challenges in the region. One of JHM s major contributions will involve consulting and working together with JHAH staff and leadership

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1 e c n e l l e c Ex BY SARAH L. PALMER Teams of JHAH staff will be undertaking fellowships with the Armstrong Institute. The Armstrong Institute for Patient Safety and Quality strives to reduce preventable harm, improve clinical outcomes and experiences and reduce waste in health care delivery at Johns Hopkins and around the world. (JHAH) is the result of a joint venture between two world leaders in their respective fields: Saudi Aramco and Johns Hopkins Medicine (JHM). In addition to providing industry-leading quality health care to Saudi Aramco employees and their eligible dependents, JHAH will fuel clinical innovation and serve as a model in the provision of health care in the region. It will contribute to the development of the health care industry in alignment with Saudi Aramco s commitment to enabling growth, opportunities and diversification within the Kingdom. Over the coming years, this international collaboration will contribute significantly to the health and well-being of 8 Dimensions International Saudi Arabia and its citizens. JHAH is evolving into a health system of excellence that provides enhanced specialty and subspecialty services, new lines of treatment, research and education that address some of the most significant health care challenges in the region. One of JHM s major contributions will involve consulting and working together with JHAH staff and leadership to enhance numerous clinical programs and develop tailored education and training programs related to nursing, quality and safety, research and health care leadership development to ensure sustainability. Since late January, more than 65 renowned faculty and experts from JHM visited JHAH to work and initiate collaborations with JHAH staff in Saudi Arabia.

2 Joint Commission International success On November 27, Keith Vander Kolk, CEO, JHAH, commented, I am proud to share with you that the Joint Commission International (JCI) Survey, which concluded today, resulted in a preliminary report score of 99 percent, which is excellent. Vander Kolk added that the evaluators had recommended JHAH for reaccreditation. The one-week, on-site survey followed the 5 th Edition of the JCI accreditation standards, which are widely regarded as being markedly more rigorous than previous editions. At the debrief presentation JCI Survey team leader, Enrico Baldantoni, M.D., commented Johns Hopkins Aramco Healthcare is a point of excellence in health care delivery in the Middle East and the world. JCI accreditation is subject to assessment, which takes place every three years. The JCI survey is a challenging process for any health care provider. To meet the required standards, an organization must examine its current processes, policies, and procedures relative to the current standards of care and improve any areas that are not in compliance. JCI is not the only accreditation agency in health care, but it is by far the largest and most prestigious. Hospitals and other health care providers who receive JCI accreditation have proven that they provide the highest level of performance and service to their patients. In the months preceding the JCI Survey, at every level and in every aspect of JHAH operations, staff worked diligently to achieve the positive outcome. The amount of work involved in the preparation, review and training is vast and staff members have invested a tremendous amount of effort and energy to earn reaccreditation. More good news Consistency is an important part of quality and JHAH is also celebrating the achievements of Laboratory Services, whose sustained commitment to excellence has resulted in the following reaccreditations: Reaccreditation for Transfusion Services and the Donor Center by the American Association of Blood Banks (AABB) continuously accredited since Reaccreditation for the Medical Laboratories by the College of American Pathologists (CAP) continuously accredited since It is not only the implementation of evidence-based medicine and use of advancing technologies, but also the small, seemingly imperceptible everyday interactions that contribute to an overall high quality of service for patients. Reaccreditation by these respected organizations reflects the commitment to care, which is being demonstrated throughout operations at JHAH. The presence at JHAH Dhahran by His Excellency Adel Fakeih and his delegation represented the first ever official visit to the facilities by a Minister of Health. Dimensions International 9

3 JHAH staff are preparing for the implementation of the Epic system. The new electronic health record is a state-of-the-art integrated information system that will combine all available patient information in a single database to improve all caregivers ability to review and treat patients. This is especially critical in areas such as Emergency Medicine where a critically injured patient may not be able to share information verbally. Major ongoing projects Over the coming months and years, JHAH will share the progress and impact of integral projects, such as the following. The remote area clinics pilot Recognizing the community-based health care delivery model isn t the right fit for the full spectrum of Saudi Aramco s operations, Vander Kolk and other members of the leadership team took time to visit a number of the remote areas, including Shaybah, Tanajib and Manifa. The objective of the visits was to better understand the needs of the Saudi Aramco employees working in those areas and to create a pilot program to improve medical services in such remote areas. As a result, the Tanajib pilot proposal was presented and approved by the Tanajib leadership team; the pilot program includes: Better access to on-site primary care services. Improved access to select specialty services at Dhahran. Embedded preventive/wellness services provided at Tanajib. Modifications to the provision of emergency services. Provision of on-site social and behavioral services. Nursing school A Memorandum of Understanding signed in January 2014 expressed the commitment to collaborate to develop a plan for academic nursing education programs and a nursing school pursuing a two-phase approach. Phase 1 encompasses the development of a plan for a range of academic nursing educational programs. Phase 2 encompasses the establishment of a school of nursing in collaboration with the Johns Hopkins University School of Nursing (JHUSON) to be located on a campus in Dhahran. Activities to date include the completion of the preliminary assessment by a delegation of nursing leaders from JHUSON and Johns Hopkins Medicine International (JHI) (January 2014) The next steps will be ongoing discussions with JHAH and JHUSON to form a study team to assess JHAH s existing nursing capabilities and challenges. The insight from specialized consultants and Johns Hopkins entities provides the opportunity to review lessons learned from local, regional and international bodies. YOU ARE PASSIONATE ABOUT WHAT YOU DO, PATIENT CARE AND QUALITY. TERRY AMERINE, MBA, JCI SURVEY EVALUATOR 10 Dimensions International

