Development of the Joint Commission's indicators for monitoring the medication use system

The Joint Commission on Accreditation of Healthcare Organizations, as part of the Agenda for Change, has directed extensive efforts toward the development and testing of patient care indicators. The medication use indicators are designed to target processes and outcomes of the drug use system as defined by five major components: 1) selection and prescribing, 2) preparation and dispensing, 3) administration, 4) monitoring and 5) systems management/control. The indicators focus on several aspects of the drug use process including: serum drug level monitoring, medication errors, adverse drug reactions, patient teaching, pharmacist interventions and the appropriateness of prescribing. The testing of indicators is currently underway at test-site hospitals and includes 2 major phases: Alpha and Beta. Alpha-testing is designed to assess the face validity and collectability of the indicators, while Beta-testing will evaluate data collection and analysis as well as the reliability of the indicators. These indicators are intended to serve as measures of aspects of patient care that can be used to guide and monitor the quality and appropriateness of health care delivery and to facilitate continuous improvement in care.