Development of medication-use indicators by the Joint Commission on Accreditation of Healthcare Organizations

The development of indicators for monitoring medication use is described. The Joint Commission on Accreditation of Healthcare Organizations is establishing a national database for use in measuring performance. Initially, indicators were developed for specialties or clinical departments and for disease entities or procedures; now, indicators for key functions that cross departmental and specialty lines, such as medication use, are under development. An interdisciplinary core group constructed a medication-use flow chart depicting prescribing, dispensing, administering, and monitoring patient response; systems management/control was recognized as a fifth component. Sixteen processes were identified for which indicators were developed. Proposed indicators are now being tested in a small number of hospitals. The indicator data will enable institutions to identify areas for improvement. Although the Joint Commission will not use indicator rates per se to determine accreditation, it will ask an institution to provide an interpretation of indicator data that differ markedly from previous data or data for comparable institutions and to review its strategy for analyzing the rates. Use of indicator data will enhance the accreditation process by allowing for ongoing monitoring of particular aspects of performance between onsite surveys.