© accreditation canada international. global health care services dr. ali hojjati md, mph dr. ali...

Global Health Care Services

Global Health Care Services

Dr. Ali HojjatiMD, MPH

Dr. Ali HojjatiMD, MPH

December 18 , 2012


The Third Conference on Health Tourism in

Islamic Countries


Global Healthcare – A RealityGlobal Healthcare – A Reality

Medical Tourism

Wellness Travel

Medical Travel

Health Tourism

Travelling patient

International Patient

QUALITY SAFETY


Health


RisksRisks

Medical information Travel, transfer points Referrals, continuum of care, follow-up Language, cultural differences Assurance of expertise Insurance coverage Legal rights Privacy and access to information


Need for StandardizationNeed for Standardization

Processes &

Standards are needed to

Mitigate Risk and

ensure Quality

© Accreditation Canada International 10

State of Health

Disease

High Quality of Care

Harm

Adopted from Donabedian 2003Time

Standards , Quality and Errors


Standards – Do we still need them???Standards – Do we still need them???

11

National Standards

International Standards


Standards – Do we still need them???Standards – Do we still need them???

12


What is Accreditation?What is Accreditation?

13

Accreditation and Standards


Defining AccreditationDefining Accreditation

A process for organizations to regularly and consistently examine and improve their services

A tool to identify areas for improvement

A measure of an organization’s services compared against international standards of excellence

Digitalart, Master Isolated Images, Renjith Krishnan/FreeDigitalPhotos.net


Accreditation helps to…Accreditation helps to…

Increase credibility and demonstrate accountability

Show commitment to quality and patient safety

Increase capacity and lead to quality improvement


Accreditation helps organizations achieve excellence:

A proactive and continuous process to regularly and consistently examine and improve services

A strategic change and risk management tool to identify strengths and areas for improvement

A measure of success against standards of excellence

Accreditation Defining Healthcare

Excellence

Accreditation Defining Healthcare

Excellence


Accreditation is credible when….Accreditation is credible when….

Engages all stakeholders ex: clients, staff More than a checklist Based on best practice and evidence About sharing experience Internationally recognized Appropriate methodology is used to assess compliance Program overseen by independent body ex: ISQua

17


SurveyorsSurveyors

Independent, impartial peer reviewers removed from outside influence and interest

Experienced and trained to look for and identify organization strengths, areas for improvement, and risks

Recommend actions for quality improvement

19


GLOBAL HEALTHCARE

SPECIFIC STANDARDS


Monitoring and Quality Improvement

Planning forCare andTreatment

PreparationCare andTreatment

DischargeAndFollow-up

MonitoringAnd Quality Improvement

International Client StandardInternational Client Standard


Planning for Care and TreatmentPlanning for Care and Treatment

Assessment of international client needs Development of services according to the needs Ensuring the team’s staff are educated, trained,

qualified, and competent Enhancing wellbeing and worklife balance of staff

22


PreparationPreparation

Providing clients information on services offered Communicating with the client’s primary physician Gathering information on client’s history and current

medical condition Pre-operative instructions and timelines Travel, accommodation and transportation services Pre-travel screening

24


Care and TreatmentCare and Treatment

Team coordinates services on client arrival Assessment Procedure Discharge planning Transition to retreat area Monitoring medical condition Preparation for client’s return

26


Discharge and Follow-upDischarge and Follow-up

Evaluating and addressing client’s medical and support needs for traveling after the procedure

Communicating with clients on their return home Monitoring compliance with discharge plan Follow-up with client’s primary physician

28


Monitoring and Quality ImprovementMonitoring and Quality Improvement

Quality improvement program to enhance service delivery

Performance management Client feedback Benchmarking

30


Accreditation Canada InternationalAccreditation Canada International

• Objective, independent, 3rd party, peer evaluation• Transparent and rigorous analysis• Performance measurement & management• Client and patient safety• Quality improvement• Risk prevention• Governance• Education


Accreditation Canada International Accreditation Canada International

1000+5000+

1958 2012

CANADIAN TRADITION OF QUALITY

HEALTH CARE

GLOBAL PRESENCE

LOCAL SOLUTIONS

ACCREDITED BY ISQUA

jscreationzs / FreeDigitalPhotos.netMaster isolated images / FreeDigitalPhotos.net

1967

Bermuda HospitalFirst International

Hospital45 years ago

54 years


Global PresenceGlobal Presence

Europe

France

Italy

Ireland

Eslovenia

Middle East and North Africa

Bahrain

Egypt

Iran

Kuwait

Lebanon

Qatar

Saudi Arabia

Tunisia

UAE

Oman

Caribbean

Anguilla

Barbados

Bermuda

St. Lucia

Trinidad & Tobago

Turks and Caicos

Latin America

Brazil

Chile

Colombia

Costa Rica

Mexico

Asia

Kazakhstan

Philippines

jscreationzs / FreeDigitalPhotos.net


One third of all new accreditation programs and standards developed worldwide have taken the lead from Accreditation Canada Charles D. Shaw , ISQua

Accreditation Canada International


Accreditation in Canadian and international Health CareAccreditation in Canadian and international Health Care

StructureClient

Centered Program

AIM – Achieving Improved

Measurement

Qmentum/

Qmentum Intl

Strong focus on structure i.e. policies, procedures, fire safety,

etc.

Introduced in 1995 forcing

organizations to understand who

were their clients, their needs &

how to improve services.

