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Where patients come first
Jci accreditation is a sign of distinctive accomplishment ■ Latha Krishnan
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ll over the world, the healthcare industry and community view Joint Commission International (JCI) accreditation as the gold standard. A healthcare organisation that has met the rigorous standards of JCI can proudly display the JCI Gold Seal of Approval™ as a sign of this distinctive accomplishment. When you see the Gold Seal of Approval on the premises of JCIaccredited organisations or in their communications you can be sure the organisation is focused on providing the highest quality of care and safety. The Gold Seal of Approval is a visible sign of the commitment of the healthcare organisation to deliver quality care in a safe environment. “At a JCI-accredited healthcare organisation the patient comes first, always. Accreditation helps organisations focus on the most important aspects of improvement that affect the quality of care and patient safety including things such as provider qualifications, infection control, coordination of care and the physical environment,” says Dr Ashraf Ismail, Managing Director of the JCI Middle East Office in Dubai. JCI accreditation is centred
around 340 standards. The standards are patient-centric and focus on the systems in healthcare organisations so that they consistently provide the same high-quality care. JCI stipulates compliance with continuous quality monitoring activities as part of its accreditation programme to help the healthcare organisation provide the best care of the highest quality at all times. More than 50 per cent of the JCI accreditation standards focus on patient safety. The leaders and authoritative figures in the healthcare industry realise this and pur-
sue accreditation because they are committed to putting patients first in all that they do. Patients at a JCI-accredited hospital are treated with respect of their beliefs, customs, etc. In addition, they are aware of and participate in all the decisions regarding their treatment. It is mandatory for the organisation to develop and implement a patient bill of rights. Empowerment of patients is a critical cornerstone in patient safety standards of JCI. If patient safety is compromised at an accredited organisation, then JCI has prescribed procedures and practices to help organisations. They also provide ample support at these junctures, although JCI has prepared them to face such risks. Risk management is a full chapter in the JCI standards manual and prepares organisations to identify risks and manage them effectively. Dr Ismail adds, “Healthcare organisations have to be 100 per cent compliant with the JCI standards to get the coveted JCI accreditation and Gold Seal of Approval. Our surveyors keep track of each accredited organisation’s compliance in operations and even conduct unannounced visits to ensure the high quality care is consistent. We care about patients at all times.”
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Johns Hopkins Aramco Healthcare (JHAH)
notch above the rest Johns hopkins aramco healthcare company is a joint venture between saudi aramco and Johns hopkins medicine Johns Hopkins Aramco Healthcare (JHAH) offers those in the medical field career fulfilment and development opportunities in a patient-centred environment where their contributions are valued. The organisation takes pride in continuous improvement and encourages professional advancement combined with career stability. JHAH has a dynamic blend of people from around the world who work together to achieve remarkable results. Formed in 2014, JHAH is the result of a joint venture between Saudi Aramco, a world leader in energy, and Johns Hopkins Medicine, one of the world’s
leading academic health systems. This healthcare organisation is designed to drive and enhance the well-being of the community in an environment of growth and learning by providing innovative, integrated and patient-centric care to Saudi Aramco’s employees and healthcare beneficiaries. Before evolving into JHAH, the organisation had been providing high-quality clinical care for almost 80 years as Saudi Aramco Medical Services Organisation (SAMSO). SAMSO, as
it was then known, was first accredited by the Joint Commission on Accreditation for Healthcare Organisations (JCAHO) in 1956. It first achieved accreditation from the Joint Commission International (JCI) in 2002, and has continued this journey every three years since. The organisation emphasises the “journey” because it sees it as an ongoing process of learning, sharing, improving and achieving everhigher standards of quality patient care.
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Medical institutions here are further supported by the Joint Commission International (JCI), a worldwide-recognised certification for medical organisations that sets standards in the field and aims to improve quality of patient care.
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The UAE is no short of facilities that promise to add value to the lives of patients and their families, further boosted by JCI certification ■ Farhana Chowdhury
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he field of science is constantly evolving. As more minds are busy tapping into theorems set by their predecessors, new discoveries and innovations are reigning supreme, each armed with a mission to save humanity from the hands of potential health dangers and issues. The UAE healthcare sector is on par with international standards as it has successfully established a reputable medical field and continues to improve the environment for qualified staff, sophisticated techniques and stateof-the-art technology. Medical institutions here are further supported by the Joint Commission International (JCI), a worldwide-recognised certification for medical organisations
YOUR HEALTH IN SAFE HANDS. Mediclinic Middle East’s network of private hospitals and clinics received full JCI accreditation. This ensures that you receive quality care which measures up to the most stringent international standards.
