Latha Krishnan■

A ll over the world, thehealthcare industryand community viewJointCommission In-ternational (JCI) ac-

creditation as the gold standard. Ahealthcare organisation that hasmet the rigorous standards of JCIcan proudly display the JCI GoldSeal of Approval™ as a sign of thisdistinctive accomplishment.When you see the Gold Seal of

Approval on the premises of JCI-accreditedorganisationsor in theircommunications you can be suretheorganisation is focusedonpro-viding the highest quality of careand safety. The Gold Seal of Ap-proval is a visible sign of the com-mitment of the healthcare organi-sation to deliver quality care in asafe environment.“At a JCI-accredited healthcare

organisation the patient comesfirst, always. Accreditation helpsorganisations focus on the mostimportantaspectsof improvementthat affect the quality of care andpatient safety including thingssuch as provider qualifications, in-fection control, coordination ofcare and the physical environ-ment,” says Dr Ashraf Ismail,ManagingDirector of the JCIMid-dle East Office in Dubai.JCI accreditation is centred

around 340 standards. The stan-dards arepatient-centric and focuson the systems in healthcare or-ganisations so that theyconsistent-ly provide the same high-qualitycare. JCI stipulates compliancewithcontinuousqualitymonitoringactivitiesaspartof its accreditationprogramme to help the healthcareorganisation provide the best careof the highest quality at all times.More than50per cent of the JCI

accreditation standards focus onpatient safety. The leaders and au-thoritative figures in the health-care industry realise this and pur-

sue accreditationbecause they arecommitted to putting patients firstin all that they do.Patients at a JCI-accreditedhos-

pital are treated with respect oftheir beliefs, customs, etc. In addi-tion, they are aware of andpartici-pate in all the decisions regardingtheir treatment. It is mandatoryfor theorganisation todevelopandimplement a patient bill of rights.Empowerment of patients is acritical cornerstone in patientsafety standards of JCI.If patient safety is compromised

at an accredited organisation,then JCI has prescribed proce-dures and practices to help or-ganisations. They also provideample support at these junctures,although JCI has prepared themto face such risks. Risk manage-ment is a full chapter in the JCIstandards manual and preparesorganisations to identify risks andmanage them effectively.Dr Ismail adds, “Healthcare or-

ganisations have to be 100 percent compliant with the JCI stan-dards to get the coveted JCI ac-creditation and Gold Seal of Ap-proval. Our surveyors keep trackof each accredited organisation’scompliance in operations andeven conduct unannounced visitsto ensure the high quality care isconsistent. We care about pa-tients at all times.”

WherepatientscomefirstJci accreditation is a sign of distinctive accomplishment

Johns Hopkins Aramco Health-care (JHAH) offers those in themedical field career fulfilmentand development opportunitiesin a patient-centred environ-ment where their contributionsare valued. The organisationtakes pride in continuous im-provement and encourages pro-fessional advancement com-bined with career stability.JHAH has a dynamic blend ofpeople from around the worldwho work together to achieveremarkable results.Formed in 2014, JHAH is the

result of a joint venture betweenSaudi Aramco, a world leader inenergy, and Johns HopkinsMedicine, one of the world’s

leadingacademichealthsystems.This healthcare organisation isdesigned to drive and enhancethewell-being of the communityin an environment of growth andlearningbyproviding innovative,integrated and patient-centriccaretoSaudiAramco’semployeesand healthcare beneficiaries.Before evolving into JHAH,

the organisation had been pro-viding high-quality clinical carefor almost 80 years as SaudiAramco Medical Services Or-ganisation (SAMSO). SAMSO, as

it was then known, was first ac-credited by the Joint Commis-siononAccreditation forHealth-care Organisations (JCAHO) in1956. It first achieved accredita-tion from the Joint CommissionInternational (JCI) in 2002, andhas continued this journey everythree years since. The organisa-tion emphasises the “journey”because it sees it as an ongoingprocess of learning, sharing, im-proving and achieving ever-higher standards of quality pa-tient care.

notch above the restJohns hopkinsaramco healthcarecompany is a jointventure betweensaudi aramco andJohns hopkinsmedicine

» JohnsHopkinsAramcoHealthcare (JHAH)

