conditional accreditation, and full accreditation. As a result of our survey, MGH received full accreditation. We did not do perfectly on the survey; I am not aware of a hospital that has. Our results (10 RFIs) are comparable to the results I have heard from other hospital CEOs in the area this past year. I decided to use this survey as an opportunity to encourage our staff to provide even better care; that communication has been inappropriately used as evidence against us.

I am dumbfounded (and angered) that the article about our survey was deemed today's most important news story for Globe readers by virtue of its page 1 above the fold placement and that it was entitled "Surprise check faults MGH quality of care." Please help me understand the Globe's thinking about this and also correct the misunderstanding this article has created in the minds of our trustees, staff, and patients (who have already been contacting me). Today's article will discourage other hospital leaders from communicating openly about opportunities to improve health care, the exact opposite of what our health care system needs.

Peter L. Slavin, MD
President
Massachusetts General Hospital

The bottom line is that as a result of our recent survey, we have been reaccredited by the Joint Commission. Nonetheless, we are disappointed with 10 RFIs. We wish we would have had none, and we will work hard to get to that point. Our goal is to raise higher and higher the quality and safety of care we deliver to our patients and the environment in which we provide that care. The Joint Commission survey is one roadmap that we are using to guide these efforts. I will keep you informed of our progress as we move forward together.