1. Assessing Regional Blood Centers Using Foreign or International Standards Abdulla A. Alkhashan MS, ASCP, NCA King Abdulaziz Medical City-Riyadh For the 10 th Arab Transfusion Medicine Course Kuwait City, Kuwait 29 th November to 1 st December, 2012

2. Presentation Outline Nature of Modern Health Care System Nature of Modern Health Care System History of Accreditation in Health Care History of Accreditation in Health Care The Value and Impact of Accreditation The Value and Impact of Accreditation Accreditation in the Developing Countries Accreditation in the Developing Countries The Pitfalls of Surveying The Pitfalls of Surveying Accreditation in the KSA Accreditation in the KSA

3. Nature of Modern Health Care System  44,000–98,000 annual deaths occur as a result of errors National Institute of Medicine report published in1999

4.  2,956,351 Transfusions  8 Mortalities (1:370,000 Transfusions )  117 Morbidities (1:25,000 Transfusions ) SHOT Report 2011 Nature of Modern Health Care System

5.  Not Monitored (Don’t Have Any)

6. Nature of Modern Health Care System  Facts patients need to live with it !

7. Nature of Modern Health Care System  Investigated individually (case-by-case)

8. Nature of Modern Health Care System  Investigated individually (case-by-case) What is wrong with this approach?  Reactive  Focus on individuals  Focus on corrective measures and may be taken ineffective preventive measures  No long term gains (such event may occur in the future)

9. Nature of Modern Health Care System Quality and Safety Excellence Quality and Safety Quality ball on the Hill; Koch, 1991

10. Nature of Modern Health Care System Quality and Safety Excellence Quality and Safety

11. Nature of Modern Health Care System Excellence Quality and Safety Standards and Accreditation

12. Nature of Modern Health Care System Excellence Quality and Safety Standards and Accreditation Proactive Approach

13. Nature of Modern Health Care System Excellence Quality and Safety Standards and Accreditation  Proactive Approach Risk Reduction

14. Nature of Modern Health Care System Excellence Quality and Safety Standards and Accreditation  Proactive Approach  Risk Reduction Organization Wide

15. Nature of Modern Health Care System Excellence Quality and Safety Standards and Accreditation  Proactive Approach  Risk Reduction  Organization Wide System Focus

16. Nature of Modern Health Care System Excellence Quality and Safety Standards and Accreditation  Proactive Approach  Risk Reduction  Organization Wide  System Focus Stimulate Continuous Improvements

17. History of Accreditation Accreditation is a voluntary program, in which authorized external peer reviewers evaluate the compliance of a health care organization with pre- established performance standards.

18. History of Accreditation Licensure is a process by which a government authority grants permission to an individual practitioner or healthcare organization to operate in an occupation or profession.

19. History of Accreditation American College of Surgeons in 1917

20. History of Accreditation International Standards Organization (ISO) in 1947  1917 - ACS

21. History of Accreditation American Association of Blood Banks (AABB) 1947  1917 - ACS  1947 - ISO

22. History of Accreditation Joint Commission on Accreditation of Healthcare Organizations (JCAHO) 1951  1917 - ACS  1947 - ISO  1947 - AABB

23. History of Accreditation AABB Accreditation Program -1957  1917 - ACS  1947 - ISO  1947 - AABB  1951 - JCAHO

24. History of Accreditation CAP Accreditation Program (1961)  1917 - ACS  1947 - ISO  1947 - AABB  1951 - JCAHO  1957 - AABB AP

25. History of Accreditation Accreditation modules exported (1960s)  1917 - ACS  1947 - ISO  1947 - AABB  1951 - JCAHO  1957 - AABB AP  1961 - CAP AP

26. History of Accreditation (1985) ISQua’s International Accreditation Program(1985)  1917 - ACS  1947 - ISO  1947 - AABB  1951 - JCAHO  1957 - AABB AP  1961 - CAP AP  1960s – Export of AP

27. The Value and Impact of Accreditation Helps set national standards for health care

28. Improves patient care  Helps set national standards for health care The Value and Impact of Accreditation

29. Makes information available to the public  Helps set national standards for health care  Improves patient care The Value and Impact of Accreditation

30. Lenient accreditation requirements  Helps set national standards for health care  Improves patient care  Makes information available to the public The Value and Impact of Accreditation

31. Makes health care more expensive  Helps set national standards for health care  Improves patient care  Makes information available to the public  Lenient accreditation requirements The Value and Impact of Accreditation

