International Hospital Accreditation Research Articles

International Accreditation Standards and the Benefits to Hospitals Attracting Medical Tourists

There are several studies showing international hospital accreditation does have some impact on clinical standards and even bed occupancy rates. However, little is known about the impact on attracting more international medical tourists to hospitals that have received this distinction. It was expected, prior to the study, that participating in international accreditation might increase operational expenses and greater amounts of international patients would also boost patient volumes and profitability. However, this research found that the investment in accreditation led to insignificant changes (pre-accreditation versus post-accreditation) in operating profit margins (OPM), net profit margins (NPM), and the debt-to-equity (D/E) ratio. This suggests that international hospital accreditation has little impact on the financial aspects of the hospital's operations. It appears to be more of a signaling strategy than a recipe for growth. However, there may be some other tangible benefits of international accreditation (e.g., better medical/clinical outcomes).

Hospital Accreditation: A Review of Evidence, Regulatory Compliance, and Healthcare Outcome Measures

Background: Hospitals are increasingly under pressure to provide safe and high-quality care at an affordable cost. In response to this challenge, many have adopted accreditation as an internationally recognized tool to facilitate improvements in healthcare quality and patient safety. The objectives of the study were to (a) evaluate the impact of international hospital accreditation in Dubai and (b) inform policy decision-making. Methods: We adopted a literature review, analysis of violation data, and clinical performance measures. Results: The literature review suggests insufficient evidence to link accreditation to healthcare outcomes. We report a gradual increase in hospital violations and an improvement of clinical outcomes over three years, however the improvement in clinical outcome measures were not statistically significant. Conclusions: There is limited evidence to determine the impact of international hospital accreditation. Performance measures for accreditation are needed to validate the contribution accreditation may have on reducing non-compliance and improving clinical performance measures. Further research is needed to explore how well accreditation models fit within the Donabedian framework for healthcare quality.

International Accreditation Standards and the Benefits to Hospitals Attracting Medical Tourists

There are several studies showing international hospital accreditation does have some impact on clinical standards and even bed occupancy rates. However, little is known about the impact on attracting more international medical tourists to hospitals that have received this distinction. It was expected, prior to the study, that participating in international accreditation might increase operational expenses and greater amounts of international patients would also boost patient volumes and profitability. However, this research found that the investment in accreditation led to insignificant changes (pre-accreditation versus post-accreditation) in operating profit margins (OPM), net profit margins (NPM) and the debt-to-equity (D/E) ratio. This suggests that international hospital accreditation has little impact on the financial aspects of the hospital’s operations. It appears to be more of a signaling strategy than a recipe for growth. However, there may be some other tangible benefits of international accreditation (e.g., better medical/clinical outcomes).

Application of SBAR communication mode in team cooperation between physicians and nurses

Effective communication and team work are the keys to improve medical quality and guarantee patient safety. The establishment of effective communication mechanism to improve physician-nurse communication has become important among the national and international hospital accreditation standards of patient's safety goals. This article summarizes the application of situation-background-assessment-recommendation (SBAR) communication mode in team cooperation between physicians and nurses in order to achieve better reference and guidance in further research. Key words: Review; Medical staff; Situation-background-assessment-recommendation communication mode; Team cooperation

의료기관인증제도의 국내외 비교 연구 - 한국, 미국 및 호주 중심으로 -

의료기관인증제도의 국내외 비교 연구 - 한국, 미국 및 호주 중심으로 -

International hospital accreditation and clinical nutrition service in acute care hospitals in South Korea: results of a nationwide cross-sectional survey.

Beginning in 2007, 29 hospitals in South Korea have received accreditation from Joint Commission International (JCI). The present study aimed to identify differences in clinical nutrition service provisions between JCI accredited acute care hospitals and non-accredited acute care hospitals. A survey questionnaire was sent to all 43 acute care hospitals in South Korea. A total of 35 sets of clinical nutrition service surveys, 234 sets of clinical dietitian job satisfaction surveys, and five-day daily work logs from 129 clinical dietitians were received. We used Fisher's exact test and independent t-test to analyze differences between acute care hospitals based on JCI accreditation. Nationwide cross-sectional survey. JCI accredited acute care hospitals (N=8) showed a higher, but not significantly higher, nutritional intervention rate of 12.7% among malnourished patients, compared with 7.0% in non-JCI accredited acute care hospitals (N=27). Analysis of work hours of clinical dietitians indicated time spent on direct care was higher (p<0.05), while time spent on outpatient care was lower (p<0.05) among JCI accredited acute care hospitals relative to non-JCI accredited acute care hospitals. Accreditation from JCI has a positive influence in the advancement of not only the hospital services, but also clinical nutrition services.