4 Advancing health care IT in Saudi Arabia Epic at JHAH JHAH is the first organization in the Kingdom to take steps to implement what is widely regarded as the best practice in Electronic Health Care Record (EHR) systems Epic. A BOUT JOHNS HOPKINS MEDICINE Johns Hopkins Medicine (JHM), headquartered in Baltimore, Maryland, is a $6.7 billion integrated global health enterprise and one of the leading health care systems in the United States. JHM unites physicians and scientists of The Johns Hopkins University School of Medicine with the organizations, health professionals and facilities of The Johns Hopkins Hospital and Health System. JHM s vision, Together, we will deliver the promise of medicine, is supported by its mission to improve the health of the community and the world by setting the standard of excellence in medical education, research and clinical care. Diverse and inclusive, JHM educates medical students, scientists, health care professionals and the public; conducts biomedical research; and provides patient-centered medicine to prevent, diagnose and treat human illness. JHM operates six academic and community hospitals, four suburban health care and surgery centers, and more than 30 primary health care outpatient sites. The Johns Hopkins Hospital, opened in 1889, was ranked number one in the nation by U.S. News & World Report for 21 years in a row and again in 2013 for a 22nd time. Epic is an electronic health record solution that will organize patient information, provide suggested actions and guides for caregivers, and coordinate care across multiple specialty settings. Implementing Epic is an ambitious program that will be executed over three to four years. The Epic EHR implementation is scheduled to start in January 2015 with a planned launch date in early Epic project director Robert Slepin joined the JHAH EHR project team in August The JHAH Epic project team participated in the Epic implementation go-live and support activities at JHM s Suburban Hospital, Bethesda, MD. As part of the preparation, the team first participated in one-week, end-user classroom training along with Suburban Hospital staff in Bethesda. The team then spent an additional week at the command center in Baltimore and onsite at the hospital to participate in cutover and post go-live support activities. The new JHAH department of Health Information Technology (HIT) has also contributed to the quality of clinical care by starting radiology image sharing with The Johns Hopkins Hospital (JHH). HIT facilitated the technical configuration to allow upload of JHAH radiology images to the JHH medical website for complex cases requiring a second opinion from JHH medical staff. Patient safety Armstrong Institute Substantial progress has been achieved to develop a sustainable framework for patient safety and quality within JHAH. Led by Sharon Myers, chief quality and patient safety officer, the first eight teams have been established as part of the quality and patient safety plan. Additional teams and training will take place in later phases of the quality and patient safety plan execution. The inaugural International Patient Safety Conference Dhahran, January 2015 The International Patient Safety Conference for JHAH will be held in collaboration with the Johns Hopkins Armstrong Institute for Patient Safety and Quality and the King Fahad Specialist Hospital (Dammam). Patient safety is a critical aspect of elevating the quality of clinical care within the Kingdom. Health care in the United States is facing a similar challenge; it is estimated that the deaths caused by preventable harm are equivalent to two Boeing 747 airliners crashing every day. As well as providing valuable training to attendees, it is hoped that this conference will be a part of igniting an influential and Kingdomwide dialogue around improving the safety and quality of care delivery. Dimensions International 11

