Joint Commission International Accreditation Standards for Hospitals, 4th Edition provides the basis for accreditation of hospitals throughout the world, supplying organizations with the information they need to pursue or maintain patient safety, performance improvement, and accredited status starting 1 January 2011. Important improvements to this edition include the following: Improve the Safety of High-Alert Medications, International Patient Safety Goal 3 (IPSG.3), covers all high-alert medications used by the organization. The Access to Care and Continuity of Care chapter (ACC) has new requirements on the need to stabilize emergency patients prior to transfer to another organization and the need to strengthen the integration of outpatient information for patients provided ongoing care from multiple clinics. The Patient and Family Rights chapter (PFR) introduces a requirement that the organization offers or facilitates second opinions when requested by the patient. The Assessment of Patients chapter (AOP) includes a new requirement regarding timely reporting of critical laboratory test results. The Quality Improvement and Patient Safety chapter (QPS) has expanded requirements on comprehensive risk management framework as a tool for the reduction of adverse events and two new standards are intended to focus organizations on the quality of the data they collect and use in their improvement activities. The Prevention and Control of Infections chapter (PCI) expands requirements regarding the reuse of single-use devices. The Governance, Leadership, and Direction chapter (GLD) calls for greater oversight of organizational contracts and independent practitioners, as well as establishing a framework for ethical management to ensure that patient care is provided within business, financial, ethical, and legal norms and that protects patients, their families, and employees.