New JCAHO Medication Management Standards for 2004

Darryl S. Rich


Am J Health Syst Pharm. 2004;61(13) 

In This Article

Review and Revision Process

The process of revising JCAHO's medication management standards was lengthy, lasting over two years, and involved input from numerous advisory and focus groups and committees, including a focus group from the American Society of Health-System Pharmacists (ASHP).

New medication management standards were drafted by JCAHO and sent to the JCAHO Small and Rural Hospital Committee, which evaluated the feasibility of implementing the standards. Cost was among the many considerations addressed by this committee. The JCAHO standards simplification panel streamlined and clarified the standards, eliminating nonessential elements, and the JCAHO Internal Standards Review Group evaluated the standards for consistency. The standards were then sent back to the advisory and focus groups for further input before going to a JCAHO professional and technical advisory committee (PTAC), which comprised representatives from many professional associations, including ASHP. JCAHO has multiple PTACs (one for each accreditation program), which assess the potential burden of complying and evaluating compliance with proposed standards and advise whether the standards should be approved or modifications are necessary. The JCAHO Standards and Survey Procedures (SSP) Committee, a subcommittee of the JCAHO Board of Commissioners, which includes the vice chair of each PTAC, approved changes in the proposed standards based on the advice given by the PTACs and sent the medication management standards for field review. More than 1000 comments were received from accredited hospitals, physicians, health care professional associations, and other individuals. Most field reviewers considered the proposed standards appropriate with modification (84%) and agreed that the standards would contribute to patient safety (70%). Most field reviewers (78%) thought that the new standards would result in increased costs but that the increased costs would be justified by the improvements in patient safety. The PTACs reviewed the field comments and suggested changes to the standards. The SSP Committee approved the standards based on this field review and the advice of the PTACs. The board of commissioners reviewed and approved the new standards, making one change in the wording of element of performance 1 for standard MM.4.10 in May 2003. Implementation was delayed until 2004 to coincide with implementation of the Shared Visions-New Pathways initiative, and the standards were rewritten to include elements of performance.[2]