Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

The JCAHO standards address the level of performance of health care organizations and hospitals in specific areas. The standards set forth "maximum achievable performance expectations" for activities affecting the quality of care. They define significant functions relating to patient care and the management of health care organizations. These are termed as performance objectives. The standards endeavor to improve the outcome, and for the same reason, they place little emphasis on how to achieve these objectives. The latest versions of the JCAHO standards are published in comprehensive accreditation manuals for each accreditation program. These manuals also include a list of the intent or purpose of each standard, as well as scoring/evaluation guidelines. They are developed in consultation with health care experts, providers, measurement experts, purchasers, and consumers. Standards are generally updated every two years, and new ones are added only if they are assumed to have a direct impact on the quality of health care. It would tremendously help health care organizations to seek Joint Commission accreditation because it not only aids organizations to improve the quality of care, but also provides an educational tool for the staff, expedites third-party payment, often fulfills state licensure requirements, and enhances community confidence.

In 1998, the Joint Commission's Board of Commissioners established an Oversight Task Force to oversee the continuous improvement of the accreditation process. The resulting changes are intended to enhance the evaluation of important patient safety and patient care functions and to achieve an accreditation process that remains consultative and focused on performance improvement. They further approved a plan to involve accredited organizations, professional societies, trade groups, the public and other significant stakeholders in exploring specific options for further enhancing the value of the accreditation process, while reducing overall accreditation-related costs. An accreditation program entails an appraisal to evaluate the organization's compliance against all applicable standards, besides the public they cater to. In usual practice, an organization's scope of services defines which standards apply. Surveyors evaluate compliance with each of the standards using a five-point scoring scale. A score of "1" means that the organization meets the intent of the standard. This necessitates an organization to meet the standards for at least four months before an initial survey. For purposes of accreditation, an organization need not be in full compliance with every standard. It should rather demonstrate overall compliance with the entire set of applicable standards. Compliance expectations vary by standard, but scores of 2, 3, 4, or 5 indicate some level of non-compliance and a score of 1 result in a written recommendation in the final accreditation report. In effect, the JCAHO group of standards works towards the overall improvement of healthcare organizations, and most importantly, for the advancement of the quality/effectiveness of patient-care facilities.