No, the ORYX initiative is NOT the name of some exotic animal! At its January 1997 meeting, the Joint Commission's Board of Commissioners took a far-reaching step toward creating the accreditation process of the future by approving the plan and timetable for integrating the use of outcomes and other performance measures into the accreditation process. While the Joint Commission has been laying the groundwork for this initiative for a number of years, this action by the Board sets in motion an important new set of expectations both for the accredited organizations and for the Joint Commission. This milestone initiative is named ORYX: The Next Evolution in Accreditation.

The ORYX initiative is intended to be a flexible and affordable approach to progressively increasing the relevance of accreditation, an important building block for supporting quality improvement efforts in accredited organizations. The use of performance measures as an integral feature of the new accreditation process should significantly enhance its value to health care organizations and to those who rely on accreditation information. Today, a growing number of accredited organizations are finding it necessary to have objective, quantifiable information about their own performance which they can use externally to demonstrate accountability. The ORYX initiative will help organizations meet this need.

The basic ORYX Implementation Plan will initially apply only to hospitals and long term care organizations. A parallel group of requirements is being put in place for health care networks (e.g. health plans, provider-sponsored organizations). The Implementation Plan is to be phased in over time to assure that its modest expectations accommodate the real world capabilities of the full range of accredited organizations.

Specifically, by March 2, 1998, each accredited hospital and long term care organization must select (or already be participating in) one or more performance measurement systems that have been accepted by the Board of Commissioners as having met the initial requirements for inclusion in the accreditation process and have a signed contract with the Joint Commission. There are currently 211 such systems, of which 163 (77%) contain clinical measures relevant to hospitals and 72 (34%) include measures relevant to long term care organizations. These measures will be the subject of the additional requirements described below.

Secondly, and also by March 2, 1998, each accredited hospital and long term care organization must select from its performance measurement system(s) - for future reporting purposes - at least two clinical measures which related to at least 20 percent of its patient or resident population. Each accredited organization will be asked to provide the Joint Commission the identity of its performance measurements system(s) and the clinical measures it has selected by March 2, 1998.

Finally, each accredited hospital and long term care organization will be required to begin submitting data through their selected measurements systems, to the Joint Commission relative to its selected measures no later than the first quarter of 1999. Because the Joint Commission will been comparative data for monitoring purposes, it is expected that actual data submissions will be performed by the participating performance measurement systems.

Other types of organizations accredited by the Joint Commission - clinical laboratories and home care, behavioral health care and ambulatory care organizations - are likely to be expected to meet the first two requirements by December 31, 1997, and to begin submitting data by the first quarter of 2000. These expectations will be refined and then finalized based on field readiness assessments this fall.

The new performance measurement expectations set forth above will be included in a new chapter entitled Accreditation Participation Requirements in each of the accreditation manuals. This chapter incorporates certain requirements currently found in the Accreditation Policies and Procedures sections of the manuals, such as requirements relating to the Public Information Interview.

Performance Evaluation System