In 1981, the Joint Commission on Accreditation of Hospitals instituted new quality assurance requirements. As occupational therapy departments plan for accreditation review, they must address these changes, which are markedly different from earlier standards. This article outlines the essentials. Official interpretations of the Joint Commission’s quality assurance standard and its application to occupational therapy are presented. The focus of this paper is on one possible quality assurance system. The elements of an effective quality assurance plan for an occupational therapy department are defined, and a hypothetical quarterly report for a department is presented. The ongoing review and evaluation monitors required by the Joint Commission are described.