Starting January 1, 2009, The Joint Commission implemented the Standards Improvement Initiative (SII). This involved revisions to the format, structure, numbering, and wording of standards and EPs. Redundant or nonessential standards and elements of performance were deleted, and similar standards and EPs were consolidated. Some EPs were split into separate requirements, and scoring categories were changed.

Under the new numbering method, each 2009 standard is assigned a six-digit number that refers to the standard’s place in the chapter outline. The first two digits refer to the Roman numeral in the Environment of Care (EC) outline. The second two digits refer to the letter under the Roman numeral in the outline, and the last two digits refer to the standard number. Figure 1 is an example of the standard EC.6.10 and its corresponding 2009 standard EC.02.04.01.

This article will provide an overview of where the requirements of the two main medical equipment standards (EC.6.10 and EC.6.20) and EC.9.10 have been moved. The chart in Figure 2 is the cross-reference between the 2008 standards EC.6.10, EC.6.20, EC.9.10 (EPs 1, 4, 5); the corresponding 2009 standards; and the specific Joint Commission requirement.

Figure 1


EC.02.04.01 EP 1: Selection and Acquisition of Equipment. This EP now requires that when a hospital selects and acquires medical equipment that it solicits input from those who operate and maintain equipment.

EC.02.04.01 EP 2: Inclusion Criteria and Inventory. The requirements in EC.6.10 EP 3 (inclusion criteria) and EC.6.20 EP 1 (inventory) have been consolidated into this new EP.

EC.02.04.01 EP 3: Maintenance Strategies.1 Reliability-centered maintenance (RCM) has been added as a new maintenance strategy for maintaining medical equipment. RCM is a process used to determine the maintenance requirements of any physical asset in its operating context (being used). The RCM process entails asking seven questions about the asset or system (equipment) under review. These questions include determining the cause of each failure and what can be done to prevent each failure.

2008 Standard 2009
2009 Joint Commission Requirement

EC.6.10 EP 1

EC.01.01.01 EP 7

Medical Equipment Management Plan

EC.6.10 EP 2

EC.02.04.01 EP 1

Selection and Acquisition of Equipment

EC.6.10 EP 3

EC.02.04.01 EP 2

Inclusion Criteria & Inventory

EC.6.10 EP 4

EC.02.04.01 EP 3

Maintenance Strategies

EC.6.10 EP 5

EC.02.04.01 EP 4

Maintenance Intervals

EC.6.10 EP 6

EC.02.01.01 EP 11

Hazard Notices and Recalls

EC.6.10 EP 7

EC.02.04.01 EP 5

Incident Reporting and Monitoring-Safe Medical Devices Act (SMDA) of 1990

EC.6.10 EP 8

EC.02.04.01 EP 6

Emergency Equipment Failure Procedures

EC.6.20 EP 1

EC.02.04.01 EP 2

Inclusion Criteria & Inventory

EC.6.20 EP 2

EC.02.04.03 EP 1

Performance and Safety Testing

EC.6.20 EP 3

EC.02.04.03 EP 2

Maintenance of Life Support Equipment

EC.6.20 EP 4

EC.02.04.03 EP 3

Maintenance of Non-Life Support Equipment

EC.6.20 EP 5

EC.02.04.03 EP 4

Performance Testing of Sterilizers

EC.6.20 EP 6

EC.02.04.03 EP 5

Dialysis Water Testing

EC.9.10 EP 1

EC.04.01.01 EP 10

Reporting to Safety/Environment of Care Committee

EC.9.10 EP 4

EC.04.01.01 EP 15

Annual Evaluation

EC.9.10 EP 5

EC.04.01.01 EP 15

Annual Evaluation

Figure 2

EC.04.01.01 EP 10: Reporting to Safety/Environment of Care Committee. In this EP, the term “user error” has been replaced with “use error.” This reinforces the fact that rather than blaming the user, error prevention depends on a number of factors including device design (human factors), environment, or a situation promoting incorrect use.

EC.04.01.01 EP 15: Annual Evaluation.

The requirements in EC.9.10 EP 4 and EC.9.10 EP 5 have been consolidated into this new EP.


  1. For more details about RCM, see the January 15, 2009 ACCE teleconference on Advancing Medical Equipment Maintenance using RCM Methodology by Malcolm Ridgway ( and Reliability-centered Maintenance by John Moubray (1997).

Arif Subhan, MS, CCE, is a senior clinical engineer, Masterplan, Chatsworth, Calif; adjunct assistant professor, biomedical engineering, University of Connecticut; and a member of 24×7’s editorial advisory board. For more information, contact .


  1. The 2009 Joint Commission standards use a new numbering method where each standard is assigned a ____ digit number.
    1. Three
    2. Six
    3. Four
    4. Two
    5. None of the above

    See the answer

  2. The 2009 Joint Commission standard EC.02.04.01 EP 1 requires the hospital to solicit input from those who ____ when it selects and acquires medical equipment.
    1. Operate medical equipment
    2. Maintain medical equipment
    3. Operate or maintain medical equipment
    4. Operate and maintain medical equipment
    5. None of the above

    See the answer

  3. The 2009 Joint Commission standard EC.02.04.01 EP 3 has a new maintenance strategy added for 2009 which is ____.
    1. Predictive maintenance
    2. Corrective maintenance
    3. Reliability-centered maintenance
    4. Metered maintenance
    5. None of the above

    See the answer

  4. The requirements in the standards EC.6.10 EP 3 and EC.6.20 EP 1 have been consolidated into a new standard _________.
    1. EC.02.04.01 EP 2
    2. EC.02.04.01 EP 3
    3. EC.04.01.01 EP 15
    4. EC.02.04.01 EP 5
    5. None of the above

    See the answer