The Joint Commission Elevates Healthcare Equity Standard to National Patient Safety Goal

The Joint Commission announced it is elevating Leadership (LD) Standard LD.04.03.08 – which addresses health care disparities as a quality and safety priority – to a new National Patient Safety Goal (NPSG) for all critical access hospitals and hospitals, as well as some ambulatory care organizations and behavioral health care and human services organizations that provide certain services, effective July 1, 2023. 

Current requirements for Joint Commission-accredited organizations will not change. The intent behind the standard and associated elements of performance will remain the same; however, they will now be stated as NPSG Goal 16. The purpose of NPSGs is to improve patient safety – focusing on significant problems in health care and specific actions to prevent and solve them.

Accredited health care organizations will still be required to:

  • Identify an individual to lead activities to improve health care equity.
  • Assess patients’ health-related social needs.
  • Analyze quality and safety data to identify disparities. 
  • Develop an action plan to improve health care equity. 
  • Act when the organization does not meet the goals in its action plan. 
  • Inform key stakeholders about progress to improve health care equity.

“The new National Patient Safety Goal will help increase the focus on improving health care equity, a global patient safety priority,” says Jonathan B. Perlin, MD, PhD, MSHA, MACP, FACMI, president and chief executive officer, The Joint Commission. “Everyone needs a chance for safe, equitable and meaningful care. As such, equity must be the foundation for safety and quality in health care. By elevating the existing standard to a National Patient Safety Goal, we are emphasizing the importance for health care organizations to ensure oversight and accountability for health care equity.”

Following the implementation of NPSG Goal 16, Standard LD.04.03.08 will be deleted.

Information on the research used to develop the requirements, including rationales and references, are available in R3 Report, Issue 38: National Patient Safety Goal to Improve Health Care Equity. Additionally, the new NPSG is posted on The Joint Commission’s Prepublication Standards page until July 1. 

Joint Commission, National Patient Safety Goal, NPSG

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