Accreditation of Health-Care Organizations

Bates, D.W., Preventing Medication Errors. In Medication Use A Systems Approach to Reducing Errors (D.D. Cousins, ed.). Joint Commission on Accreditation of Health Care Organizations, Oakbrook Terrace, IL, 1999, pp. 57-73. 

Joint Commission on Accreditation of Health Care Organizations. 1998 Comprehensive Accreditation Manual for Hospitals. A.M.H Oakbrook Terrace, IL 1997. 

Joint Commission for the Accreditation of Health-Care Organizations... 

Joint Commission on Accreditation of health care Organizations (JCAHO) a private, not-for-profit organization that evaluated and accredits hospitals and other health care organizations providing home care, mental health care, ambulatory care, and long term care services. 

Since establishment of the Joint Commission, the scope of health care organizations that are eligible for accreditation has widened from hospitals to encompass health systems and now even pharmacy benefit... 

The Centers for Medicare and Medicaid Services has incorporated pneumococcal and influenza immunization rates into some of their quality standards. Patients admitted to a hospital for community-acquired pneumonia should be screened for, offered, and vaccinated with pneumococcal and influenza vaccines prior to discharge if not previously administered. In physicians office practice, all persons over 65 years of age who have been hospitalized in the past year should be screened for, offered, and vaccinated with pneumococcal and influenza vaccines if not previously administered. Both of these standards will affect payment if the standard is not met. The Joint Commission on Accreditation of Healthcare Organizations has also incorporated these standards into their accreditation reviews of health care facilities. 

The Joint Commission is a nonprofit organization founded in 1951 by the American Medical Association and the American College of Surgeons (O Malley, 1997). The Joint Commission was established to continuously improve the safety and quality of health care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations ... 

While health care accreditation organizations have existed for quite a while, quality data were not readily available to the general public until recendy. These quality measurements (sometimes called report cards ) make health care quality indicators readily available to the public. This encourages health care organizations to compete on the basis of quality and creates markets where quality, not just cost containment, is rewarded (Blumenthal and Kilo, 1998 O Malley, 1997). 

A related initiative to provide ongoing measurement of the quality of care provided by health systems are the ORYX indicators. ORYX is intended to integrate the use of outcomes and other performance measurement data into the accreditation process. Performance measures are expected to be applicable across the accredited health care organizations with the evolution of core performance measures applicable to each accreditation program. The initial four core measurement areas will be for hospitals and will focus on acute myocardial infarction, heart failure, community-acquired pneumonia, and pregnancy and related conditions. Hospitals are expected to collect data that will allow assessment of patient care based on the standards. The ORYX standards for acute myocardial infarction in Table 21.3 reflect the focus on medications and how pharmacists can impact their organizations performance. ... 

A key public service of the JCAHO is a comprehensive guide to help individuals learn more about the safety and quality of JCAHO-accredited health care organizations and programs throughout the U.S. This guide. Quality Check , includes each organization s name, address, telephone number, accreditation decision, accreditation date, current accreditation status and effective date, and its most recent performance report. 

The goal of the JCAHO accreditation process is that it will continue to be standards driven with an increased emphasis on continuous data. In the last few years, the JCAHO accreditation process—in particular, for hospitals—has been challenged. Payers continue to challenge the value of the accreditation process cost versus quality. As health care organizations continue to evolve, change, and consolidate, so must JCAHO evolve, change, and consolidate. 

The United States has several major performance measurement systems in place. Two of the most important systems are those directed by the National Committee for Quality Assurance (NCQA) for managed care organization (MCO) accreditation and The Joint Commission on Accreditation in Healthcare Organizations (JCAHO) for health care organization accreditation. Both NCQA s performance measurement system, HEDIS, and JCAHO s IMSystem include several pharmaceutical outcomes indicators. 

Allison, David J. (ed.) (1997), Planning, Designing, and Construction of Health Care Environments, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook, III. 

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