International Society For Quality In Health Care Research Articles

How Iran’s Hospital Accreditation Program Meets the International Society for Quality in Health Care (ISQua)

Background: Hospital health service quality is a fundamental component of the health system. Hospital accreditation is a key approach to enhancing this quality, necessitating the correct implementation of processes. Objectives: This study aims to investigate the compliance of the executive processes of Iran’s hospital accreditation program with the requirements of the International Society for Quality in Health Care and to provide corrective solutions. Methods: This qualitative study uses an inductive content analysis technique. A checklist with seven axes was established by extracting and interpreting the requirements of the executive processes from the International Society for Quality in Health Care. By examining existing documents at the Ministry of Health’s Accreditation Office and conducting interviews with managers and experts in the field, challenges in the domain of the executive processes of Iran’s hospital accreditation program were identified using the relevant checklist. Corrective solutions were then gathered through semi-structured interviews with 19 experts, managers, and accreditation field specialists, categorized inductively, and presented using MAXQDA software. Results: Challenges in seven areas were identified, including governance; strategic, operational and financial management; risk management; human resources management; information management; survey and client management; and the granting of accreditation approval. Subsequently, solutions were categorized into five groups encompassing 26 concepts, focusing on reforming macro policies, addressing implementation challenges, fostering appropriate interactions, improving human resource management, and promoting evidence-based decision-making. Conclusions: The Iran hospital accreditation program’s adherence to International Society for Quality in Health Care standards is inadequate. Establishing a semi-autonomous, non-profit accreditation body that operates under government control and ensuring the independence of the accreditation office is essential for achieving higher compliance and receiving certification from International Society for Quality in Health Care.

Phase 3 of COVID-19: Treat your patients and care for your radiographers. A designed projection for an aware and innovative radiology department

Abstract Since the spread of Covid-19 outbreak, healthcare workers (HCWs) have faced an unprecedented and unpredictable situation on the frontlines. The aim of this document is therefore to provide useful and operative recommendations to radiographers who perform imaging services, such as chest X-ray (XR) and Computer Tomography (CT) scans to three types of patients: negative, suspected or suffering from Severe Acute Respiratory Syndrome by Coronavirus (SARS-CoV-2). It is paramount to design two different paths’ layouts for patients entering the Radiology Department. One path should care for the confirmed and suspected SARS-CoV-2 patients, whereas the other path should be for negative patients. A setting envisaging two radiographers is highly recommended when managing Covid-19 patients. One radiographer fully-equipped with proper personal protective equipment (PPE) should deal with the patient in the scanning or x-ray room. The second one should stay in the console room wearing essential PPE. Disinfection plays a crucial role in reducing the risk of disease transmission. Moreover, having clear protocols is key to ensure personal safety and avoid cross-infections. Taking care of patients and HCWs, such as radiographers, is crucial to minimize the risk of disease transmission. Within a Radiology Department, different designed pathways should be taken into consideration both for everyday and epidemic/pandemic healthcare situations. Though Covid-19 pandemic has been a harsh experience in terms of world health and care systems for patients and health professionals - being radiographers among the most involved - we must not miss this chance to learn from what happened. There is the need to address wider causes through learning and in order to prevent failures. The distinction between passive learning (where lessons are identified but not put into practice) and active learning (where those lessons are embedded into an organization’s culture and practices) is crucial in understanding why truly effective learning so often fails to take place.

Coping with more people with more illness. Part 2: new generation of standards for enabling healthcare system transformation and sustainability.

In Part 2 of this two-part contribution made on behalf of the Innovation and Systems Change Working Group of the International Society for Quality in Health Care (ISQua), we continue the argument for refashioning health systems in response to ageing and other pressures. Massive ageing in many countries and accompanying technological, fiscal and systems changes are causing the tectonic plates of healthcare to shift in ways not yet fully appreciated. In response, while things remain uncertain, we nevertheless have to find ways to proceed. We propose a strategy for stakeholders to pursue, of key importance and relevance to the ISQua: to harness flexible standards and external assessment in support of needed change. Depending on how they are used, healthcare standards and accreditation can promote, or hinder, the changes needed to create better healthcare for all in the future. Standards should support people's care needs across the life cycle, including prevention and health promotion. New standards that emphasise better coordination of care, those that address the entire healthcare journey and standards that reflect and predict technological changes and support new models of care can play a part. To take advantage of these opportunities, governance bodies, external assessment agencies and other authorities will need to be less prescriptive and better at developing more flexible standards that apply to the entire health journey, incorporating new definitions of excellence and acceptability. The ISQua welcomes playing a leadership role.