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JointCommissioninternational

Farhana Chowdhury■

The field of science isconstantly evolving. Asmore minds are busytapping into theorems

set by their predecessors, newdiscoveries and innovations arereigning supreme, each armedwith a mission to save humanityfrom the hands of potentialhealth dangers and issues.The UAE healthcare sector is

on par with international stan-dards as it has successfully estab-lished a reputable medical fieldand continues to improve the en-vironment for qualified staff, so-phisticated techniques and state-of-the-art technology.Medical institutions here are

further supported by the JointCommission International (JCI),a worldwide-recognised certifi-cation for medical organisations

that sets standards in the fieldand aims to improve quality ofpatient care.From specialised hospitals and

diagnostic centres to long-termresidential care and post-treat-ment services, the UAE is noshort of facilities that promise toadd value to the lives of patientsand their families.The diversity of internationally

accredited specialists is amongthe reasons behind the flurry ofmedical tourists to the country.Medical tourism is on the rise

and Dubai, in particular, is look-ing to buildmore hospitals as partof its plans to attract 500,000 vis-iting patients and boost its econo-my by up to Dh2.6 billion by theyear 2020. This year, around170,000 medical tourists are ex-pected to arrive inDubai for treat-ments, according to DHA.To date, around 26 existing

hospitals are a part of the DubaiHealth Authority’s medical tour-ism initiative. Adding to patientcare, the city will also establishan e-investigation system thatwill help combat malpractice.TheUAE is also a part of a spe-

cial global edition titled PatientsBeyond Borders, a resource sitethat compiles trustworthy infor-mation about healthcare and re-search institutions across theworld for medical tourists.Dubai Healthcare City, an in-

ternational hub of top hospitals

and clinics from around theglobe, launched its own bilingualedition to provide comprehensiveinformation after an extensivereview. The compilation is avail-able in English and Arabic.While official reports are yet to

be released, the Director ofHealthRegulation atDHAsharedthat Dubai treated over 115,000domestic and inbound medicaltourists and garnered revenue ofover Dh778.4million during thefirst quarter of 2015.

— farhana@khaleejtimes.com

Quick notes135,000 tourists were treated in 2014, according to Dubai»Healthcare City officials.Medical Tourism to boost UAE economy by Dh2.6 billion.»26 hospitals are currently part of the Dubai Medical Tourism»project, initiated by Dubai Health Authority (DHA) with moreon the way.‘» Patients Beyond Borders: Dubai Healthcare City edition’ is aninternational guide for medical tourists seeking care in theemirate.170,000 medical tourists are expected in 2016, according to DHA.»500,000 patients are expected to visit Dubai by the year 2020.»JCI certification overall boosts integrity of the UAE’s»healthcare sector.

UAE • SOUTH AFRICA • NAMIBIA • SWITZERLANDwww.mediclinic.ae

EXPERTISE YOU CAN TRUST.

Mediclinic Middle East’s network of private hospitals and clinics received full JCIaccreditation. This ensures that you receive quality care which measures up to themost stringent international standards.

• Mediclinic City Hospital

• Mediclinic Al Sufouh

• Mediclinic Dubai Mall

• Mediclinic Ibn Battuta

• Mediclinic Beach Road

Thank you to all our staff for their hard work and dedication.

YOUR HEALTHIN SAFE HANDS.

• Mediclinic Welcare Hospital

• Mediclinic Mirdif

• Mediclinic Meadows

• Mediclinic Al Qusais

• Mediclinic Arabian Ranches

GlobalhubforyourmedicalneedsTheUAE is no short of facilities thatpromise to add value to the lives ofpatients and their families, furtherboosted by JCI certification

Medical institutions here are further supportedby the Joint Commission International (JCI), aworldwide-recognised certification for medicalorganisations that sets standards in the field andaims to improve quality of patient care.

