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 sets of valid, reliable, and evidence-based quality measures
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 places 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:
Beginning in January 2012, The Joint Commission also incorporated a standards-based expectation for minimum performance on ORYX® accountability measures against which hospitals are surveyed and requirements for improvement (RFIs) can be made
The Joint Commission has developed a target measure range approach (target analysis) as a basis to evaluate Joint Commission accredited organizations' rating for the performance measures.
The use of target analysis in addition to a control chart is a key feature of the Joint Commission's analytic methods in the ORYX® initiative. The two analyses are alike in that an organization's actual (or observed) performance level is evaluated against a comparative norm, but are fundamentally different as to how such a norm is established. In control chart analysis, the norm is determined from an organization's own historic data so that one may assess the organization's internal process stability. In target analysis, the norm is obtained based on multiple organizations' performance data to evaluate an organization's relative performance level. Therefore, the two analyses evaluate an organization's performance in two distinct perspectives and, as a result, can provide a more comprehensive framework to assess an organization's overall performance level.
The ORYX® Performance Measure Report assists health care organizations in using their ORYX® data for ongoing performance improvement activities. Joint Commission surveyors receive an identical copy of the report prior to an onsite survey. Surveyors use the report as a guide to understanding how the organization uses and responds to performance measure data. The report, available quarterly, summarizes performance measure information at both the measure set and individual measure level. This includes highlighting measures with standards compliance issues and performance issues.
The Joint Commission uses two methodologies for performance measurement for disease-specific care programs. Each certified program collects either standardized or nonstandardized measures, as directed by The Joint Commission. During the certification review the program will demonstrate that it has established a data history that supports quality improvement. Selected standardized measure sets have been incorporated in this specification manual to centralize the measures used for Joint Commission programs into one manual. For more information on the certification process refer to The Joint Commission website and the specific certification program of interest.
Individuals are also able to determine how healthcare organizations compare with others in meeting national requirements that help them prevent devastating medical accidents. The requirements specifically seek to avoid misidentification of patients, surgery on the wrong body part, miscommunication among caregivers, unsafe use of infusion pumps, medication mix-ups, problems with equipment alarm systems, and infections acquired in the healthcare setting.
Consumers can access Quality Check at http://www.qualitycheck.org and search for healthcare organizations by name, type, and/or location. Interactive links to information are designed to help individuals better understand how to use and interpret the information presented.