Coping with more people with more illness. Part 1: the nature of the challenge and the implications for safety and quality.

Health systems are under more pressure than ever before, and the challenges are multiplying and accelerating. Economic forces, new technology, genomics, AI in medicine, increasing demands for care-all are playing a part, or are predicted to increasingly do so. Above all, ageing populations in many parts of the world are exacerbating the disease burden on the system and intensifying the requirements to provide effective care equitably to citizens. In this first of two companion articles on behalf of the Innovation and Systems Change Working Group of the International Society for Quality in Health Care (ISQua), in consultation with representatives from over 40 countries, we assess this situation and discuss the implications for safety and quality. Health systems will need to run ahead of the coming changes and learn how to cope better with more people with more chronic and acute illnesses needing care. This will require collective ingenuity, and a deep desire to reconfigure healthcare and re-engineer services. Chief amongst the successful strategies, we argue, will be preventative approaches targeting both physical and psychological health, paying attention to the determinants of health, keeping people at home longer, experimenting with new governance and financial models, creating novel incentives, upskilling workforces to fit them for the future, redesigning care teams and transitioning from a system delivering episodic care to one that looks after people across the life cycle. There are opportunities for the international community to learn together to revitalise their health systems in a time of change and upheaval.

Critical Analysis of Patient and Family Rights in JCI Accreditation and Cbahi Standards for Hospitals

Patient and Family Rights (PFR) is a common chapter available in the Joint Commission International (JCI) Accreditation[i] (fifth edition) and Central Board for Accreditation of Healthcare Institutions (CBAHI) Standards for hospitals (second edition)[ii]. JCI Accreditation is a USA based international healthcare accrediting organization, whereas CBAHI is the Kingdom of Saudi Arabia based national health care accrediting organization. However, both these standards are accredited by Ireland based International Society for Quality in Health Care (ISQua), which is the only accrediting organization who “accredit the accreditors' in the world. In Patient and Family Rights (PFR) chapter of JCI Accreditation for hospitals, there are nineteen (19) standards and seventy-seven (77) measurable elements (ME) whereas in CBAHI Accreditation there are thirty one (31) standards, ninety nine (99) sub-standards and fifty (50) evidence(s) of compliance (EC). The scoring mechanism is totally different in both these accrediting organizations. The researcher has identified thirty two (32) common parameters from JCI Accreditation and CBAHI standards, intent statement, measurable elements, sub-standard and evidence of compliance. On the basis of these identified common parameters, the researcher has compared the Patient and Family Rights chapter in JCI Accreditation and CBAHI Standards. Methods: This is a comparison study (normative comparison) in which the researcher has critically analyzed and compared the Patient and Family Rights (PFR) standards of JCI (Joint Commission International) Accreditation of USA (United States of America) and CBAHI (Central Board for Accreditation of Healthcare Institutions) of the Kingdom of Saudi Arabia. Data Collection: Primary data are collected from the JCI Accreditation Standards for hospitals, fifth edition, 2013 and CBAHI Standards for hospitals of Kingdom of Saudi Arabia, second edition, 2011. Secondary data are collected from relevant published journals, articles, research papers, academic literature and web portals. Objectives of the Study: The aim of this study is to analyze critically Patient and Family Rights (PFR) Standards in JCI Accreditation and CBAHI Standards to point out the best in among both these standards. Conclusion: This critical analysis of Patient and Family Rights (PFR) Standards in JCI Accreditation and CBAHI Standards for hospitals clearly show that the PFR Standards in CBAHI Standards are very comprehensive than the JCI Accreditation standards.

Critical Analysis of Staff Qualifications and Education Standards in JCI and Medical Staff & Staffing Management Standards in DNV Accreditation for Hospitals

