Introduction and Background

The Joint Commission Quality Initiative

In 1987, The Joint Commission announced its Agenda for Change, which outlined a series of major steps designed to modernize the accreditation process. A key component of the Agenda for Change was the eventual introduction of standardized core performance measures into the accreditation process. As the vision to integrate performance measurement into accreditation became more focused, the name ORYX® was chosen for the entire initiative. ORYX® is The Joint Commission's performance measurement and improvement initiative, which integrates outcomes and other performance measure data into the accreditation process.

The ORYX® initiative became operational in March of 1999, when performance measurement systems began transmitting data to The Joint Commission on behalf of accredited hospitals. ORYX® measurement requirements are intended to support Joint Commission accredited organizations in their quality improvement efforts.

The initial phase of the ORYX® initiative provided healthcare organizations a great degree of flexibility in terms of the measures that could be reported. Over time, the ORYX® measures have evolved into standardized valid, reliable, and evidence-based quality measures

Related Joint Commission Activities

Accreditation Process

In January 2000, Joint Commission surveyors began using organization-specific ORYX® Pre-Survey Reports, effectively commencing the use of performance measure data in the survey process.

In 2004, the survey process was substantially modified to be more data-driven and patient-centered thus enhancing its value, relevance, and credibility. Many of the key components of the survey process utilize data derived from the national hospital inpatient quality measures. The survey process now has a greater focus on evaluating actual care processes because patients are traced through the care, treatment and/or services they receive. In addition, surveyors conduct “systems tracers” to analyze key operational systems that directly impact the quality and safety of patient care.

In June 2010 The Joint Commission categorized its process core performance measures into accountability and non-accountability measures.  This approach placed more emphasis on an organization's performance on accountability measures — quality measures that meet four criteria designed to identify measures that produce the greatest positive impact on patient outcomes when hospitals demonstrate improvement:

• Research:  Strong scientific evidence demonstrates that performing the evidence-based care process improves health outcomes (either directly or by reducing risk of adverse outcomes).
• Proximity:  Performing the care process is closely connected to the patient outcome; there are relatively few clinical processes that occur after the one that is measured and before the improved outcome occurs.
• Accuracy: The measure accurately assesses whether or not the care process has actually been provided.  That is, the measure should be capable of indicating whether the process has been delivered with sufficient effectiveness to make improved outcomes likely.
• Adverse Effects:  Implementing the measure has little or no chance of inducing unintended adverse consequences.

In 2021, The Joint Commission released the Assisted Living Community accreditation program and applied the same approach to selecting performance measures for the assisted living community setting.

Direct Data Submission Platform

The Joint Commission began accepting direct data submission of clinical quality measure data from organizations with the submission of calendar year (CY) 2017. The Direct Data Submission Platform enables an ORYX measure submission process that simplifies operations and reduces the burden for our accredited organizations while ensuring regulatory compliance and security.