Guarding quality in challenging times. Interview by Emily Friedman.

As Dennis S. O'Leary, MD, FACPE, reaches the 18-month mark in his tenure as president of the Joint Commission on Accreditation of Hospitals, Chicago, the organization's future is a foremost concern. In this concluding article of a two-part series, he discusses his vision of where the Commission is going, and how and why. Among key issues that will affect the Joint Commission's future, he says, are changing determinants of quality, evaluation of nonhospital organizations, the interplay of the increasingly diverse individuals and groups that participate in Joint Commission activities, and Joint Commission relations with key health professions and other interest groups, including consumers. The first article, which focused on the Joint Commission's "clinical indicators" project, was published in the July-August issue of Physician Executive.