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s the twentieth century comes to a close, issues in health care continue to pose challenges for individuals seeking health care services, as well as for those who work within the health care industry. Consumers and purchasers of health care want comparative information they can use to make care and treatment decisions. Health care professionals interested in providing such information have discovered that measuring performance, particularly for comparative purposes, can be a complicated process.
As one of the nation's largest and most experienced accreditors of health care organizations, the Joint Commission on Accreditation of Healthcare Organizations recognized this challenge more than 10 years ago and initiated a series of activities to evolve the accreditation process into one that is more continuous and focused on performance. Following a series of revisions to the standards and survey process, the ORYX initiative was designed in 1995, and new performance measurement requirements were announced in 1997 for two of the seven Joint Commission accreditation programs (ie, hospitals and long-term care facilities). This initiative will integrate performance measurement data into survey and accreditation activities.
ENHANCING ACCREDITATION
The Joint Commission's current accreditation decisions are based exclusively on compliance with standards that describe structures and processes associated with important organizational and clinical functions. The standards were developed with extensive input from health care professionals. A health care organization's compliance to standards is assessed triennially via an on-site survey conducted by specially trained health care professionals. Additional on-site surveys can follow up on issues identified during the triennial survey, in response to serious events that occur within an organization, or as a result of selection associated with the Joint Commission's random unannounced survey policy.
This "snapshot" approach to assessing an organization's performance does not ensure a sustained level of compliance with standards, nor does it consider the actual results (ie, outcomes) of care.
To achieve a more continuous, datadriven accreditation process, the Joint Commission designed the ORYX initiative, which requires the periodic submission of performance measurement data by accredited health care organizations. These performance measurement data will be used by the Joint Commission to help health care organizations improve care processes. It also will be used to verify the effectiveness of action and improvement initiatives and to shape the on-site...