Introduced in 2001 requiring organizations to measure the outcomes of

health care as well as other components including

continuous learning and improvement cycle and are

we improving the health status of the population.

Introduced in 2010 emphasis has shifted

to health system performance, risk

mitigation and prevention planning,

client safety, performance measure, and governance.

1995 2001 2010


Accreditation in Canadian and international Health CareAccreditation in Canadian and international Health Care

Why is it constantly changing?

Change is necessary to remain relevant in our ever-shifting

health care environment.


The leader in raising the bar for health quality


What does “Qmentum” Mean? What does “Qmentum” Mean?

Quality + Momentum=Qmentum


Accreditation Canada International: ServicesAccreditation Canada International: Services

Accreditation Advisory Services

Education

renjith krishnan / FreeDigitalPhotos.netAmbro / FreeDigitalPhotos.net


From Current Situation to

Desire level of Quality

Level of Quality

Current Situation in organization

Readiness Assessment Report

Self Assessment Tools

Review Standards in Teams

Gap Assign an Account Manager for Each Hospital

How Accreditation Canada International can help?

Consultation

Education

Advisory Services


43

Acute Care

STANDARD AREAS

SUSTAINABLE GOVERNANCE

EFFECTIVE ORGANIZATION

SERVICE EXCELLENCE

POSITIVE CLIENT EXPERIENCE

Public Health

• Public Health• Animal Health and

Food Safety

• Ambulatory Care• Blood Bank and

Transfusion• Biomedical Laboratory• Cancer Care• Diagnostic Imaging• Laboratory and Blood• Operating Rooms• Rehabilitation• Surgical Care

Ambulatory Care

Medication Management – Infection Prevention and Control

Public Health• Primary Care• Blood Bank and

Transfusion• Diagnostic Imaging• Biomedical Laboratory• Laboratory and Blood

Primary Care

Community Care

• Home Care• Mental Health• Developmental

Disabilities• Semi-Residential and

Residential• Substance Abuse and

Addiction

Independent Laboratory

• Blood Bank and Transfusion

• Biomedical Laboratory• Laboratory and Blood

Qmentum International StandardsQmentum International Standards

Nov 2012 Release

• Independent Medical/Surgical Facilities

• Assisted Reproductive Technology

• Populations with Chronic Conditions

• Hospice Palliative Care

• Ambulatory Care• Blood Bank and

Transfusion• Biomedical Laboratory• Cancer Care• Critical Care • Diagnostic Imaging• Emergency Department• Emergency and Disaster

Preparedness• Global Health Care• Laboratory and Blood• Medicine• Mental Health• Obstetrics/Perinatal Care• Operating Rooms• Rehabilitation• Reprocessing and

Sterilization• Surgical Care• Primary Care


Qmentum InternationalQmentum International

Foundational elements of quality and safety

Client-centred care;Consistency of service delivery

Monitoring outcomes; Using evidence and best

practices to improve service Diamond level

Gold level

Platinum level


Standards formatStandards format

46

SUB-SECTION HEADING

CRITERIA

Each criterion is associated with a Quality Dimension

Level

Standard


Accredits the AccreditorsAccredits the Accreditors

ISQuaThe International Society for

Quality in Health Care


ISQuaISQua

Accredited Organisations Accredited Standards Accredited Surveyor Training Programme

48


ConclusionConclusion

Standardization is key as global healthcare has multiple interfaces

Robust, sustainable accreditation programs are urgently needed in current environment

Accreditation assures the quality and safety of care to the international client

49


Accreditation Canada International For further information

Accreditation Canada International For further information

Dr. Ali HojjatiAccreditation Advisor

[email protected]

www.accreditation.ca

mailto:[email protected]



Le leader qui hausse la barre en matière de qualité de santéLe leader qui hausse la barre

en matière de qualité de santé


Sample Patient Safety RequirementsSample Patient Safety Requirements

Client Safety Area Required Organizational Practices

Communication Client verification

Transfer of client information at transition points

Medication reconciliation

Safe surgical practices

Medication Use Control of concentrated electrolytes

Worklife Training on patient safety

Infection Prevention and Control

Hand hygiene

Timely administration of prophylactic antibiotics

Safe injection practices

54


Patient Safety Area Phase 1(2013)

Phase 2(2015)

Safety Culture Adverse event reporting (G) Adverse event disclosure (G)Prospective analysis (D)Client safety quarterly reports (G)

Communication Dangerous Abbreviations (G) Verification processes for high risk activities (D)Client and family role in safety (G)

Medication Use High alert medications (includes former drug concentrations) (P)Infusion pump training (P)

Heparin safety (P)Narcotic safety (P)Antimicrobial Stewardship (P)

Worklife Preventive maintenance program (G) Client safety plan (G)

Infection Control Sterilization Processes (G)Infection Control guidelines (G)Hand Hygiene Audit (P)

Infection rates (D)

Risk Assessment Pressure Ulcer Prevention (P)Falls Prevention (P)Venous Thromboembolism Prophylaxis (P)

Home Safety Risk Assessment (P)Suicide Prevention (P)

Total 11 12


Gold

Platinum

Diamond

© accreditation canada international. global health care services dr. ali hojjati md, mph dr. ali...

Documents

quality slide

information slide

healthcare excellence

quality improvement

time standards

global health care services

organizations services

continuum of care