New JCAHO Medication Management Standards for 2004

Darryl S. Rich


Am J Health Syst Pharm. 2004;61(13) 

In This Article

What Changed

The new JCAHO medication management standards place a greater emphasis on medication safety than did previous standards. The new standards are also more prescriptive and have a larger number of more detailed requirements.

In addition, many standards related to medication use are now consolidated in a new and separate chapter on medication management. The new medication management standards can be found in the 2004 Comprehensive Accreditation Manual for Hospitals[3] as well as the 2004 Comprehensive Accreditation Manuals for Ambulatory Health Care, Behavioral Health, and Home Care and Long Term Care. The chapter will be expanded to manuals in other programs (e.g., critical access hospitals, networks) in 2005 or 2006. The glossary in each manual was expanded to include more definitions related to medication management.

Medication Management Process

The system for how health care organizations handle medications was renamed from "medication use" to "medication management" to better reflect the process. In the past, the medication-use process had four steps: (1) ordering and prescribing, (2) preparing and dispensing, (3) administration, and (4) monitoring. Two new steps have been added: (1) medication selection and procurement (i.e., formulary considerations) and (2) storage. They have been placed before the ordering step, which now includes transcribing medication orders. The chapter on medication management was reorganized around these six steps.

Definition of Medication

The definition of medication was revised ( Table 1 ) to include more examples, as the definition of the past was the source of many questions. The new definition is found in the glossary and preamble to the chapter and includes, but is not limited to, any product considered a drug by the Food and Drug Administration (FDA), with the exception of enteral nutrient solutions, oxygen, and other medical gases. The JCAHO definition of medication does not include enteral nutrient solutions because they are considered food products, nor does it include medical gases purchased in gaseous form because they are handled differently from medications. The definition does include anesthetic agents that are purchased in liquid form before becoming a gas. JCAHO has separate standards for nutritional products and medical gases.