In order to get reasonable requirements and uniform adherence in the 5,000 EDs in the country, it will be necessary for an external body like JCAHO to be thinking about this now.
They must have everyone following the rules uniformly. 
mnli hypothesis: They must have everyone following the rules uniformly.  premise: In order to get reasonable requirements and uniform adherence in the 5,000 EDs in the country, it will be necessary for an external body like JCAHO to be thinking about this now.