Impact of Arab Accreditation Project on Patient Safety Arab Hospital Federation Congress Sharm El Sheikh-Egypt 4-5 March,2008 Dr.Safa El Qsoos/Quality Director Ministry of health/Jordan

Accreditation Process in which an entity, separate and distinct from the health care organization, assesses the health care organization to determine if it meets set of requirements designed to improved the quality of care, its usually voluntary and provides a visible committement to improve quality of patient care, ensure a safe environment, and continually work to reduce risks to patients and staff

Accreditation history 1910 Ernest Codman, M.D., proposes the “end result system of hospital standardization.” Under this system, a hospital would track every patient it treated long enough to determine whether the treatment was effective. If the treatment was not effective, the hospital would then attempt to determine why, so that similar cases could be treated successfully in the future.

1913 American College of Surgeons (ACS) is founded at the urging of Franklin Martin, M.D., a colleague of Dr. Codman. The “end result” system becomes an ACS stated objective.

1917 The ACS develops the Minimum Standard for Hospitals. Requirements fill one page. The ACS develops the Minimum Standard for Hospitals. Requirements fill one page The ACS begins on-site inspections of hospitals. Only 89 of 692 hospitals surveyed meet the requirements The ACS begins on-site inspections of hospitals. Only 89 of 692 hospitals surveyed meet the requirements

1926 The first standards manual is printed consisting of 18 pages. The first standards manual is printed consisting of 18 pages The standard of care improves over time and more than 3,200 hospitals achieve approval under the program The standard of care improves over time and more than 3,200 hospitals achieve approval under the program

1951 The American College of Physicians (ACP), the American Hospital Association (AHA), the American Medical Association (AMA), and the Canadian Medical Association (CMA) join with the ACS to create the Joint Commission on Accreditation of Hospitals (JCAH), an independent, not-for-profit organization whose primary purpose is to provide voluntary accreditation. The American College of Physicians (ACP), the American Hospital Association (AHA), the American Medical Association (AMA), and the Canadian Medical Association (CMA) join with the ACS to create the Joint Commission on Accreditation of Hospitals (JCAH), an independent, not-for-profit organization whose primary purpose is to provide voluntary accreditation.

1953 JCAH publishes Standards for Hospital Accreditation. JCAH publishes Standards for Hospital Accreditation Standards are recast to represent optimal achievable levels of quality, instead of minimum essential levels of quality. Standards are recast to represent optimal achievable levels of quality, instead of minimum essential levels of quality. Accreditation for hospitals and long term care facilities is reduced to a maximum of two years from three years. Where survey findings indicated that necessary improvements had not been made or completed, accreditation is given for one year. Accreditation for hospitals and long term care facilities is reduced to a maximum of two years from three years. Where survey findings indicated that necessary improvements had not been made or completed, accreditation is given for one year.

1987 The organization name changes to the Joint Commission on Accreditation of Healthcare Organizations to reflect an expanded scope of activities. The organization name changes to the Joint Commission on Accreditation of Healthcare Organizations to reflect an expanded scope of activities. The Agenda for Change is launched with a set of initiatives designed to place the primary emphasis of the accreditation process on actual organization performance.

1992 The Accreditation Manual for Hospitals begins the multiyear transition to standards that emphasize performance improvement concepts.

1996 The Sentinel Event Policy is established for the evaluation of sentinel events in accredited organizations and their relationship to accreditation status. The Sentinel Event Policy is established for the evaluation of sentinel events in accredited organizations and their relationship to accreditation status.

IOM Report /1999 To Err Is Human: Building a Safer Health care System Building a Safer Health care System 98,000 preventable deaths each year,with an associated cost of $17 to $29 billion. 98,000 preventable deaths each year,with an associated cost of $17 to $29 billion.

1999 The Joint Commission’s mission statement is revised to explicitly reference patient safety : "The mission of the Joint Commission is to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations

2001 The Joint Commission forms a 20-member Standards Review Task Force to identify the accreditation standards most relevant to the safety and quality of patient care, and target for elimination or modification those standards that do not contribute to good patient outcomes. New standards that focus directly on patient safety and medical/health care error reduction in hospitals take effect July 1. New standards that focus directly on patient safety and medical/health care error reduction in hospitals take effect July 1.