Relationship of Nurses' Perception of the Joint Commission International Hospital Accreditation, Nursing Performance, Self-concept and Retention Intention

Relationship of Nurses' Perception of the Joint Commission International Hospital Accreditation, Nursing Performance, Self-concept and Retention Intention

Providers’ perspectives on inbound medical tourism in Central America and the Caribbean: factors driving and inhibiting sector development and their health equity implications

BackgroundMany governments and health care providers worldwide are enthusiastic to develop medical tourism as a service export. Despite the popularity of this policy uptake, there is relatively little known about the specific local factors prospectively motivating and informing development of this sector.ObjectiveTo identify common social, economic, and health system factors shaping the development of medical tourism in three Central American and Caribbean countries and their health equity implications.DesignIn-depth, semi-structured interviews were conducted in Mexico, Guatemala, and Barbados with 150 health system stakeholders. Participants were recruited from private and public sectors working in various fields: trade and economic development, health services delivery, training and administration, and civil society. Transcribed interviews were coded using qualitative data management software, and thematic analysis was used to identify cross-cutting issues regarding the drivers and inhibitors of medical tourism development.ResultsFour common drivers of medical tourism development were identified: 1) unused capacity in existing private hospitals, 2) international portability of health insurance, vis-a-vis international hospital accreditation, 3) internationally trained physicians as both marketable assets and industry entrepreneurs, and 4) promotion of medical tourism by public export development corporations. Three common inhibitors for the development of the sector were also identified: 1) the high expense of market entry, 2) poor sector-wide planning, and 3) structural socio-economic issues such as insecurity or relatively high business costs and financial risks.ConclusionThere are shared factors shaping the development of medical tourism in Central America and the Caribbean that help explain why it is being pursued by many hospitals and governments in the region. Development of the sector is primarily being driven by public investment promotion agencies and the private health sector seeking economic benefits with limited consideration and planning for the health equity concerns medical tourism raises.

Policy implications of medical tourism development in destination countries: revisiting and revising an existing framework by examining the case of Jamaica.

BackgroundMedical tourism is now targeted by many hospitals and governments worldwide for further growth and investment. Southeast Asia provides what is perhaps the best documented example of medical tourism development and promotion on a regional scale, but interest in the practice is growing in locations where it is not yet established. Numerous governments and private hospitals in the Caribbean have recently identified medical tourism as a priority for economic development. We explore here the projects, activities, and outlooks surrounding medical tourism and their anticipated economic and health sector policy implications in the Caribbean country of Jamaica. Specifically, we apply Pocock and Phua’s previously-published conceptual framework of policy implications raised by medical tourism to explore its relevance in this new context and to identify additional considerations raised by the Jamaican context.MethodsEmploying case study methodology, we conducted six weeks of qualitative fieldwork in Jamaica between October 2012 and July 2013. Semi-structured interviews with health, tourism, and trade sector stakeholders, on-site visits to health and tourism infrastructure, and reflexive journaling were all used to collect a comprehensive dataset of how medical tourism in Jamaica is being developed. Our analytic strategy involved organizing our data within Pocock and Phua’s framework to identify overlapping and divergent issues.ResultsMany of the issues identified in Pocock and Phua’s policy implications framework are echoed in the planning and development of medical tourism in Jamaica. However, a number of additional implications, such as the involvement of international development agencies in facilitating interest in the sector, cyclical mobility of international health human resources, and the significance of health insurance portability in driving the growth of international hospital accreditation, arise from this new context and further enrich the original framework.ConclusionsThe framework developed by Pocock and Phua is a flexible common reference point with which to document issues raised by medical tourism in established and emerging destinations. However, the framework’s design does not lend itself to explaining how the underlying health system factors it identifies work to facilitate medical tourism’s development or how the specific impacts of the practice are likely to unfold.

"The Major Forces that Need to Back Medical Tourism Were … in Alignment": Championing Development of Barbados's Medical Tourism Sector.

