The Joint Commission on Accreditation of Healthcare Organizations last week sketched out broad characteristics of performance measures by which all accredited providers will be judged.
It's the first of several steps that must be taken before the JCAHO can activate a longstanding plan to evaluate how well accredited organizations are doing, not just how capable they are of doing well.
The plan was rewritten after the JCAHO last year abandoned visions of developing its own evaluation program and requiring providers to adopt it for accreditation purposes.
Instead, the Oakbrook Terrace, Ill.-based accreditation agency opened up the process to consider a range of existing performance-measurement initiatives.
A 19-member council on performance measurement reached consensus last December on an initial set of attributes and supporting criteria that a prospective measure must demonstrate to make the first cut, said JCAHO President Dennis O'Leary, M.D.
The commission's board approved that initial evaluation framework at its meeting Jan. 19-20. The JCAHO said the framework will be made widely available for comment among accredited organizations, health professionals, purchasers, performance-measurement systems and the public.
No date has been set for the introduction of performance measures into the accreditation process. O'Leary said the board isn't likely to act on a schedule until it's presented with measures that are judged ready.
That time could come as early as the board's spring meeting in March or April, when the first results of the evaluations are expected and the JCAHO staff presents a business plan for formal introduction of the program, O'Leary said.
The program will start with "fairly modest requirements" in an incremental rollout that's expected to take five to six years, he said. In the first year, accredited organizations probably will be required only to select a measurement organization, and in the second year they'll be expected to use a few of the performance indicators.
After years of fielding criticism and resistance to the planned introduction of its home-grown IMSystem, the JCAHO may have market forces on its side this time.
An American Hospital Association survey of hospitals undergoing accreditation last month reported an upswing in the number of hospitals installing performance measurement capabilities, mainly to satisfy requests for quality-related information from managed-care companies and third-party payers.
The JCAHO said its performance-measurement umbrella will provide a choice of measures to organizations depending on the patient-care services they provide.
The mix of process-oriented and outcomes-related indicators are intended to support internal comparisons of performance over time and also comparisons with similar organizations.