The Staff Qualifications and Education (SQE) is a chapter in the Joint Commission International (JCI) Accreditation (Fifth Edition)[i] which describes the standards of Medical Staff & Staffing Management Standards in DET NORSKE VERITAS (DNV) Standard, Interpretive Guidelines and Surveyor Guidance for Hospitals, May 2013, Version 3.0.[ii] JCI Accreditation is a USA based international healthcare accrediting organization, whereas DNV is a Norway based international accreditation organization. The DNV International Accreditation Standard for Hospitals are based on the National Integrated Accreditation for Healthcare Organizations (NIAHO) standard platform developed in the United States (US), and has been adopted by hospitals around the world as a new standard of excellence. These standards integrate clinical and patient safety requirements with proven quality principles into one seamless program. It’s a highly developed management system uniquely formulated to promote excellence within hospitals. However, both these standards are accredited by Ireland based International Society for Quality in Health Care (ISQua), which is the only accrediting organization who “accredit the accreditors' in the world.Methods: This is a comparison study (normative comparison) in which the researcher has critically analyzed and compared the Staff Qualifications and Education (SQE) standards in the Joint Commission International (JCI) Accreditation (Fifth Edition) and Medical Staff & Staffing Management Standards in DNV Standards for Hospitals, May 2013, Version 3.0.Data Collection: Primary data are collected from the JCI Accreditation Standards for hospitals, fifth edition, and DNV Standards for hospitals, Version 3.0. Secondary data are collected from relevant published journals, articles, research papers, academic literature and web portals.Objectives of the Study: The aim of this study is to analyze critically SQE Standards in JCI Accreditation and Medical Staff & Staffing Management Standards in DNV Standards to point out the best among both these international standards.Conclusion: This critical analysis of SQE, MS and SM standards in JCI and DNV Accreditation for hospitals clearly shows that the SQE Standards in JCI Accreditation are very comprehensive, to the point and are much better than the DNV Accreditation.

Abstract P-460: ANALYSIS OF QUALITY INDICATORS OF A PEDIATRIC INTENSIVE CARE UNIT IN INDIA

Aims & Objectives: There is a dearth of literature about the Quality indicators of Pediatric Intensive Care units (PICU). Methods This is a retrospective analysis of two-year (January 2016 till December 2017) quality indicators which were collected on an everyday basis by a team of Quality manager, clinical pharmacist and infection control nurse. Our 14 bedded PICU is part of a hospital which is accredited by National Accreditation Board for Hospitals and healthcare providers (NABH), complying with the International Society for Quality in Healthcare (ISQua) standards. Results During the study period, there were 2143 admissions, 712 ventilated (47 on High Frequency Oscillator). 30 children underwent CRRT. Standardized-mortality rate (based on PRISM-3) was 80.08. SOFA score below 6 predicted survival with 87.7% sensitivity and 87.1% and specificity. PRISM-3 score below 8 predicted survival with 88.7% sensitivity and 69.9% specificity. Average ventilator-days was 3.47 days. Re-intubation rate was 13.2%, readmissions in PICU in 48 hours 1.17%. Incidence of pressure-sores was 12.2/1000 patient days, needle-stick injuries was 0.06/10000 venepunctures and fall-from-bed was 0.45/1000 days. Incidence of medication-errors was 4.8/1000 patient days. Incidence of Ventilator-Associated Pneumonia (VAP) was 11.5/1000 ventilator days, Catheter-Related Bloodstream Infection (CRBSI) was 4.32/1000 catheter days, Catheter-Associated Urinary Tract Infection was zero. Compliance to hand hygiene was 72.8%. Patients developing VAP had longer ventilator-days (p=0.006) and higher mortality (p=0.04). Patients getting re-intubated had higher but not statistically significant (p=0.59) VAP rate. 78.7% patients strongly agreed to recommend the PICU to others. Conclusions Our data represents a single unit in India. Collaboration from multiple units is essential to develop national and international databank and benchmarking.

Healthcare improvements from the unit to system levels: contributions to improving the safety and quality evidence base.

The International Journal for Quality in Health Care, which is an official journal of the International Society for Quality in Health Care (ISQua), presents two editor’s choices in this issue. Together they span from the unit through to the system levels, and capture the diversity, challenges and positive benefits associated with healthcare continuous quality improvement studies.

Challenges of the New Iranian Accreditation System Based on the Requirements of the International Society for Quality in Healthcare (ISQua)