• Mediclinic City Hospital
• Mediclinic Welcare Hospital
• Mediclinic Al Sufouh
• Mediclinic Mirdif
• Mediclinic Dubai Mall
• Mediclinic Meadows
• Mediclinic Ibn Battuta
• Mediclinic Al Qusais
• Mediclinic Beach Road
• Mediclinic Arabian Ranches
Thank you to all our staff for their hard work and dedication.
EXPERTISE YOU CAN TRUST. UAE • SOUTH AFRICA • NAMIBIA • SWITZERLAND www.mediclinic.ae
that sets standards in the field and aims to improve quality of patient care. From specialised hospitals and diagnostic centres to long-term residential care and post-treatment services, the UAE is no short of facilities that promise to add value to the lives of patients and their families. The diversity of internationally accredited specialists is among the reasons behind the flurry of medical tourists to the country. Medical tourism is on the rise and Dubai, in particular, is looking to build more hospitals as part of its plans to attract 500,000 visiting patients and boost its economy by up to Dh2.6 billion by the year 2020. This year, around 170,000 medical tourists are expected to arrive in Dubai for treatments, according to DHA. To date, around 26 existing
Quick notes » 135,000 tourists were treated in 2014, according to Dubai Healthcare City officials. » Medical Tourism to boost UAE economy by Dh2.6 billion. » 26 hospitals are currently part of the Dubai Medical Tourism project, initiated by Dubai Health Authority (DHA) with more on the way. » ‘Patients Beyond Borders: Dubai Healthcare City edition’ is an international guide for medical tourists seeking care in the emirate. » 170,000 medical tourists are expected in 2016, according to DHA. » 500,000 patients are expected to visit Dubai by the year 2020. » JCI certification overall boosts integrity of the UAE’s healthcare sector. hospitals are a part of the Dubai Health Authority’s medical tourism initiative. Adding to patient care, the city will also establish an e-investigation system that will help combat malpractice. The UAE is also a part of a special global edition titled Patients Beyond Borders, a resource site that compiles trustworthy information about healthcare and research institutions across the world for medical tourists. Dubai Healthcare City, an international hub of top hospitals
and clinics from around the globe, launched its own bilingual edition to provide comprehensive information after an extensive review. The compilation is available in English and Arabic. While official reports are yet to be released, the Director of Health Regulation at DHA shared that Dubai treated over 115,000 domestic and inbound medical tourists and garnered revenue of over Dh778.4 million during the first quarter of 2015. — farhana@khaleejtimes.com
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ProVita International Medical Center
Enhancing Quality of Life ProVita ensures long-term patients live life to the fullest no matter their condition ■ Farhana Chowdhury
Serving citizens of the UAE and bringing worldclass care to chronically ill patients is a privilege we do not take lightly. Our JCI affiliation ensures that we stay up-to-date and are compliant with evidence-based practice to provide safe and effective care to all of our residents. We are proud to be part of the UAE continuum of care and proud to be accredited by Joint Commission International. — Michael davis, CEO, ProVita International Medical Center
ProVita International Medical Center, part of NMC Health, is a residential long-term care facility dedicated to patients who require mechanical ventilation and rehabilitation. Armed with a mission to reintegrate patients back into society, it also promotes and enhances their quality of life while tending to complicated healthcare needs. “We include the patient’s family in the multi-disciplinary planning process and ensure that the patient receives appropriate cultural, religious, and social experiences to continue to enrich their lives despite their underlying conditions,” says Michael Davis, CEO, ProVita International Medical Center. The centers currently operate two facilities within the UAE, with a recent expansion of 30 beds in Abu Dhabi, which increased the total capacity to 120. Its facilities are designed with an emphasis on clinical care, safety, individuality, and quality of life, while adhering to international quality standards and excellence in care. Interestingly, cultural attitude to long-term care is among its biggest obstacles in the country, Davis highlights, but ProVita has been successful in harbouring change. Currently, almost 100 patients reside in the centers, with 98 per cent being Emirati, according to Davis. “In the UAE, families are very
close-knit and much of the extended care of chronic patients is done in short-term acute care or at homes. ProVita founded the long-term care market in the UAE and we have worked hard so that our families and residents don’t feel ‘institutionalised’. ProVita is home to our residents and their families,” he adds. ProVita’s optimum care to patients earned them the JCI accreditation and is the first privately held long-term care facility
outside of the US and in the region to achieve the recognition. “Serving citizens of the UAE and bringing world-class care to chronically ill patients is a privilege we do not take lightly. Our JCI affiliation ensures that we stay up-to-date and are compliant with evidence-based practice to provide safe and effective care to all of our residents. We are proud to be part of the UAE continuum of care and proud to be accredited by Joint Commission
