© accreditation canada international. global health care services dr. ali hojjati md, mph dr. ali...
TRANSCRIPT
Global Health Care Services
Global Health Care Services
Dr. Ali HojjatiMD, MPH
Dr. Ali HojjatiMD, MPH
December 18 , 2012
© Accreditation Canada International
Global Healthcare – A RealityGlobal Healthcare – A Reality
Medical Tourism
Wellness Travel
Medical Travel
Health Tourism
Travelling patient
International Patient
QUALITY SAFETY
© Accreditation Canada International
Global Healthcare – A RealityGlobal Healthcare – A Reality
Medical Tourism
Wellness Travel
Medical Travel
Health Tourism
Travelling patient
International Patient
QUALITY SAFETY
© Accreditation Canada International
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
© Accreditation Canada International
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
© Accreditation Canada International
Standards – Do we still need them???Standards – Do we still need them???
11
National Standards
International Standards
© Accreditation Canada International
Standards – Do we still need them???Standards – Do we still need them???
12
© Accreditation Canada International
What is Accreditation?What is Accreditation?
13
Accreditation and Standards
© Accreditation Canada International 1414
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 Canada International
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 Canada International
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 Canada International
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
© Accreditation Canada International
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
© Accreditation Canada International
Monitoring and Quality Improvement
Planning forCare andTreatment
PreparationCare andTreatment
DischargeAndFollow-up
MonitoringAnd Quality Improvement
International Client StandardInternational Client Standard
© Accreditation Canada International
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
© Accreditation Canada International
Monitoring and Quality Improvement
Planning forCare andTreatment
PreparationCare andTreatment
DischargeAndFollow-up
MonitoringAnd Quality Improvement
International Client StandardInternational Client Standard
© Accreditation Canada International
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
© Accreditation Canada International
Monitoring and Quality Improvement
Planning forCare andTreatment
PreparationCare andTreatment
DischargeAndFollow-up
MonitoringAnd Quality Improvement
International Client StandardInternational Client Standard
© Accreditation Canada International
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
© Accreditation Canada International
Monitoring and Quality Improvement
Planning forCare andTreatment
PreparationCare andTreatment
DischargeAndFollow-up
MonitoringAnd Quality Improvement
International Client StandardInternational Client Standard
© Accreditation Canada International
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
© Accreditation Canada International
Monitoring and Quality Improvement
Planning forCare andTreatment
PreparationCare andTreatment
DischargeAndFollow-up
MonitoringAnd Quality Improvement
International Client StandardInternational Client Standard
© Accreditation Canada International
Monitoring and Quality ImprovementMonitoring and Quality Improvement
Quality improvement program to enhance service delivery
Performance management Client feedback Benchmarking
30
© Accreditation Canada International 32
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 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
© Accreditation Canada International
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
© Accreditation Canada International 35
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 Canada International 36
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 Canada International
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.
© Accreditation Canada International
What does “Qmentum” Mean? What does “Qmentum” Mean?
Quality + Momentum=Qmentum
© Accreditation Canada International 40
Accreditation Canada International: ServicesAccreditation Canada International: Services
Accreditation Advisory Services
Education
renjith krishnan / FreeDigitalPhotos.netAmbro / FreeDigitalPhotos.net
© Accreditation Canada International
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
© Accreditation Canada International
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
© Accreditation Canada International
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
© Accreditation Canada International
Standards formatStandards format
46
SUB-SECTION HEADING
CRITERIA
Each criterion is associated with a Quality Dimension
Level
Standard
© Accreditation Canada International
Accredits the AccreditorsAccredits the Accreditors
ISQuaThe International Society for
Quality in Health Care
© Accreditation Canada International
ISQuaISQua
Accredited Organisations Accredited Standards Accredited Surveyor Training Programme
48
© Accreditation Canada International
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
Accreditation Canada International For further information
Accreditation Canada International For further information
Dr. Ali HojjatiAccreditation Advisor
www.accreditation.ca
The leader in raising the bar for health quality
The leader in raising the bar for health quality
Le leader qui hausse la barre en matière de qualité de santéLe leader qui hausse la barre
en matière de qualité de santé
© Accreditation Canada International
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
© Accreditation Canada International
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