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.

Performance Measurement in Certification

In 2004, The Joint Commission launched the Health Care Staffing Certification Program to promote the quality and safety of temporary staffing services. Significant, on-going shortages of nurses, pharmacists, and other health care professionals were a key driver to fill positions with temporary workers through contractual arrangements with staffing firms. The Joint Commission certification program offered an independent, comprehensive evaluation of a staffing firm's abilities to provide competent staffing services.

Standardized performance measures were later integrated into the certification process. August 1, 2006, marked the beginning of a six-month pilot test of a candidate measure set. The pilot process, completed on January 31, 2007, tested the utility and reliability of a set of three standardized performance measures. Modifications were then made based on the feedback received from pilot site participants and recommendations from industry experts to finalize the measures used for certification.

Efforts to update the measure set based on historical measure data and feedback from multiple stakeholders in the healthcare staffing industry, including a panel of expert advisors, was initiated in 2020. In January 2022, revised and new performance measure requirements were implemented for all currently certified healthcare staffing firms, as well as, firms seeking initial certification.

Certification Measure Information Process

The Joint Commission uses the Certification Measure Information Process (CMIP) available on The Joint Commission Connect extranet to electronically receive performance measure data from certified healthcare staffing firms. Quarterly reporting of standardized performance measure data no later than 45 days following the end of the calendar quarter is a requirement to maintain certification. Monthly data points (numerator and denominator values) for each standardized HCSS measure should be submitted.