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.
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