This article first appeared in the February 2021 issue of Joint Commission Perspectives®, the official newsletter of The Joint Commission.

Effective July 1, 2021, The Joint Commission will offer the Advanced Certification in Spine Surgery (ACSS). Participation in the American Spine Registry (ASR), a collaborative effort of the American Association of Neurological Surgeons (AANS) and the American Academy of Orthopaedic Surgeons (AAOS), is needed to meet the certification’s registry requirement and facilitate the calculation of performance measures.

Currently, The Joint Commission certifies spine surgery programs in more than 100 health care organizations through its foundational Disease-Specific Care (DSC) Certification Program. ACSS goes beyond the core DSC standards to assess an organization’s spine surgery program more in depth. This new program will address the various domains related to spine surgery such as program structure, delivery of care, care coordination, and performance measurement.

The ACSS program was developed with the help of a spine surgery technical advisory panel composed of clinical experts with specific knowledge of this type of care including clinical leadership from the ASR. ACSS standards improve quality and safety for spine surgery patients. Components of the new program include the following:

  • On-site intraoperative observations by Joint Commission reviewers
  • Consistent communication and effective collaboration among all health care providers involved in the care of the patient from the initial spine surgery consultation through the follow-up visit with the spine surgeon after discharge
  • Demonstrated application of and compliance with clinical practice guidelines, which may include the guidelines and recommendations published by the AAOS, American Society of Anesthesiologists (ASA), National Association of Orthopaedic Nurses (NAON), and North American Spine Society (NASS)
  • Data collection for clinical performance measures through the ASR

The Joint Commission, in collaboration with ASR surgeon leaders, adopted four standardized measures (see the following table) from the ASR. Data collection for these measures must commence four months prior to the initial certification review for organizations seeking certification. Data collection is then ongoing thereafter for all ACSS-certified organizations.

ACSS Measures Table

Further details regarding the standardized performance measures, including measure descriptions, specifications, and education for abstracting the measures, are forthcoming. Questions regarding the measures may be sent to the ASR at

The standards are available on The Joint Commission’s Advanced Certification in Spine Surgery page and will publish online in the spring 2021 E-dition® update to the Comprehensive Certification Manual for Disease-Specific Care (DSC).

For questions about the ACSS standards, please contact Helen Lairos, MBA, MSN, RN, Project Director, Department of Standards and Survey Methods, at



Copyright 2021 The Joint Commission

Joint Commission Perspectives®, February 2021, Volume 41, Issue 2