International,” says Davis. ProVita International Medical Center is proud to announce the successful completion of its triennial Joint Commission International Accreditation survey. As a result of the survey, ProVita will now be Joint Commission International accredited until January 2019. ProVita CEO Michael Davis states, “At ProVita, we see the Joint Commission as an essential partner in the success and growth of our organisa-
tion throughout the Middle East Northern Africa (MENA) region. The standards provide a roadmap for building a patient-centric, quality-focused organisation from the ground up and we are proud to be recognised by JCIA as a Gold Seal hospital.” Looking ahead, ProVita is working on projects across the GCC with an aim to extend the brand beyond the UAE. — farhana@khaleejtimes.com
ServiceS offered at Provita international Medical center » » » » » » » » » » »
24/7 ICU with highly trained physician coverage 24/7 paediatric consultant and specialist 24/7 intensivist and anaesthesia specialist, internal medicine and GP 24/7 respiratory therapy coverage 24/7 ambulance coverage 24/7 nursing coverage from registered nurses with a minimum of two years ICU experience 1:1 nursing ratio for mechanically ventilated and complex patients Portable haemodialysis Physiotherapy, occupational therapy, speech therapy, and dietician five days a week Family involvement Social services and cultural integration
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The truth about medication errors Tall lettering for LASA drugs and an alert staff at pharmacies can mitigate risks and ensure correct delivery of medicines
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liminating medication errors is a goal for all healthcare organisations, but the path to this outcome is not always clear. Medication errors are often complex and rooted in systemic gaps. Jeannell Mansur (RPh, PharmD, FASHP, FSMSO, CJCP), a medication management expert, talks about the multi-layered topic in detail. in your experience, where are medication gaps most likely to occur?
I’d encourage professionals looking to locate some potential risk points in their medication processes to think about a couple of things. First, what are the highest risk medication processes that are taking place in your organisation? Are those processes structured to reduce risk, as much as possible, through design? For example, consider areas like preparing and ordering chemotherapy, prescribing and preparing paediatric medications, and the sterile compounding of IVs. High alert medications are also important areas of focus, due to their potential to cause harm if given in error. Strategies to improve safety for these medications should be individualised to each category of medication, and should be designed to address the specific risks of that category. Another high alert area is the implementation and use of medication-related technology. Healthcare organisations make significant capital expenditures on technology with goals of improving patient care and improving efficiencies. Healthcare organisations should take the opportunity to evaluate the performance of these technologies to identify and act on opportunities for improvement. Errors associated with look-alike sound-alike (LASA) medications can also
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frequently factor into medication gaps. Many medications have names that sound or look similar. Hydroxyzine and hydralazine are a perfect example of two medications with very different purposes whose names sound very similar. Packaging can also contribute to LASA medication mix-ups. The selection, storage, and prescription of LASA medications can all lead to medication errors. How can you evaluate the performance of your medication system? When looking to evaluate your organisa-
tion’s performance, it is important to understand that the medication system goes beyond the pharmacy. With the figure above as a reference, think of all the activities that occur in each of the areas that are part of the medication system. Ask yourself what the key performance measures for activities in each area are. With storage, it might be ensuring that medications are secure, or that medication refrigerators are monitored and steps have been taken to protect medications when temperatures are out of range. By using this type of exercise for each of the areas, you will be able to identify important activities and measures that help you to understand how well your medication system is performing. How can companies mitigate some of these risk points? There are a few relatively simple things organisations can do that would reduce the risk of medication errors. I recommend that organisations utilise tall man lettering when labelling LASA drugs. Tall man lettering capitalises the parts of the names that are different. For example: “hyDROXYzine” and “hyDRALAzine.” Additionally, some organisations do not organise drugs alphabetically, instead choosing to keep LASA drugs on different shelves, or even in different cabinets altogether. Prescription errors are easier to