32. Accreditation in the Developing Countries Absence of strong regulatory and local accreditation bodies

33. Accreditation in the Developing Countries Used as a term for contracting with hospital's operating companies  Absence of strong regulatory and local accreditation bodies

34. Accreditation in the Developing Countries Business owners recognized accreditation a powerful marketing tool  Absence of strong regulatory and local accreditation bodies  Term for contracting with hospital's operating companies

35. Accreditation in the Developing Countries Skeptical about the impact of foreign or international accreditation on the quality of healthcare services provided  Absence of strong regulatory and local accreditation bodies.  Term for contracting with hospital's operating companies  Powerful marketing tool

36. Accreditation in the Developing Countries Prohibitively expensive and unjustified  Absence of strong regulatory and local accreditation bodies.  Term for contracting with hospital's operating companies  Powerful marketing tool  Skeptical about the impact

37. Accreditation in the Developing Countries Improve efficiency and clinical outcomes of a wide spectrum of clinical conditions  Absence of strong regulatory and local accreditation bodies.  Term for contracting with hospital's operating companies  Powerful marketing tool  Skeptical about the impact  Prohibitively expensive and unjustified

38. The Pitfalls of Surveying Interrogating and Inspecting instead of Interviewing and Assessing

39. The Pitfalls of Surveying Consideration to the local circumstances and available resources  Interrogating and Inspecting instead of Interviewing and Assessing

40. The Pitfalls of Surveying Misconception of the process owner  Interrogating and Inspecting instead of Interviewing and Assessing  Consideration to the local circumstances and available resources

41. The Pitfalls of Surveying Pressured to consider “in progress” as “compliance”  Interrogating and Inspecting instead of Interviewing and Assessing  Consideration to the local circumstances and available resources  Misconception of the process owner

42. The Pitfalls of Surveying The pace of developing Policies and Procedure faster than the implementation  Interrogating and Inspecting instead of Interviewing and Assessing  Consideration to the local circumstances and available resources  Misconception of the process owner  Pressured to consider “in progress” as “compliance”

43. Licensing and Accreditation in K.S.A 370 Hospital (244 Governmental and 126 Private)

44. Licensing and Accreditation in K.S.A 13 Blood Banks and Transfusion Services Accredited by the AABB and CAP  370 Hospital (244 Governmental and 126 Private)

45. Licensing and Accreditation in K.S.A 21 Laboratories Accredited by the CAP only  370 Hospital (244 Governmental and 126 Private)  13 AABB/CAP

46. Licensing and Accreditation in K.S.A 53 Hospitals Accredited by the JCI  370 Hospital (244 Governmental and 126 Private)  13 AABB  21 CAP

47. Licensing and Accreditation in K.S.A 74 Hospitals are CBAHI Accredited 6 Regional Laboratories and Central Blood Banks  370 Hospital (244 Governmental and 126 Private)  13 AABB  21 CAP  53 JCI

48. Licensing and Accreditation in K.S.A  370 Hospital (244 Governmental and 126 Private)  13 AABB  21 CAP  53 JCI  74 CBAHI  6 CBAHI-RRL

49. Health Care Providers in KSA 1.Ministry Of Health 2.Private Hospitals Sector 3.National Guards Health Affairs 4.Armed Forces Medical Services Sector 5.Ministry of Interior Medical Services 6.University Hospitals 7.King Faisal Specialized Hospital 8.Saudi Aramco Medical Services

50. 1.Saudi FDA 2.Council of Health Services 3.Council for Healthcare specialties 4.Ministry of Health (licensing) Health Care Regulators in KSA

51. CBAHI Accreditation Programs  Hospitals  Primary Health Care Centres  Ambulatory Care Centres  Reference Laboratories and Blood Banks Central Board of Accreditation for Healthcare Institutions (CBAHI)

52. Services of CBAHI  Standards Orientation  Training/Education  Onsite Consultation  Mock Survey  Accreditation

53. Central Board of Accreditation for Healthcare Institutions (CBAHI) Central Board of Accreditation for Healthcare Institutions (CBAHI) المجلس المركزي لاعتماد المنشآت الصحية www.cbahi.org

54. Summary Potential benefits of accreditation are far beyond the anticipated expenses and the healthcare providers need to be educated about these benefits and convinced by conducting cost / benefit analysis.

55. Thank You alkhashan@ngha.med.sa