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Accreditation and Certification
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International Accreditation and Certification

At present, international accreditation is one of the major criteria for assessing performance quality of any medical centre.

Accreditation level of a medical centre directly mirrors the level of services offered there. In more simple words, accreditation can be defined as expert assessment of an organization used to review the functional level for compliance with set standards and to define the way of ongoing service quality perfection.

Accreditation enables to make a dynamic evaluation of main aspects of medical centre performance: from medical service quality to staff management system. This procedure aims at not just mere quality assessment in itself, but also at finding ways of quality improvement.

Accreditation came into practice in the number of Western European states and in the USA back at the dawn of the XX century. In the USA, special standards were initially applied to monitor the sanitary state and patient accommodation conditions at medical centres — these standards then developed into accreditation procedures. Later on, similar procedures were developed in other countries around the world, South East Asia in particular.

In many countries, accreditation of medical centres is necessarily performed at the national level by a specially authorised state body. In such countries as the UK, USA, Australia, and Canada, accreditation is performed by special bodies, non-governmental for most part, but state-authorised according to the national legislation. Such organizations are entitled to accredit medical centres as a whole or any of their separate subdivisions, for example, laboratories. In many countries, however, medical centres more and more often seek the aid of major international accrediting groups and organizations with global acclaim.

Below are some international accrediting organizations:

• ISQua (The International Society for Quality in Health)

• SOFIHA (The Society for International Healthcare Accreditation)

These organizations developed several widely accepted accreditation systems:

• QHA Trent Accreditation

• Joint Commission International, or JCI

• Australian Council for Healthcare Standards International, or ACHSI

• Canadian Council on Health Services Regulation, or CCHSA.

Accreditation systems are designed in such a way as to provide objective data for external independent quality assessment and to demonstrate the way this organization management regulates the issues of medical service quality.

A model quality management scheme in any organization should guide a patient through all stages of medical aid, from monitoring healthy patients locally, through outpatient or in-patient treatment, to medical monitoring after checking out from the hospital. This model scheme is centred on a list of professional standards providing a systematic and comprehensive assessment of hospital activities. These standards include, apart from direct interaction of clinical staff with patients, also staff education and training, distribution of functions, clinic management principles and audit, research activity, ethical standards, etc.

JCI Accreditation

At present, the most objective and prestigious method of assessing the quality and organizational level of medical service internationally, in the sphere of medical tourism in particular, is undoubtedly JCI accreditation (Joint Commission International).

JCI accreditation is the evidence of supreme medical service quality, patient safety, application of correct treatment methods, and effective management at a medical centre. This is a highly sought-after accreditation, which automatically grants the possibility of gaining a global-level position and attracting hundreds of foreign patients.

Joint Commission International is a non-profit organization headquartered in the USA. It has been actively working for 75 years already towards quality and safety improvement in the medical field.

Joint Commission originated back in 1917 under the name of Hospital Standardizations, and in 1951 it was renamed as Joint Commission on Accreditation of Health care Organization (JCAHO).

Initially, accreditation system developed by Joint Commission was applied to medical centres in the USA alone. Considering high demand for accreditation on the part of medical centres in other countries, JACHO reached a decision in 1998 to establish Joint Commission International (JCI) as a subsidiary meant to perform activities related to issuing accreditation certificates to medical centres outside the USA.

At the beginning of 2007, JCAHO was restructured into The Joint Commission. In particular, there was a change in the organization’s structure, functions, and even logo. As for JCI, changes were made in the logo only.

Currently Joint Commission is the largest and most widely reputed accrediting organization both in the USA and around the world. Joint Commission has accredited about 20,000 medical centres in the USA and over 250 medical centres in 40 around the world. Unfortunately, this list includes not a single CIS country.

Accreditation procedure takes place over a period of several years and costs a sizable amount of money. Acquiring national accreditation is one of the prerequisites for receiving an international JCI accreditation.

JCI assessment system includes 197 core standards, 368 general standards, and 1032 measurable elements. Some of these standards are:

  • standards of medical centre’s management activity;
  • arrangement of self-improvement processes: the way a medical centre deals with its mistakes to prevent their recurrence;
  • general and medical ethical standards active in a given medical centre: the way top management and average executives of a hospital apply individual and group ethical standards towards an individual patient and groups of patients;
  • quality and skills of clinical staff, including staff educational and professional level: staff members should provide evidence of their continuous professional training and growth;
  • arrangement of document flow of a medical centre: the way medical records are analysed, processed, and stored in medical history;
  • prevention and registration of infectious complications. Control over sanitary security;
  • evidence of proper, transparent and fair system of processing patient complaints (which are inevitable from time to time) and mechanisms of rational and fair compensation of patient losses, if their claims are grounded.

The above list is by no means exhaustive. JCI accreditation accounts even for each party’s legal, religious, and/or cultural factors. Particular attention during the accreditation process is given to such aspects of medical centre’s activity as professional level of staff (education medical staff have received, advanced training courses, practical training abroad are evaluated), ethical standards (personal attitude to patients from the side of medical and administrative staff are evaluated), statistics of successful surgeries, etc.

Additionally, work quality is evaluated in terms of monitoring mechanisms over activities in the field of scientific research work, interaction and communication with colleagues. Medical centres are evaluated also by the criteria of care reliability, safety of patients and accompanying persons, technological infrastructure, management system, environment-friendly activities, facade design, etc.

Lately, Joint Commission International has significantly toughened assessment rules and criteria as to provide maximum objectivity of assessment for medical centres in various countries around the world. Additional parameters were introduced in assessing safety, patient service quality, education of medical staff, technological infrastructure, and management system. Moreover, within the JCI system there is constant monitoring of medical service quality control performed annually by JCI experts.

Procedures performed during expert assessment of medical centre’s compliance with international standards:

  • interviews with staff members and patients;
  • evaluation of procedures and location of patient care;
  • review of registration procedures, records management, HR policies;
  • assessment of overall accreditation process results (including all previous accreditations);
  • evaluation of measures taken towards facilitating safety of patients, their accompanying persons, and medical staff within a medical centre
  • control over the sanitary state of premises;
  • evaluation of measures performed towards improving the quality of care and services offered.

Accrediting bodies perform control activities after the lapse of definite time periods. Generally, JCI expert group performs test check of a medical centre in several stages. Basing on the results of study conducted by JCI experts, they present the action plan of eliminating revealed shortcomings specifying particular terms and persons responsible for their elimination.

After a certain period of time (generally about 3 years) since a successfully completed JCI accreditation process and issue of accreditation certificate, Joint Commission International performs assessment of major aspects of a medical centre’s activity closely monitored by JCI experts. In fact, medical centres that have received accreditation certificates have to confirm them from time to time.

Therefore, the fact that a medical centre has received a JCI accreditation certificate undoubtedly testifies high standards of service quality, comfort and safety for patients.

Tags: accreditation, JCI

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