From JCI 7th Edition to the 8th -From “Achieving Accreditation” to “Sustaining Global Standards”-

For healthcare organizations that have already achieved JCI accreditation,

renewal is never simply a repetition of the initial accreditation process.

Through our extensive experience supporting hospitals worldwide, we have seen that renewal brings its own, very specific challenges:

• Standards that were fully met at the time of initial accreditation may, due to revisions, no longer align with current requirements

• Policies, procedures, training programs, and KPIs may still exist, yet no longer reflect the intent or effectiveness expected under the latest JCI standards

• Staff turnover and organizational changes can lead to the loss of institutional knowledge and original operational intent

JCI renewal is best understood as

a process of reassessing existing operations and realigning them with the latest international standards.

This process requires a different level of expertise from that needed for initial accreditation.

 What Has Changed in the JCI 8th Edition

While the 8th Edition builds upon the foundation of the 7th,the focus of evaluation has clearly shifted.

1. From “Having Systems in Place” to “Demonstrating Effectiveness”

Under the 7th Edition, assessment often emphasized whether:

• Policies and procedures existed

• Staff training was conducted

• Documentation was maintained

In the 8th Edition, these elements alone are no longer sufficient.

Surveyors now place stronger emphasis on whether:

• Processes are consistently implemented in daily practice

• Outcomes are measured through data and used for improvement

• Patient safety and quality of care are demonstrably improved

In short, effectiveness, not mere existence, has become a central evaluation criterion.

2. From Frontline Effort to Organizational Accountability

The 8th Edition clearly signals that patient safety and quality should not depend solely on frontline efforts.

With strengthened emphasis on:

• Governance, Leadership, and Direction (GLD)

• Quality Improvement and Patient Safety (QPS)

• Accreditation Participation Requirements (APR)

JCI now evaluates how leadership and governance bodies oversee, manage, and sustain quality and safety at an organizational level.

For renewal organizations, this represents a significant shift:

“It is working in the field” is no longer enough—

clear organizational design, decision-making, and oversight are required.

3. From Internal Compliance to Social Accountability

The 8th Edition also reinforces the need for transparency and accountability to patients, families, and society.

Hospitals are expected to clearly explain:

• What JCI accreditation represents

• How patients and the public can raise concerns or seek guidance

• How the organization fulfills its responsibilities to society

The strengthening of APR and the introduction of GHI (Global Health Impact) symbolize JCI’s evolution toward evaluating hospitals as social actors, not just clinical institutions.

GHI formally incorporates the perspective of how healthcare delivery impacts communities, society, and global health beyond hospital walls.

Renewal Success Requires Redesign, Not Addition

Successfully adapting to the 8th Edition does not mean simply adding new documents or committees.

What matters is reassessment:

• Do existing policies reflect the intent of the latest standards?

• Are KPIs and QI activities truly driving improvement, not just measurement?

• Is the PDCA cycle functioning meaningfully, rather than becoming routine paperwork?

Renewal success depends on redesigning hospital systems through the lens of the 8th Edition, rather than layering new requirements on top of old frameworks.

At Afya Management and Innovation, we combine deep expertise in JCI accreditation with healthcare management consulting to support renewal efforts that strengthen both quality improvement and sustainable organizational performance.

Conclusion

The JCI 8th Edition is not merely a revision of standards.It represents a fundamental shift in perspective—from asking whether accreditation has been achieved,to asking whether global standards are being sustainably upheld by the organization as a whole.

For hospitals already accredited, renewal is not a process of negating past efforts.

Rather, it is an opportunity to refine and elevate accumulated practices in line with evolving international expectations.

We also recognize how challenging it can be to address these changes while maintaining daily clinical operations.Rising expectations around quality, patient safety, governance, and social responsibility require thoughtful, structured responses.

At Afya Management and Innovation, we view JCI accreditation not as an endpoint,

but as a framework for sustaining excellence in healthcare quality and management.

We hope that renewal becomes an opportunity—not just for compliance,but for meaningful reflection on organizational culture and long-term direction.

If you are preparing for renewal, or if you feel uncertainty about how current operations align with the 8th Edition, please feel free to contact us.

We also invite you to read our related blog on GHI (Global Health Impact), newly introduced in the JCI 8th Edition, for a deeper understanding of this important new perspective.

>Our Blog on GHI

JCI Reaccreditation Consultation Service