The Joint Commission's Agenda for Change: what does it mean for equipment managers?

As the Agenda for Change unfolds, several major changes will take place. Organizations seeking accreditation will face potentially greater pressure to improve as accreditation and performance data become more available to the public and payers. Future accreditation decisions will be based more on observed, demonstrated, and measured performance than on statements of policy and practice. Key to this in the survey process are the new unit-based survey and the use of indicators. Finally, accreditation evaluation activities provided by the Joint Commission will become a more persistent part of the life of accredited organizations. New activities will include an annual contact to update demographic information, the random, unannounced survey process, and frequent data and information exchanges based on the indicator database. The goal of these changes is to get closer to the real work of patient care through measurement and assessment of organizational competence, performance, and ability to change. The challenge facing clinical engineers as equipment or technology managers is to extend their vision of the equipment management process beyond the engineering needs of medical equipment. The key focus of the new Joint Commission standards and accreditation process is the acquisition and use of information. Equipment, as it becomes more complex, requires more user knowledge to be applied effectively. As part of the information highway, the clinical engineer of tomorrow must focus on the information content of the equipment being introduced and determine the most effective method of transferring the information into user "brainwave."