JCAHO announces quality initiatives program
A new initiative of the Joint Commission on Accreditation of Healthcare Organizations called ORYX: The Next Evolution in Accreditation, proposes to incorporate outcomes and other performance measures into accreditation requirements. ORYX will be applied to hospitals and nursing homes by the end of this year, with expansion to other providers, including home care, planned by the end of 1998.
Because the Oakbrook Terrace, Il-based Joint Commission currently accredits hospices as a subset of its home care accreditation program, hospices, too, will be required to begin collecting and using quantifiable performance data and submitting these data to the Commission. This initiative represents a long awaited first step toward basing its accreditation at least in part on providers’ actual patient care performance not just on their quality structures and processes. However, the initiative is intended more for providers to improve on their own past performance, rather than being judged in comparison to their peers. Thus, their accreditation would be in jeopardy only if they were unable to show how they used the outcomes data to drive internal performance improvement.
Sixty information system vendors’ outcomes measurement systems have been reviewed and approved by the Joint Commission for use in meeting the new requirements. Some of these measures would have application across program models or settings. The problem for hospices is that conventional approaches to end-of-life care have been widely documented as inadequate. Thus, applying mainstream measurement systems to providers of terminal care could be a case of the blind leading the blind.
Jerod M. Loeb, PhD, chief scientific officer with the Joint Commission, agrees. "We are building a national library of outcomes indicators, and one area we have recognized as inadequate is end-of-life care." However, the Commission is not in the business of developing its own indicators, but instead evaluating indicators developed by others "as well as calling attention to areas where more development is needed, including end-of-life care." Loeb adds.
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