Joint commission internationalii

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06 7431333 admissions@gmu.ac.ae www.gmu.ac.ae

OUR NETWORK OF HOSPITALS

OUR NETWORK OF COMMUNITY CLINICS

UMM AL QUWAIN National PaintSHARJAH

Al Rams RoadRAS AL KHAIMAH

Al Mateena St.,DEIRA, DUBAI

Hytham Building, nearHonda Showroom,

AJMAN

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COLLEGE OFMEDICINE • COLLEGE OF ALLIED HEALTH SCIENCESCOLLEGE OF PHARMACY • COLLEGE OF DENTISTRY

COLLEGE OF GRADUATE STUDIESCENTER FOR CONTINUING EDUCATION AND COMMUNITY OUTREACH

Farhana Chowdhury■

ProVita International MedicalCenter, part of NMC Health, is aresidential long-term care facilitydedicated to patientswho requiremechanical ventilation andrehabilitation.Armedwith amission to reinte-

grate patients back into society, italso promotes and enhances theirquality of life while tending tocomplicated healthcare needs.“We include the patient’s fam-

ily in the multi-disciplinary plan-ning process and ensure that thepatient receives appropriate cul-tural, religious, and social experi-ences to continue to enrich theirlives despite their underlying con-ditions,” says Michael Davis,CEO, ProVita InternationalMed-ical Center.

The centers currently operatetwo facilitieswithin theUAE,witha recent expansion of 30 beds inAbu Dhabi, which increased thetotal capacity to 120.Its facilities are designed with

anemphasis on clinical care, safe-ty, individuality, and quality oflife, while adhering to interna-tional quality standards and ex-cellence in care.Interestingly, cultural attitude

to long-term care is among itsbiggest obstacles in the country,Davis highlights, but ProVita hasbeen successful in harbouringchange.Currently, almost 100 pa-

tients reside in the centers, with98 per cent being Emirati, ac-cording to Davis.“In the UAE, families are very

EnhancingQuality of Life

ProVita ensureslong-term patientslive life to thefullest nomattertheir condition

ServiceS offered at Provitainternational Medical center

24/7 ICU with highly trained physician coverage»24/7 paediatric consultant and specialist»24/7 intensivist and anaesthesia specialist, internal medicine and GP»24/7 respiratory therapy coverage»24/7 ambulance coverage»24/7 nursing coverage from registered nurses with a minimum of»two years ICU experience1:1 nursing ratio for mechanically ventilated and complex patients»Portable haemodialysis»Physiotherapy, occupational therapy, speech therapy, and dietician»five days a weekFamily involvement»Social services and cultural integration»

» ProVita InternationalMedical Center

Serving citizens of theUAE and bringing world-class care to chronically illpatients is a privilege wedo not take lightly. OurJCI affiliation ensures thatwe stay up-to-date andare compliant withevidence-based practiceto provide safe andeffective care to all of ourresidents.We are proudto be part of the UAEcontinuum of care andproud to be accredited byJoint CommissionInternational.

— Michael davis,CEO, ProVita International

Medical Center

close-knit and much of the ex-tended care of chronic patients isdone in short-term acute care orat homes. ProVita founded thelong-termcaremarket in theUAEand we have worked hard so thatour families and residents don’tfeel ‘institutionalised’. ProVita ishome to our residents and theirfamilies,” he adds.ProVita’s optimum care to pa-

tients earned them the JCI ac-creditation and is the first private-ly held long-term care facility

outsideof theUSand in the regionto achieve the recognition.“Serving citizens of the UAE

and bringing world-class care tochronically ill patients is a privi-lege we do not take lightly. OurJCI affiliation ensures that westay up-to-date and are compli-ant with evidence-based practiceto provide safe and effective careto all of our residents. We areproud to be part of the UAE con-tinuum of care and proud to beaccredited by Joint Commission

International,” says Davis.ProVita International Medical

Center is proud to announce thesuccessful completion of its tri-ennial Joint Commission Inter-national Accreditation survey.As a result of the survey, ProVitawill now be Joint CommissionInternational accredited untilJanuary 2019. ProVita CEOMi-chael Davis states, “At ProVita,we see the Joint Commission asan essential partner in the suc-cess and growth of our organisa-

tion throughout the Middle EastNorthern Africa (MENA) region.The standards provide a road-map for building a patient-cen-tric, quality-focused organisa-tion from the ground up and weare proud to be recognised byJCIA as a Gold Seal hospital.”Looking ahead, ProVita is

working on projects across theGCC with an aim to extend thebrand beyond the UAE.