2002 The Joint Commission establishes its first annual National Patient Safety Goals and associated requirements for improving the safety of patient care in health care organizations, to be effective in Joint Commission President Dennis S. O’Leary, M.D., testifies before the House Committee on Energy and Commerce, Subcommittee on Health, on private sector efforts to improve patient safety

2003 The Joint Commission announces a Universal Protocol™ for preventing wrong site, wrong procedure, wrong person surgery, effective July 1, The Joint Commission announces a Universal Protocol™ for preventing wrong site, wrong procedure, wrong person surgery, effective July 1, The Joint Commission forms a 20-member expert panel to consider and recommend ways in which the Joint Commission’s infection control standards can be strengthened. Later in the year, the panel approves revised standards that sharpen and raise the expectations of organization leadership and of the infection control program itself.

2004 The World Health Organization launches its World Alliance for Patient Safety in October, and the Joint Commission is invited to be involved in several of the Alliance’s initiatives.

2005 Joint Commission President Dennis S. O’Leary, M.D., testifies before Congressional leaders in June that American health care facilities must embrace a “systems approach” to preventing adverse events that keeps the errors that caregivers inevitably make from reaching patients.

2005 The World Health Organization in August designates the Joint Commission and Joint Commission International as the WHO Collaborating Centre for Patient Safety Solutions.

2006 The World Health Organization Collaborating Centre on Patient Safety, the World Alliance for Patient Safety and the Commonwealth Fund announces a seven-country collaborative project in December that will leverage the implementation of five standardized patient safety solutions to prevent avoidable catastrophic events in hospitals.

2006 JCI introduced the IPSGs in 2006 and surveyors have been evaluating compliance with these goals during accreditation surveys in 2006, but these findings have not affected the accreditation decision. Beginning 1 January 2007, hospitals accredited by JCI are required to display compliance with the following ISPGs (in addition to JCI’s 368 standards in 11 chapters): Goal: Identify Patients Correctly. Goal: Improve Effective Communication Goal: Improve the Safety of High-alert Medications Goal: Eliminate Wrong-site, Wrong-patient, Wrong-procedure Surgery. Goal: Reduce the Risk of Health Care–acquired Infections Goal: Reduce the Risk of Patient Harm Resulting from Falls JCI introduced the IPSGs in 2006 and surveyors have been evaluating compliance with these goals during accreditation surveys in 2006, but these findings have not affected the accreditation decision. Beginning 1 January 2007, hospitals accredited by JCI are required to display compliance with the following ISPGs (in addition to JCI’s 368 standards in 11 chapters): Goal: Identify Patients Correctly. Goal: Improve Effective Communication Goal: Improve the Safety of High-alert Medications Goal: Eliminate Wrong-site, Wrong-patient, Wrong-procedure Surgery. Goal: Reduce the Risk of Health Care–acquired Infections Goal: Reduce the Risk of Patient Harm Resulting from Falls

Joshua Goldberg Death of 23 year old son This is a living case history concerning the death of my 23 year old son who died at Bumrungrad Hospital in Bangkok Thailand on 23 February 2006 at approximately 9:00 PM, Thai time Yes, this is a case about the death of a human being at the hands of malicious people. But it is also a case which illustrates that money and power drives medical care in the US and, by extension, internationally. The last concern of this machine is your health, care and safety.

Bumrungrad, the hospital where my son was murdered, is accredited by the Joint Commission. Yet, despite having informed them, time and again, of factual wrong doing, they have remained silent and have denied that they have any responsibility to the public reveal the Accreditation: Once Given, Never Revoked

Patient for patient safety Movement Leaded by Susan Sheridan Lost her husband because of the health care provided in accredited hospital,and her son is suffering of permanent disability patient safety awareness week patient safety awareness week March 2 nd - 2th. 2008

In the Arab countries ? Research in 2005 on the size of harm to patient WHO/EMRO,Dr.AHMAD ABDULATIF Australian Research Center Dr.Ross Wilson

The Arab Accreditation Project Introduction on Why the project focus on patient safety Standards relevant to patient safety أ. معايير رعاية المريض ب. معايير أمان وسلامة المريض ج. معايير الإدارة د. معايير الخدمات المجتمعية Classification and scoring high lighting standard on patient safety

رابعا : مستويات التطابق المستوى المبدئي : 75% تطابق مع معيار A 50% تطابق من معيار B %85 تطابق مع معايير آمان المريض

مستوى الاعتماد : 85% تطابق من معيار A 75% تطابق من معيار B 95% تطابق مع معايير آمان المريض 95% تطابق مع معايير آمان المريض