Quality assurance, control, and monitoring. The future role of information technology from the Joint Commission's perspective.

In summary, the Joint Commission's current perspective on "quality assurance" in the 1990s includes three different, but complementary, activities: 1) structure and process triennial reviews (Joint Commission surveys); 2) Case-based reviews conducted by professional review organizations and/or other third parties; and 3) a combination of internal and external data-driven improvement systems. All these systems will work best supported by computers and software programs that foster the manipulation and management of data related to quality of care monitoring systems in addition to those in use today to monitor the hospital's profit and loss position. The Joint Commission's accreditation decision process will continue to be based on surveys of compliance with standards and their key characteristics. Problems related to the organization's performance against the external monitoring systems will not directly impact accreditation status. The Joint Commission will be more interested in how the organization responds to aberrant indicator data and how it conducts problem solving activities. New Joint Commission standards (yet to be developed) will relate to such activity and only then, after standards are written, field tested, and published, could the information generated by the Joint Commission's external indicator monitoring system impact on accreditation status. During a speaking engagement in Florida, a physician on the panel with me from the state's physician monitoring organization shared the following diagnostic label: "Mural Graphic Dyslexia." He defined it as the inability to read the handwriting on the wall. I believe that the handwriting is very clear and can be read very well. Data-driven quality improvement processes are the survival tools of the future.(ABSTRACT TRUNCATED AT 250 WORDS)