Recent changes in JCAH standards affecting the accreditation of psychiatric facilities.

During the past five years, the Accreditation Manual for Hospitals (AMH) has undergone two separate but not entirely unrelated revisions: the incorporation of psychiatric and substance abuse standards, a step that allowed all hospital-based psychiatric services to be surveyed through the AMH and that had implications for both psychiatric and nonpsychiatric patients, and the rewriting of the standards in the medical staff chapter, which relates to staff composition and organization, staff responsibilities, and medical staff quality assurance activities. The author discusses some of the forces behind the revisions, the specific changes resulting from each revision process, and the rationale for the changes.