BACKGROUND:The Australian Council on Healthcare Standards (ACHS) conducts a voluntary program of health facility accreditation modeled along the lines of the Joint Commission. To increase clinician involvement in the accreditation process and in quality assurance programs and to enable some assessment of the outcome of care in a facility at the time of survey, the ACHS, together with the medical colleges, is developing objective measures of care (clinical indicators). METHODS:Ten medical colleges are now involved in the program. The first set of measures, the Hospital-Wide Medical Indicators (HWMIs) developed in conjunction with the Royal Australian College of Medical Administrators, was formally introduced into the accreditation process in January 1993. These indicators were developed by a combined working party of the Care Evaluation Program and the Royal Australian College of Medical Administrators. The HWMIs address the areas of trauma, postoperative pulmonary embolism, readmissions to hospital, returns to the operating room, hospital-acquired infection, medication errors, and hospital throughout. CONCLUSION:It is hoped that the development of objective measures of care (clinical indicators) will facilitate the accreditation process. The development of these measures also enables Australian physicians to compare patient care throughout the hospital with national indicators of quality of care.