Errors associated with lookalike sound-alike (LASA) medications can also frequently factor into medication gaps. Many medications have names that sound or look similar. Hydroxyzine and hydralazine are a perfect example of two medications with very different purposes whose names sound very similar. circumvent when the drugs are entered into databases using both their generic and brand names. These changes may seem simple, but they are a few important ways to help reduce medication errors in your organisation. Many organisations need to drill down to find the true cause of medication errors and gaps. For example, disciplinary action directed at a nurse who accidentally administered the wrong drug to a patient will not necessarily prevent this error from happening again. Taking the time to anal-
yse the error and looking for the root cause will. Examine your entire medication process and find where the gaps have occurred. Once you fully understand how the patient came to harm – where in the continuum of care your processes failed – then educate staff and physicians in order to prevent a repeat incident. Can anything good come from medication errors? Medication errors are an opportunity to learn about where your organisation’s medication system is breaking down, and an opportunity to work on fixing it. While we certainly don’t want medication errors to occur, we want those that occur to be reported so that we can learn from them. Low reporting rates may occur when staff does not feel safe or comfortable in reporting errors and near misses. Explore why reporting is low, and also examine and understand systematic reasons for errors. Don’t just focus on the individuals who made the error. Ensure that you are helping to implement a culture of safety in your organisation. In fact, medication error reporting is a diagnostic of high reliability healthcare and of your organisation’s culture. If staff and physicians in your organisation feel comfortable and safe, medication errors will be reported, and this leads to greater quality of care for your patients.
JCI modifies requirements for quality measures The latest slew of measures gives hospitals and academic medical centres the flexibility to tailor their quality improvement efforts to the needs of their patients
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oint Commission International (JCI) has recently modified the Accreditation Participation Requirement 7, which specifies requirements for selection and use of quality measures for its accredited hospitals and academic medical centres. Effective July 1, each accredited hospital and academic medical centre is required to select and
use quality measures as part of its quality programme in order to comply with Accreditation Participation Requirement (APR.7). The original APR.7 in Joint Commission International Accreditation Standards for Hospitals, Fifth Edition, as well as the Governance, Leadership, and Direction (GLD) standards GLD.11 and GLD.11.1, called for hospitals and academic medical centres to collect and submit data on measures selected from JCI’s International Library of Measures (ILOM) and to use data specifications provided by JCI. For on-site surveys conducted on July 1, 2015 and later, selection and use of measures other than those from the ILOM as part of the organisation’s quality improvement programme will be considered acceptable proof of compliance with APR.7 for hospitals and academic medical centres. Hospitals and academic medi-
We listened to our accredited organisations when they told us that they need to select and use measures that best address their most critical quality issues. — Paul Chang cal centres may use JCI’s ILOM measures and tools or measures and tools developed by the following bodies: ◗ The hospital or academic medical centre’s quality leadership ◗ A municipal, regional, or national health authority ◗ An internationally recognised healthcare quality organisation, such as the Institute for Healthcare Improvement (IHI), the Organisation for Economic Co-operation and Development (OECD) Health Care Quality Indicators programme, or the US-based Agency for Healthcare Research and Quality (AHRQ)
At this time, JCI does not require data submission except for surveyor review of data during the on-site survey as evidence of an ongoing quality improvement programme. “We listened to our accredited organisations when they told us that they need to select and use measures that best address their most critical quality issues,” said Paul Chang, MD, Vice-President, Accreditation, Standards, and Measurement, JCI. “In some cases, organisations were collecting data on specific measures for local or national oversight bodies and data on other separate measures for JCI compliance. Those processes were becoming onerous in some cases. We think this change gives our accredited hospitals and academic medical centres the flexibility to tailor their quality improvement efforts to their needs and those of their patient populations, while remain-
ing in compliance with JCI requirements.” Dr Chang emphasised that quality measurement and data analysis remain essential components of JCI’s accreditation process and that the ILOM should still be among the tools in the data-collection arsenal of a hospital or academic medical centre. “Data measurement and analysis are cornerstones of the JCI accreditation process. They are linked directly or indirectly to nearly every one of our standards,” said Dr Chang. “Ensuring organisations generate meaningful data and using those data to inform decisions that improve patient care and outcomes remain at the center of our mission.” For more information contact the JCI Accreditation Central Office at jciaccreditation@jcrinc.com.
Data measurement and analysis are cornerstones of the JCI accreditation process. They are linked directly or indirectly to nearly every one of our standards. — Paul Chang