— farhana@khaleejtimes.com

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iiiJoint coMMiSSion international

Joint Commission internationaliV

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J oint Commission Interna-tional (JCI) has recentlymodified the AccreditationParticipation Requirement

7, which specifies requirementsfor selection and use of qualitymeasures for its accredited hos-pitals and academic medicalcentres.Effective July 1, each accredit-

ed hospital and academic medi-cal centre is required to select and

use qualitymeasures as part of itsquality programme in order tocomply with Accreditation Par-ticipation Requirement (APR.7).The original APR.7 in Joint Com-mission International Accredita-tion Standards forHospitals, FifthEdition, as well as the Gover-nance, Leadership, andDirection(GLD) standards GLD.11 andGLD.11.1, called for hospitalsand academic medical centres tocollect and submit data on mea-sures selected from JCI’s Interna-tionalLibraryofMeasures (ILOM)and to use data specificationsprovided by JCI.For on-site surveys conducted

on July 1, 2015 and later,selection and use of measuresother than those from the ILOMas part of the organisation’squality improvement programmewill be considered acceptableproof of compliance with APR.7for hospitals and academicmedical centres.Hospitals and academic medi-

cal centres may use JCI’s ILOMmeasures and tools or measuresand tools developed by the fol-lowing bodies:

The hospital or academic◗medical centre’s qualityleadershipA municipal, regional, or na-◗tional health authorityAn internationally recognised◗healthcare quality organisa-tion, such as the Institute forHealthcare Improvement(IHI), the Organisation forEconomic Co-operation andDevelopment (OECD) HealthCare Quality Indicators pro-gramme, or the US-basedAgency for Healthcare Re-search and Quality (AHRQ)

JCImodifies requirementsforqualitymeasuresThe latest slewofmeasures giveshospitals andacademicmedicalcentres the flexibilityto tailor their qualityimprovement effortsto theneeds oftheir patients

We listened to ouraccreditedorganisations whenthey told us that theyneed to select and usemeasures that bestaddress their mostcritical quality issues.

— Paul Chang

Eliminatingmedication errors is agoal for all healthcare organisa-tions, but the path to this out-come is not always clear. Medi-

cationerrorsareoftencomplexandrootedin systemic gaps. Jeannell Mansur (RPh,PharmD, FASHP, FSMSO,CJCP), amedi-cation management expert, talks aboutthemulti-layered topic in detail.

in your experience, where are medica-tion gaps most likely to occur?

I’d encourage professionals looking to lo-cate some potential risk points in theirmedication processes to think about acouple of things. First, what are the high-est riskmedication processes that are tak-ing place in your organisation? Are thoseprocesses structured to reduce risk, asmuch as possible, through design? For ex-ample, consider areas like preparing andordering chemotherapy, prescribing andpreparing paediatricmedications, and thesterile compounding of IVs.High alert medications are also

important areas of focus, due to theirpotential to cause harm if given in error.Strategies to improve safety for thesemedications should be individualised toeach category of medication, and shouldbe designed to address the specific risksof that category.Another high alert area is the imple-

mentation and use of medication-relatedtechnology. Healthcare organisationsmake significant capital expenditures ontechnology with goals of improving pa-tient care and improving efficiencies.Healthcare organisations should take theopportunity to evaluate the performanceof these technologies to identify and acton opportunities for improvement.Errors associated with look-alike

sound-alike (LASA)medications can also

frequently factor into medication gaps.Many medications have names thatsound or look similar. Hydroxyzine andhydralazine are a perfect example of twomedicationswith very different purposeswhose names sound very similar. Pack-aging can also contribute to LASAmedi-cation mix-ups. The selection, storage,and prescription of LASA medicationscan all lead tomedication errors.

How can you evaluate the performanceof your medication system?

When looking to evaluate your organisa-

tion’s performance, it is important to un-derstand that the medication systemgoes beyond the pharmacy. With the fig-ure above as a reference, think of all theactivities that occur in each of the areasthat are part of the medication system.Ask yourself what the key performancemeasures for activities in each area are.With storage, it might be ensuring thatmedications are secure, or that medica-tion refrigerators are monitored andsteps have been taken to protectmedica-tionswhen temperatures are out of range.By using this type of exercise for each ofthe areas, you will be able to identify im-portant activities andmeasures that helpyou to understand howwell yourmedica-tion system is performing.

