Joint Commission perspective: using standards and indicators to monitor performance.

Two activities are concurrently underway at the Joint Commission on Accreditation of Healthcare Organizations: revision of standards for "Infection Control" which will continue to be used for the survey of hospitals development of the "Agenda for Change", a progress report on an extensive research and development project which is expected to use several infection control-related topics in the development of hospital-wide clinical indicators. This article outlines the Joint Commission's scope of services, and discusses the proposed new infection control standards and the topics to be pilot-tested for potential use as hospital-wide clinical indicators. The initiatives defined in the Agenda for Change, which involve several programmatic changes and modifications in the standards and survey procedures for the 1990s, are also addressed.