Objective: Nowadays, successful health systems in the world have focused their attention on performance indicators, particularly on quality indicators. Given that accreditation is one of the main aspects of health system management and has a profound effect on these indicators, this study aimed to investigate challenges of Iranian accreditation system based on the requirements of the International Society for Quality in Healthcare (ISQua). Methods : This was a qualitative study and its instrument was a checklist earlier published by ISQua. The researchers initially translated checklist and assessed its validity based on the opinions of 20 experts finally developing a checklist with 39 items to assess four main dimensions. Furthermore, the experts’ perspective was obtained and analyzed related to procurement of requirements in Iranian accreditation system and the results were reported in descriptive statistics. Results: The Iranian accreditation system had a variety of weaknesses in all dimensions such as the involuntary participation of health centers in accreditation process; the weak participation of clinicians in accreditation activities and performance improvement; management of the accreditation process by a governmental organization; the accreditation program is not conducted by a committee composed of main stakeholders; healthcare organizations do not provide suitable data of clinical practice, and hospital administrators do not have formal training in health management (with 100% agreement of Experts). But this system has strengths including; the government has approved the creation of the accreditation program (95% agreement); there is a professional organization for controlling the registration of medical practitioners and nurses nationally, and accreditation program has access to data collected routinely by health providers to the Ministry of Health (80% agreement). Conclusions: This study showed that the challenges facing the new accreditation system of the country are abundant and the successful implementation of this program requires serious monitoring to eliminate detected obstacles. Undoubtedly, the barriers identified and the recommendations presented in this study can be used as a guide to achieve this important.

Assessment of the accreditation standards of the Central Board for Accreditation of Healthcare Institutions in Saudi Arabia against the principles of the International Society for Quality in Health Care (ISQua)

BACKGROUND AND OBJECTIVES:Accreditation is usually a voluntary program, in which trained external peer reviewers evaluate health care organization’s compliance with pre-established performance standards. Interest in accreditation is growing in developing countries, but there is little published information on the challenges faced by new programs. In Saudi Arabia, the Central Board for Accreditation of Healthcare Institutions (CBAHI) was established to formulate and implement quality standards in all health sectors across the country. The objective of this study was to assess a developing accreditation program (CBAHI standards) against the International Society for Quality in Health Care (ISQua) principles to identify opportunities for improvement of the CBAHI standards.METHODS:A qualitative appraisal and assessment of CBAHI standards was conducted using the published ISQua principles for accreditation standards.RESULTS:The CBAHI standards did not describe the process of development, evaluation or revision of the standards. Several standards are repetitive and ambiguous. CBAHI standards lack measurable elements for each standard. CBAHI standards met only one criterion (11.1%) of the Quality Improvement principle, two criteria (22.2%) of Patient/Service User Focus principle, four criteria (40%) of the Organizational Planning and Performance principle, the majority (70%) of the criteria for the safety principle, only one criteria (7.1%) for the Standards Development principle, and two criteria (50%) of the Standards Measurement principle.CONCLUSIONS:CBAHI standards need significant modifications to meet ISQua principles. New and developing accreditation programs should be encouraged to publish and share their experience in order to promote learning and improvement of local accreditation programs worldwide.

A conversation among friends

For the past ten years, working with my able Managing Editor Morag Teek, and Associate Editors Andrew Thompson, Heather Buchan, Joseph Ibrahim, Jorge Hermida and Klaus Piwernetz, I have edited this Journal. Guided and supported by the Chief Executive Officer of the International Society for Quality in Health Care (ISQua), Lee Tregloan, and the ISQua Board members responsible for the Publications Portfolio, Nancy Dixon and Heather Buchan, we have lived through exciting times—most notably the transfer of the Journal to joint-ownership by ISQua and the Oxford University Press (OUP) in 1998. From that date on, we have had support and guidance also from the experts at OUP, especially Mandy Hill, the Head of Science and Medical Journals in the Journals Editorial Department. Throughout, we have received valuable advice from an Editorial Committee of 30 individuals, all members of ISQua, drawn from around the world (the names of the current committee members appear on the title page of every issue). Most important of all, without the hundreds of authors and reviewers, each devoting many hours to their efforts, the Journal would not exist. So, after thousands of manuscripts submitted and reviewed and hundreds published, what has it all been for? What is all this activity about? From the author side …

International Society for Quality in Health Care (ISQua)

International Society for Quality in Health Care (ISQua)

XII World Congress of the International Society for Quality in Health Care (ISQua)

XII World Congress of the International Society for Quality in Health Care (ISQua)

XII World Congress of the International Society for Quality in Health Care (ISQua)

Journal Article XII World Congress of the International Society for Quality in Health Care (ISQua) Get access International Journal for Quality in Health Care, Volume 6, Issue 3, September 1994, Page 283, https://doi.org/10.1093/intqhc/6.3.283 Published: 01 September 1994

News from the International Society for Quality in Health Care (ISQua)

News from the International Society for Quality in Health Care (ISQua)