Standards development is an ongoing, dynamic process that continually incorporates the experiences and perspective of health care professionals and other individuals and organizations throughout the world. The process for the development of standards should:

1. Focus on those functions and aspects of patient care that are essential to the safety and quality of patient care;
2. Apply to all organizations and across all services;
3. Represent a consensus on the state-of-the-art in expected organization operation
4. State, to the extent possible, objective or principles, rather than specific mechanisms for meeting the requirements;
5. Be reasonable and achievable; and
6. Be surveyable.

The standards development process could involve developing an entirely new manual of standards for a specific program, such as for healthcare organizations, telehealth, advanced infection prevention and control, etc. or modification of existing standards.The need to develop new or revised standards is prompted by various issues, such as:

1. New and emerging organization configurations or structures of delivery systems, such as Medical Travel Programs, Telehealth, and the like.
2. Strategic issues, such as developing standards in areas similar to competing accreditation and certification bodies.
3. Specific quality and safety of patient care, such as infection control.
4. Changes in technology, practice, or other issues in the international health care environment.
5. Research-based information, which may make apparent the need to modify standards requirements.
6. The need to incorporate the standards and guidelines from international organizations such as the World Health Organizations.
7. Specific concerns expressed by national and international professional organizations.

PHASES OF THE STANDARDS DEVELOPMENT PROCESS

PHASE I. This phase is ongoing.
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1. The need for new or revised standards is identified. Evidence from Regional Advisory Councils, surveyors, accredited organizations, staff and others is considered.

PHASE II. This phase will take up to three months.

2. The standards are drafted by staff and may involve outside experts. In drafting the standards, attention is paid to the documentation of the evidence basis for the proposed new or revised standards, and attention is paid to documentation of the cultural, religious, ethnic, regulatory and other factors that may influence compliance with the standards.
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3. The draft standards are reviewed by the Standards Committee and makes a recommendation for continued drafting or for field evaluation.

PHASE III. This phase will take up to six months.

5. Staff introduce the draft standards to stakeholder groups for field review and comment. The internet is used to facilitate wide distribution and review, national and/or regional panels are used as well as the standards are sent to individual experts for comment.
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6. Based on the comments generated during field evaluation, the standards are revised. At this juncture planning begins for the final publication of the standards and the survey process is designed and tested.
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7. The final draft of the standards are presented to the Standards Committee for review and comment.
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8. Edits are made if necessary.
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9. The GHA CEO reviews and approves the standards.
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10. The standards are published, their availability and effective date announced.