ORYX: March 2 is breathing down your neck

Pay special attention to global measures

Although you now have some breathing room for reporting your ORYX data to the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, don’t get too comfortable. March 2 is nearly upon us, and all the remaining ORYX deadlines that were previously established remain unchanged.

The agency extended for 60 days from Dec. 31, 1997, its deadline for hospitals and long-term care organizations to select a performance measurement system and indicators for its ORYX initiative. Its motive seems consistent with its intent to keep the initial requirements simple. So you have till March 2 to report the measurement system you’ve selected (or have already enrolled in) and a maximum of five acceptable clinical measures relevant to your internal performance improvement activities.

The 60-day extension came in response to growing concerns regarding the significant numbers of measures that are needed to address the targeted 20% of the organization’s patient population. "Doing a quality project like ORYX takes effort. I don’t think the dust has fully settled on this," says Robert Pollack, MD, director of Professional Quality Analysts in Casselberry, FL.

Last fall the Joint Commission reviewed some measures that facilities had submitted. Reviewers determined they were unsuitable and didn’t apply to the accreditation process. Most rejected measures were global — for example, overall hospital mortality — and didn’t lend themselves to interorganization performance comparisons or to internal root-cause analysis.

Organizations have found that when those global measures were eliminated, it became next to impossible to meet ORYX’s target of 20%, even with the use of multiple measures. So the measures were capped at five. Now each accredited organization is being asked to select a sufficient number of measures to address 20% of its patient population or five measures, whichever is fewer. The minimum number of required measures remains unchanged at two.

"Financially based measures are not reportable either," says Eric Kriss, CEO of MediQual Systems in Westborough, MA, "so anything having to do with charges or the cost of a hospital stay can not be included."

Once you’ve met the March 2 deadline, you’ll be expected to have actually enrolled in the measurement systems you’ve finally selected and to have committed to specific measures by June 30, 1998. You can make any changes you wish in your initial selections up until that date. The fit between an organization’s measurement needs and the scope and types of measures offered by various systems is expected to be a key factor in the selection of specific measurement systems by organizations.

Patient population monitoring targets for coming years have been reduced, and caps on the numbers of measures required in coming years have been set. (See table of requirements, above.) Future changes in requirements are incremental.

To begin submitting data to the Joint Commission through measurement systems by the end of the first quarter of 1999 as required under ORYX, you have to begin collecting data during the third quarter of this year.

The Joint Commission’s ORYX information line can provide you with more information: (630) 792-5085.