The United States health care system is under a period of rapid change. Managed care growth, technological changes and a growing population is forcing the American health system to reform and change its traditional health care model.

With the rapid changes in the health care system, oversight of these changes will be crucial to ensure compliance. Health care providers will be facing challenges and pressures on implementing the changes from reform. Ensuring that the changes brought from reform are followed and evaluated will ensure the American public is receiving health care from providers that is safe, effective, and appropriate.

Third party oversight to health care providers in the United States will need to be performed. In order for reform to take place health care organizations will need to obtain an accreditation from an accrediting organization tha

censure and schedule and pass another survey.

The Joint Commission is facing challenges of it's own. The Tucson Heart Hospital laboratory department was recently surveyed by JCAHO and I asked Diane Bertrand a few questions about the challenges that JCAHO has been under. Diane Bertrand stated that the Joint Commission has been under increased pressure for the government to survey hospitals more stringently. She also stated that different surveyors interpret the standards differently which causes confusion and frustration when an institution is surveyed again and is cited for not meeting a standard when the previous surveyor thought the standard was met. Another challenge she felt that JCAHO was facing was a shortage of surveyors. Many surveyors have retired or resigned from JCAHO that has created pressure on existing surveyors to survey more organizations. Teaching and training new surveyors takes a

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