For 75 years, Joint Commission has played a central role in advancing healthcare quality and patient safety across the US. Today, the organization is undergoing a significant transformation, reframing how it partners with clinicians, surgical teams, and healthcare organizations.
For many surgeons, Joint Commission surveys have long been associated with extensive documentation, paperwork, and operational disruption. Accreditation was often perceived as focusing more on process compliance than on the realities of clinical care. While that perception was understandable, it no longer reflects today’s Joint Commission.
The organization has evolved from a guard dog to a guide dog—less focused on identifying failure and more focused on preventing it. Central to that evolution is the newly launched Survey Analysis for Evaluating STrengths (SAFEST™) program, which identifies and shares leading practices that advance quality and patient safety.
From Policing to Partnership
Historically, accreditation feedback focused almost exclusively on deficiencies. During a survey, Joint Commission representatives visited healthcare organizations to evaluate operational processes and identify opportunities for improvement. Teams of trained surveyors determined whether standards were in place and being followed appropriately. When deficiencies were identified, organizations were required to develop and implement corrective action plans. Failure to do so could affect reimbursement and licensure.
This process unquestionably improved the quality and safety of healthcare. Nevertheless, it also contributed to the apprehension many healthcare organizations felt leading up to a Joint Commission survey.
Today, the mission remains unchanged: ensuring that every patient receives the highest-quality, safest care possible. What has changed is the approach.
Through the SAFEST program, surveyors formally identify and document performance strengths—novel, innovative, or exceptionally reliable practices observed during a survey that contribute to safe, high-quality care. These strengths are summarized in a SAFEST report shared with the organization at the conclusion of the survey.
Rather than asking, Where did you fail? SAFEST asks, What should others learn from you? What are you doing right?
Joint Commission began collecting performance strengths during hospital and critical access hospital surveys in February 2026, and the initiative has been met with widespread enthusiasm. The long-term vision is to create a searchable database of leading practices that healthcare organizations can use to address common safety challenges.
Joint Commission currently accredits nearly 4,000 hospitals in the US. As SAFEST expands, surgeons can expect the accreditation process not only to identify gaps in care, but also to recognize and disseminate effective surgical safety practices as part of a dynamic, shared learning system.
The organization is using a sophisticated information platform to collect, evaluate, and categorize these data. In the not-too-distant future, surgeons and other healthcare professionals will be able to access proven practices at their fingertips, share successful approaches, strengthen benchmarking, and ultimately improve patient outcomes.
Why This Matters for Surgeons
Surgeons practice in environments where outcomes, reliability, and teamwork are paramount. Joint Commission’s evolution brings accreditation closer to those realities by highlighting excellence—not just deficiencies—and reinforcing a culture of learning rather than blame. In many ways, the approach mirrors the philosophy behind surgical quality improvement programs by promoting transparency, benchmarking, and continuous learning.
One of the most promising aspects of SAFEST is the opportunity to translate leading practices into practical tools that clinicians can use every day.
Consider the reprocessing of endoscopes, a critical patient safety issue. Under a SAFEST-informed model, a high-performing organization’s approach could be identified, validated, and shared broadly. Rather than relying solely on written standards, clinicians could access concise visual guidance—such as a short instructional video or checklist—demonstrating the key steps needed to ensure proper reprocessing.
Looking ahead, these resources could be delivered through mobile applications, allowing surgical teams to review essential steps immediately before a procedure. This kind of real-time support represents a fundamental shift from retrospective evaluation to prospective, point-of-care guidance.
For the surgical community, these changes signal a more engaged and practical partnership with Joint Commission. By integrating data, highlighting performance strengths, and delivering actionable insights, the organization is making safety guidance more accessible, relevant, and immediately useful.
The rigor that established a national baseline for patient safety is now being paired with tools and insights designed to accelerate improvement across the healthcare system. For surgeons and health system leaders, this evolution offers a more constructive, and ultimately more effective, path toward achieving the shared goal of safer care for every patient.
Accreditation is no longer simply something to “get through.” It can become another tool—alongside registries, peer review, and morbidity and mortality conferences—for advancing surgical quality, patient safety, and trust.
Disclaimer
The thoughts and opinions expressed in this article are solely those of Dr. Jacobs and do not necessarily reflect those of Joint Commission or the ACS.
Dr. Lenworth Jacobs is a professor of surgery at the University of Connecticut in Farmington and director of the Trauma Institute at Hartford Hospital in Connecticut.