Governments around the world have expressed interest in developing local medical tourism sectors, framing the industry as an opportunity for economic growth and health system improvement. This article addresses questions about how the desire to develop a medical tourism sector in a country emerges and which stakeholders are involved in both creating momentum and informing its progress. Presenting a thematic analysis of 19 key informant interviews conducted with domestic and international stakeholders in Barbados's medical tourism sector in 2011, we examine the roles that "actors" and "champions" at home and abroad have played in the sector's development. Physicians and the Barbadian government, along with international investors, the Medical Tourism Association, and development agencies, have promoted the industry, while actors such as medical tourists and international hospital accreditation companies are passively framing the terms of how medical tourism is unfolding in Barbados. Within this context, we seek to better understand the roles and relationships of various actors and champions implicated in the development of medical tourism in order to provide a more nuanced understanding of how the sector is emerging in Barbados and elsewhere and how its development might impact equitable health system development.

Thoughts on China's hospital accreditation

The paper described development characteristics of international hospital accreditation, and challenges faced by China's hospital accreditation. The author proposed for such accreditation, as that accreditation entities are the organizational support for building a permanent mechanism of hospital accreditation, and two organizational modes: the first is societies and associations of capacity to build accreditation organizations and the government to build professional hospital accreditation bodies, and the second is to build the assessors system. Key words: Hospital accreditation; Accreditation organization; Accreditation body; Assessor system

Value and impact of international hospital accreditation: a case study from Jordan.

We assessed the economic impact of Joint Commission International hospital accreditation on 5 structural and outcome hospital performance measures in Jordan. We conducted a 4-year retrospective study comparing 2 private accredited acute general hospitals with matched non-accredited hospitals, using difference-in-differences and adjusted covariance analyses to test the impact and value of accreditation on hospital performance measures. Of the 5 selected measures, 3 showed statistically significant effects (all improvements) associated with accreditation: reduction in return to intensive care unit (ICU) within 24 hours of ICU discharge; reduction in staff turnover; and completeness of medical records. The net impact of accreditation was a 1.2 percentage point reduction in patients who returned to the ICU, 12.8% reduction in annual staff turnover and 20.0% improvement in the completeness of medical records. Pooling both hospitals over 3 years, these improvements translated into total savings of US$ 593 000 in Jordan's health-care system.

Value and impact of international hospital accreditation: a case study from Jordan

Value and impact of international hospital accreditation: a case study from Jordan

Relationships of Nurses' Perception, Nursing Performance, Job Stress, and Burnout in Relation to the Joint Commission International Hospital Accreditation

The scores for per-ception, nursing performance, job stress and burnout in relation to the JCI hospital accreditation were(on a five-point Likert scale) 3.23, 4.01, 3.56 and 3.40 respectively. A positive correlation was observed between perception and nursing performance. Burnout was negatively correlated with perception and nursing performance, and positively correlated with job stress.

Scoping medical tourism and international hospital accreditation growth

Uwe Reinhardt stated that medical tourism can do to the US healthcare system what the Japanese automotive industry did to American carmakers after Japanese products developed a value for money and reliability reputation. Unlike cars, however, healthcare can seldom be test-driven. Quality is difficult to assess after an intervention (posteriori), therefore, it is frequently evaluated via accreditation before an intervention (a priori). This article aims to scope the growth in international accreditation and its relationship to medical tourism markets. Using self-reported data from Accreditation Canada, Joint Commission International (JCI) and Australian Council on Healthcare Standards (ACHS), this article examines how quickly international accreditation is increasing, where it is occurring and what providers have been accredited. Since January 2000, over 350 international hospitals have been accredited; the JCI's total nearly tripling between 2007-2011. Joint Commission International staff have conducted most international accreditation (over 90 per cent). Analysing which countries and regions where the most international accreditation has occurred indicates where the most active medical tourism markets are. However, providers will not solely be providing care for medical tourists. Accreditation will not mean that mistakes will never happen, but that accredited providers are more willing to learn from them, to varying degrees. If a provider has been accredited by a large international accreditor then patients should gain some reassurance that the care they receive is likely to be a good standard. The author questions whether commercializing international accreditation will improve quality, arguing that research is necessary to assess the accreditation of these growing markets.