​The standard that an organization "establishes and maintains a safe, functional environment" was the most challenging requirement for hospitals in 2016, according to compliance data released by the Joint Commission on March 29, 2017. More than two-thirds (68%) of hospitals were noncompliant with that requirement, while 60% of hospitals did not comply with the standard requiring that hospitals reduce the risk of infection associated with medical equipment and devices. This was also the standard most frequently not met by ambulatory care clinics (53% noncompliant). Reducing the risk of infections from medical equipment was the second most challenging requirement for critical access hospitals (64% noncompliant), behind only the requirement that the facility manages risks associated with its utility system (67% noncompliant.) The full release lists the top five most challenging requirements for ambulatory care, behavioral health care, critical access hospitals, home care, hospitals, laboratory and point-of-care testing, nursing care centers, office-based surgery practices, palliative care certification, disease-specific care certification, and health care staffing services certification. The Joint Commission also released a list of frequently ask questions about how to interpret its standards.

HRC Recommends: Organizations must know and address not only their high priority risks but also risks that might become high priorities, such as risks that occur with the use of new technology or care delivery models. As healthcare strives to become an industry of high-reliability organizations, risk managers must remain aware that part of being a high-reliability industry means staying vigilant and identifying problems proactively. By adhering to accreditation standards and identifying and managing newly emerging risks proactively, patient safety can be improved across the continuum of care. Risk managers should know whether their organizations are experiencing problems with adherence to Joint Commission standards and also be aware of the top 10 patient safety risks identified by ECRI Institute and determine whether they have processes and systems in place to address them.