Joint commission plans for clinical indicator development for oncology

on Accreditation of Healthcare Organizations'Agenda for Change is to establish an ongoing monitoring system based on indicators of clinical and organizational performance.'The purpose of this system is to allow both health care organizations and the Joint Commission to monitor trends of care across key operations of an organization between times of on-site surveys.The system will provide the health care organizations with comparative performance data and allow them to focus more eflectively on areas which need improvement in the delivery of quality care.The Joint Commission would utilize this informalion to focus its evaluation in subsequent survey and accreditation processes to those areas highlighted by the indicators and evaluate the health care organization's response to the indicator data.Thus, the purpose of the Joint Commission's efforts to develop clinical indicators is to provide a better means of surveying and accrediting health care organizations.What then is a clinical indicator from the prospective of the Joint Commission?An operational definition is that a clinical indicator is a quantative measure of an aspect of patient care which can be used as a guide to monitor and evaluate the quality and appropriateness of health care delivery.Some important caveats, however, must be noted.First, a clinical indicator as such is not a direct measure of quality; it is merely a screen or flag indicating areas which require more detailed analysis.The focus of the Joint Commission is not so much on the indicator data per se, but on the structures and processes that the hospital uses to investigate indicator data and respond appropriately to it.Second, all variances in indicator data do not necessarily indicate a "problem."This is the area in which "risk adjustment" or "severity of ill-Presented at the American College of Surgeons/American Cancer Society Workshop on Quality Assurance in Cancer Care.Chicago, Illinois, August 25-27, 1988.