How can companies mitigate some ofthese risk points?

There are a few relatively simple thingsorganisations can do that would reducethe risk of medication errors. I recom-mend that organisations utilise tall manlettering when labelling LASA drugs. Tallman lettering capitalises the parts of thenames that are different. For example:“hyDROXYzine” and “hyDRALAzine.”Additionally, some organisations do notorganise drugs alphabetically, insteadchoosing to keep LASAdrugs on differentshelves, or even in different cabinets alto-gether. Prescription errors are easier to

circumvent when the drugs are enteredinto databases using both their genericand brand names. These changes mayseemsimple, but they are a few importantways to help reduce medication errors inyour organisation.Many organisations need to drill down

tofind the true cause ofmedication errorsandgaps. For example, disciplinary actiondirected at a nurse who accidentally ad-ministered the wrong drug to a patientwill notnecessarily prevent this error fromhappening again. Taking the time to anal-

yse the error and looking for the rootcause will. Examine your entire medica-tion process and findwhere the gaps haveoccurred.Once you fully understand howthe patient came to harm – where in thecontinuum of care your processes failed –then educate staff and physicians in orderto prevent a repeat incident.

Can anything good come frommedica-tion errors?

Medication errors are an opportunity tolearn about where your organisation’smedication system is breaking down, andan opportunity to work on fixing it.Whilewe certainly don’twantmedication errorsto occur, we want those that occur to bereported so that we can learn from them.Low reporting ratesmay occurwhen staffdoes not feel safe or comfortable in re-porting errors and near misses. Explorewhy reporting is low, and also examineandunderstand systematic reasons for er-rors. Don’t just focus on the individualswho made the error. Ensure that you arehelping to implement a culture of safety inyour organisation. In fact, medication er-ror reporting is a diagnostic of high reli-ability healthcare and of your organisa-tion’s culture. If staff and physicians inyour organisation feel comfortable andsafe, medication errors will be reported,and this leads to greater quality of care foryour patients.

The truthaboutmedicationerrorsTall lettering for LASAdrugs and an alert staffat pharmacies canmitigate risks andensure correct deliveryofmedicines

Errors associated with look-alike sound-alike (LASA)medications can alsofrequently factor intomedication gaps. Manymedications have names thatsound or look similar.Hydroxyzine and hydralazineare a perfect example of twomedications with verydifferent purposes whosenames sound very similar.

Pictures for illustration purposes only

At this time, JCI does not requiredata submission except for sur-veyor review of data during theon-site survey as evidence of anongoing quality improvementprogramme.“We listened to our accredited

organisations when they told usthat they need to select and usemeasures that best address theirmost critical quality issues,” saidPaul Chang,MD, Vice-President,Accreditation, Standards, andMeasurement, JCI. “In some cas-es, organisations were collectingdata on specific measures for lo-cal or national oversight bodiesand data on other separate mea-sures for JCI compliance. Thoseprocesses were becoming oner-ous in some cases. We think thischange gives our accredited hos-pitals and academicmedical cen-tres the flexibility to tailor theirquality improvement efforts totheir needs and those of their pa-tient populations, while remain-

ing in compliance with JCI re-quirements.”DrChangemphasised thatqual-

itymeasurementanddataanalysisremain essential components ofJCI’s accreditation process andthat the ILOM should still beamong the tools in thedata-collec-tion arsenal of a hospital or aca-demicmedical centre.“Datameasurement and analy-

sis are cornerstones of the JCI ac-creditation process. They arelinked directly or indirectly tonearlyeveryoneofourstandards,”said Dr Chang. “Ensuring organi-sations generate meaningful dataandusing thosedata to informde-cisions that improve patient careand outcomes remain at the cen-ter of our mission.”

For more informationcontact the JCI AccreditationCentral Office atjciaccreditation@jcrinc.com.

Data measurementand analysis arecornerstones ofthe JCI accreditationprocess. They are linkeddirectly or indirectlyto nearly every oneof our standards.

— Paul Chang