The Joint Commission on Accreditation of Healthcare Organizations last week announced a major reallocation of its staff and resources to concentrate forces on accreditation operations at the expense of other projects.
The revamp includes laying off 14 people and eliminating another 26 unfilled positions. However, 33 new positions are being created, most of them within the Division of Accreditation Operations under the direction of Executive Vice President Charles Bair.
The commission now has 532 full-time equivalent employees.
The commission said the moves are intended to support implementation of an "action plan" for improvement of customer service and accreditation activities (See related stories, p. 41). The plan was hammered out last month under pressure from the American Hospital Association to improve service to accredited organizations (Jan. 30, p. 3).
The commission also is reorganizing to flesh out its proposed re-engineering of the accreditation process, put together under Bair's direction. Dubbed the Orion Project, the initiative seeks to make compliance with accreditation standards an ongoing, decentralized process rather than a high-stakes affair riding on a visit by surveyors once every three years (Jan. 23, p. 3).
The largest proportion of the 40 eliminated positions will come from the Division of Performance Measures and Research, which has focused its efforts on developing the IMSystem, a performance-measurement initiative, and other components of the JCAHO's eight-year accreditation reform program, called the Agenda for Change.
The commission statement said the staff reductions and other changes in the division reflect plans to shift its performance measurement initiatives toward efforts to broaden the IMSystem's menu of clinical measures by relying on those developed by other organizations in the healthcare field.
The JCAHO originally had planned to develop its own roster of 30 performance indicators as the foundation for making performance measurement a part of the accreditation process (March 14, 1994, p. 30). Those indicators were to become mandatory when the development and testing were completed, a controversial aim that became one of many complaints lodged by the The commission also announced it was suspending salary merit increases for 1995. But the increases could be restored at year-end depending on how financial performance exceeds expectations.
"I believe these efforts demonstrate the Joint Commission's commitment to being a lean, cost-conscious organization that is focused on its basic business activities," said JCAHO President Dennis O'Leary, M.D.
The staff reorganization follows an executive restructuring that split the duties for day-to-day operations among three executive vice presidents instead of one chief operating officer (Feb. 13, p. 4).