The Joint Commission revises volume criteria for cardiac, stroke certifications

Editor's Note

The Joint Commission announced significant updates taking effect immediately to the eligibility requirements for its cardiac and stroke certifications, developed in collaboration with the American Heart Association (AHA) and the American Stroke Association (ASA). According to the April 2 announcement,  key revisions involve the removal of percutaneous coronary intervention (PCI) volume thresholds from several cardiac certifications and a reduction in the annual aneurysmal subarachnoid hemorrhage (aSAH) interventions required for stroke certification.

These decisions follow an extensive literature review conducted by The Joint Commission and the AHA/ASA to assess any potential relationship between a facility’s patient volume and its quality and safety outcomes. Through close consultation with stakeholders and organizations that The Joint Commission serves, it became clear that eliminating or adjusting these volume-based requirements would enable more facilities to achieve certification and further standardize high-quality patient care.

New criteria by certification type is as follows:

• Primary Heart Attack Center (PHAC): Previously, eligibility required 200 PCI procedures per year and 36 primary PCI procedures annually for STEMI and STEMI-equivalent patients. Under the new guidelines, those volume requirements have been removed entirely.
• Comprehensive Heart Attack Center (CHAC) & Comprehensive Cardiac Center (CCC): The prior requirement of 400 PCI procedures per year, including 36 primary PCI procedures for STEMI and STEMI-equivalent patients, has been eliminated, allowing additional programs to seek certification without strict volume constraints.
• Comprehensive Stroke Center (CSC): The annual requirement of 20 aSAH interventions has been reduced to 10. This change is designed to enable more stroke centers to pursue CSC certification, provided they maintain safe, evidence-based practices.

Despite these revisions, The Joint Commission will continue collecting volume data through its E-Application process to maintain insight into each program’s patient load. The official update will appear in the Comprehensive Certification Manual for Disease-Specific Care in January 2026, though again, the changes take effect immediately. The E-Application itself will be updated soon to reflect these modifications.