The Joint Commission's 2026 National Performance Goals

If you've been in a patient safety meeting recently, someone in the room has probably said "National Patient Safety Goals" — and been gently corrected.

They're gone.

Effective January 1, 2026, the Joint Commission officially replaced its National Patient Safety Goals (NPSGs) with a new framework: the National Performance Goals (NPGs). For hospitals, critical access hospitals, and nursing care centers, this isn't a cosmetic rebrand. It's a meaningful shift in how accreditation bodies expect patient safety to be measured, documented, and improved.

For clinical leaders focused on fall prevention and pressure injury reduction, it's worth understanding exactly what changed — and what the new framework actually demands.

What Were the National Patient Safety Goals?

The NPSGs have been a cornerstone of Joint Commission accreditation since 2003. Each year, the Joint Commission identified a set of critical patient safety priorities — things like correct patient identification, medication safety, and fall prevention — and required accredited organizations to implement specific evidence-based practices to address them.

They were prescriptive: here are the practices, implement them, document compliance. The framework worked, but it had limits. Critics noted that it focused more on process compliance than measurable outcomes.

What Are the National Performance Goals — and What Changed?

The NPGs are 14 high-priority, measurable topics organized to make it easier for hospitals to track progress and demonstrate improvement on key areas of patient safety and care quality. According to the Joint Commission, the NPG chapter organizes requirements that rise above regulation into salient, measurable topics with clearly defined goals.

The critical distinction is in that word: measurable.

The shift from NPSGs to NPGs signals a move from "are you doing the right things?" to "are you achieving the right outcomes?" That's a fundamentally higher bar — and it has direct implications for how hospitals approach fall prevention.

Fall prevention remains a core priority in the NPG framework. Falls with serious injury are classified as serious reportable events (SREs) under Joint Commission accreditation, and the new framework strengthens the expectation that hospitals will demonstrate evidence-based, measurable reductions in fall rates — not simply document that a fall prevention program exists.

Why This Matters More Than Most Leaders Realize

Here's the practical implication of the NPG shift: documenting that you have a bed alarm policy no longer tells the same story it once did.

The NPG framework asks hospitals to show movement on outcomes. That means your fall rate. Your falls-with-injury rate. Your hospital-acquired pressure injury (HAPI) rate. These are the metrics that matter now — and that surveyors will increasingly want to see trending in the right direction.

This is where many hospitals face a structural problem. Traditional fall prevention tools — bed and chair pads, sitter programs, call lights — are reactive by design. They notify staff after a patient has already begun to move. They measure activity, not risk. And they generate enormous volumes of false alarms that contribute to one of the most well-documented hazards in acute care: alarm fatigue.

If your fall prevention program is built primarily on reactive tools, meeting the outcomes-focused intent of the NPG framework will be an uphill challenge. The data simply won't show the kind of measurable improvement the new standard expects.

What "Measurable Outcomes" Looks Like in Practice

The hospitals we work with that have achieved the most measurable fall reduction share a common approach: they moved from monitoring to prevention.

The distinction matters. Monitoring means watching patients and alerting staff when something happens. Prevention means identifying risk before it becomes an event — and doing something about it while there's still time.

VSTOne's ambient vision AI detects fall risk 31 to 65 seconds before a fall occurs — not after. That's not a faster alarm. That's a fundamentally different intervention window. And it's what turns a monitoring system into a prevention system.

Across active VirtuSense deployments, we've validated:

• Greater than 61% reduction in falls
• 50% reduction in falls with injury
• Greater than 60% reduction in pressure injuries (HAPI)
• 98% reduction in false alarms compared to traditional bed and chair pads
• 116 hours of nurse documentation time saved per unit per month
• Replace NPSG references in internal policies and committee materials with NPG language
• Identify which of the 14 NPGs are most directly tied to your current quality priorities — fall prevention, pressure injuries, and HACs should be near the top
• Audit your current fall prevention program against an outcomes lens: can you demonstrate measurable reduction in fall rates and falls with injury?
• Evaluate whether your current tools are generating the documentation the NPG framework expects — and whether that documentation flows into your EHR automatically
• If your fall rate data isn't moving in the right direction, examine whether your program is truly prevention-oriented or primarily reactive

These are the numbers that answer the NPG framework's core question: are you demonstrating measurable improvement in patient safety outcomes?

The Documentation Advantage

The NPG framework also raises expectations for how outcomes are documented. VSTOne integrates directly with Epic MyChart — not as an add-on, but as a deep, bidirectional integration. Fall risk alerts, repositioning events, and safety interventions are documented automatically in flowsheets without requiring manual nurse entry.

For organizations preparing for Joint Commission surveys, that documentation trail — automatically generated, timestamped, and living inside the EHR — is not a minor convenience. It's the evidence the NPG framework asks you to produce.

What to Do Now

If your organization is still orienting its fall prevention strategy around NPSGs, the first step is simply updating your internal language and metrics framework to reflect the NPG standard. Here's a practical starting checklist:

The Bottom Line

The Joint Commission's move to National Performance Goals is the clearest signal yet that patient safety accreditation is shifting from compliance theater to demonstrated outcomes. Fall prevention has always been a priority — but now it needs to show up in the numbers.

The good news: the technology to achieve those numbers exists, is validated across health systems, and is live in 4 days or less. The hospitals seeing the most meaningful improvements in fall and pressure injury outcomes aren't doing more monitoring. They're doing something fundamentally different.

They're preventing falls before they happen.