5 screening and infection control related to the Ebola virus, The International Patient Safety Conference keynote admers-cov and infectious diseases. dress will be delivered by Peter Pronovost, M.D., director The JHAH Emergof the Johns Hopkins ing Infectious Diseases Armstrong Institute Taskforce has underfor Patient Safety and JOHNS HOPKINS ARAMCO HEALTHCARE taken a comprehenquality. The winis A POINT OF EXCELLENCE IN HEALTH sive review of current ner of several nationcare DELIVERY IN THE MIDDLE EAST procedures and is imal awards, including AND THE WORLD. plementing additional the 2004 John Eisenprecautionary and preberg Patient Safety ENRICO BALDANTONI, M.D. ventive measures. At Research Award and JCI SURVEY TEAM LEADER the recommendation of a coveted MacArthur the taskforce, experts Fellowship in 2008, from JHM developed a training course for licensed cliniknown popularly as the genius grant ; Pronovost was cians, i.e., emergency nurses, primary care nurses, physinamed by Time magazine as one of the world s 100 most cians and other health care providers, on how to protect influential people for his work in patient safety, and he patients and themselves from Ebola. The course took place regularly addresses the U.S. Congress on the importance of at JHAH Dhahran in early November, and covered aspects patient safety. of the screening protocols and the protective equipment the health care workers require to screen and safely care Contributing to the well-being of the Kingdom for Ebola patients. The primary objective of the course was to impart In recent times, emerging viral infections have become a knowledge about the signs and symptoms of infectious disglobal concern. JHAH medical personnel and Saudi Arameases and the proper precautions to prevent the infection co staff have proudly worked with the Saudi government and other partners to help advance the Kingdom s infection control and response infrastructure and public health policy. JHAH has provided equipment, manpower and technical knowledge to hospitals dealing with MERS-CoV cases. These activities have included education and clinical support via visits to hospitals across the Kingdom. The JHAH leadership has coordinated services from JHM-Baltimore to provide expertise in the evaluation and response to the outbreak. At this time, the JHAH staff continues to provide JUNE 23, 2013 : Saudi ongoing support for the King Abdullah Medical Complex Aramco and Johns Hopkins Medicine in Jiddah with staffing support and training. Through knowledge sharing and collaboration, JHAH International, L.L.C. (JHI), the has already begun to play a valuable role within the Kinginternational arm of JHM, signed a joint dom. In recognition of this growing spirit of alliance, in Ocventure agreement to establish a new tober, JHAH welcomed His Excellency Adel Fakeih, Minishealth care provider for Saudi Aramco. ter of Labor (who was acting Minister of Health during that time). The presence at JHAH Dhahran by His Excellency and his delegation represented the first ever official visit to JANUARY 28, 2014 : the facilities by a Minister of Health. The visit included an Ceremonial inauguration of Johns active and positive exchange of ideas centered on empowerhopkins Aramco Healthcare Company ing JHAH to reach its full potential and fulfill its role as a catalyst for change within the Kingdom s health care sector. takes place in Dhahran. Timeline Heightened preparedness JHAH conducts Ebola training for frontline medical staff Over the past months, JHAH has attempted to provide ongoing education, relevant updates and information to JHAH personnel and patients about Ebola and MERSCoV. This has included training, education, Medical Grand Rounds, s and videos. JHAH leaders and staff are collaborating with JHM to provide JHAH personnel with the most relevant education and training on protocols for 12 Dimensions International MAY 21, 2014 : Marked the first day that Johns Hopkins Aramco Healthcare began providing medical services in place of Saudi Aramco Medical Services Organization.

6 from spreading from patient to health care worker and the community. Experts from JHI provided training to 50 clinicians from Dhahran and the district hospitals. The two-day course was one aspect of the ongoing and comprehensive response to emerging viral infections, such as Ebola and MERS-CoV by JHAH. Following the successful completion of this program and additional training accreditation, the clinicians will be sharing their knowledge as part of a train the trainer approach. Dr. Jaffar Al-Tawfiq, chairman of the taskforce, commented, JHAH, in collaboration with Johns Hopkins, is taking the necessary steps from education to training of clinicians to be prepared for any potential emerging infectious disease. These preparations lay the foundation for future training across the health care system. Although a serious concern, Ebola does not pose an immediate risk within Saudi Arabia at this time and no cases have been confirmed within the Kingdom. Investing in human capital MANPOWER IS THE BIGGEST CHALLENGE THAT THE SAUDI HEALTH CARE SYSTEM FACES. DR. MAHMOUD AL YAMANY, CEO, KING FAHD MEDICAL CITY To function as an independent organization has required the creation of new departments to deliver services that historically were provided by Saudi Aramco. These areas include: law, finance, information technology, marketing and communications, and human resources. The JHAH Human Resources Department has developed the requisite compensation program, benefits package, orientation program and policies and procedures and is now actively seeking to attract high quality national and international health care talent. JHAH Marketing & Communications is working with Saudi Aramco Staffing Services and Saudi National Recruitment to create an independent and consistent look and feel for JHAH. The competitive total rewards package has been positively received by prospective candidates and progress on hiring is moving forward swiftly. Dimensions International 13