Being JCI Accredited Is Being A Patient Centered Organization

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1 Being JCI Accredited Is Being A Patient Centered Organization Quality and Safety Conference King Fahad Specialist Hospital 23 October 2012, Dammam, KSA Ashraf Ismail, MD, MPH, CPHQ Managing Director, Middle East Region Joint Commission International 1

2 Definition The Institute Of Medicine (IOM) Defined Patientcentered Care As : Care That Is Respectful Of And Responsive To Individual Patient Preferences, Needs, And Values And [Ensures] That Patient Values Guide All Clinical Decisions IOM has identified patient-centeredness as one of the six domains that define quality care. 2

3 JCI Accreditation And Patient Centered Care 3

4 JCI Accreditation Standards And International Patient Safety Goals Are Designed To Help Organizations Enhance Safety And Yield More Positive Patient Outcomes. 4

5 Organizations that achieve Accreditation emphasize involving patients in their care. JCI Speak Up initiatives: Urges patients to take a role in preventing health care errors by becoming active, involved and informed participants on the health care team 5

6 JCI Accreditation Hospital Standards for Patient-Centered Functions Patient-Centered Standards Access to Care and Continuity of Care Patient and Family Rights Assessment of Patients Care of Patients Anesthesia and Surgical Care Medication Management and Use Patient and Family Education 6

7 Patient Centered Function 1 International Patient Safety Goals (IPSG) Promote specific improvements in patient safety. The goals highlight problematic areas in health care and describe evidence- and expert-based consensus solutions to problems related to patient safety. 7

8 Patient Centered Function 2 Access to Care and Continuity of Care Address : Which patient needs can be met by the health care organization The efficient flow of services to patients, and The appropriate transfer or discharge of patients 8

9 Patient Centered Function 3 Patient And Family Rights (PFR) Address : Promoting Consideration Of Patients Values Recognizing The Hospital s Responsibilities Under Law, Informing Patients Of Their Responsibilities In The Care Process Patient Rights With Respect To Informed Consent, Resolution Of Complaints Confidentiality 9

10 Patient Centered Function 3 Assessment of Patients Addresses patient assessment at all points of care within the hospital 4 Anesthesia and Surgical Care Addresses sedation and anesthesia use and surgical care 10

11 Patient Centered Function 5 Medication Management and Use Addresses: Systems And Processes For Selecting, Procuring, Storing, Ordering/Prescribing, Transcribing, Distributing, Preparing, Dispensing, Administering, Documenting, And Monitoring Medication Therapies 11

12 Patient Centered Function Patient and Family Education 6 Address The Effectiveness Of Education That Is Provided To Patients And Families Modalities Employed To Successfully Educate Patients Readiness To Learn 12

13 JCI Accreditation Hospital Standards For Organization Functions Health Care Organization Management Standards Quality Improvement and Patient Safety Prevention and Control of Infections Governance, Leadership, and Direction Facility Management and Safety Staff Qualifications and Education Management of Communication and Information 13

14 Organization Functions 1 2 Quality Improvement and Patient Safety Standards focus on the success of a hospital s design processes as well as Processes the hospital uses to measure, assess, and ultimately improve its performance. Prevention And Control Of Infections The methods a hospital uses to design and implement a program to identify and reduce the risk of patients and staff acquiring and transmitting infections 14

15 Governance, Leadership, and Direction 3 Effective leadership depends on successfully performing the following processes: Planning and designing services Directing services Integrating and coordinating services Improving performance 15

16 Facility Management and Safety 4 These standards measure the hospital s maintenance of a : Safe Functional And Effective Environment For Patients, Staff Members, And Other Individuals. 16

17 5 6 Staff Qualifications and Education Address: Human Resources Planning; Staff Orientation, Training, And Education; Staff Competence Assessments; Handling Staff Requests; And Credentialing And Privileging Management of Communication and Information Address: How Well The Hospital Obtains, Manages, And Uses Information To Provide, Coordinate, And Integrate Services 17

18 Key Attributes Of Patient-Centered Care Education and shared knowledge Involvement of family and friends Collaboration and team management Sensitivity to nonmedical and spiritual dimensions Respect for patient needs and preferences Free flow and accessibility of information 18

19 Factors Contributing To Patient- Centered Care Leadership A Strategic Vision Clearly And Constantly Communicated To Every Member Of The Organization Involvement Of Patients And Families At Multiple Levels, Care For The Caregivers Through A Supportive Work Environment Systematic Measurement And Feedback The Quality Of The Built Or Physical Environment Supportive Technology. 19

20 1 Leadership The single most important factor contributing to patient-centered care is the commitment and engagement of senior leadership. 20

21 2 A Strategic Vision Clearly Communicated The organization needs to develop a clear Vision and strategic plan for how patient-centered care will fit into its priorities and Processes on a daily operational basis. 21

22 3 Involvement Of Patients And Families Patients and families should be involved in care at several levels Patients and families should participate on key committees Dealing with issues such as patient safety, facility design, quality improvement, Patient/family education, ethics, and research 22

23 4 Supportive Work Environment: Care for the Caregivers Involve employees directly in the design and implementation of patient-centered processes Healthcare Organizations must create and nurture an environment in which their workforce treated with dignity and respect. is valued and 23

24 5 Systematic Measurement and Feedback You cannot manage what you cannot measure. A major factor contributing to patient-centered care is the presence of a robust customer-listening capacity that enables an organization to systematically measure and monitor its performance 24

25 6 Quality of the Built Environment One of the most important factors contributing to patient-centered care is the quality of the physical environment in which care is provided. The Planetree approach to health facility design encourages settings that: Welcome the patient s family and friends. Value human beings over technology. Conti.. 25

26 6 Enable patients to fully participate as partners in their care. Provide flexibility to personalize the care of each patient. Encourage caregivers to be responsive to patients. Foster a connection to nature and beauty. 26

27 7 Supportive Technology A final contributing factor permeating virtually all of the above elements is supportive technology. Health information technology (HIT) engages patients and families directly in the care process by facilitating communication with their caregivers and by providing adequate access to needed information and decision support tools. Conti.. 27

28 7 The key to success is to make adoption easy for both patients and clinicians, and to implement applications gradually. 28

29 Strategies For Leveraging Change 29

30 Strategies For Leveraging Change Key strategies to overcome barriers and to help leverage widespread implementation of patient-centered care. I. Organization-Level Strategies- designed to strengthen the capacity to achieve patient-centered care at the organization level II. System-Level Strategies- designed to positively influence and reward organizations striving to achieve high levels of patient-centered care. 30

31 Organization-Level Strategies Leadership Development and Training Senior leadership is essential to achieving patient-centered care Leadership education and development must encompass the entire pipeline of health care leaders It must also cross disciplines, from administration to nursing to medicine, and suppliers, and insurers 31

32 Internal Rewards and Incentives Assure that the capable, committed leaders are retained and rewarded for desired levels of performance. Compensation and incentives for CEOs and senior management must shift to focus on measurements of patientcentered care as part of an overall performance scorecard. Compensation and rewards must take place at all levels of the organization, from the medical staff to frontline employees 32

33 Training in Quality Improvement Staff members at multiple levels need training in quality-improvement concepts and methods that will enable them to effectively make, measure, and manage change. 33

34 Practical Tools Derived from an Expanded Evidence Base Evidence regarding specific interventions that work to improve patient-centered care must be documented & Made available to managers and change leaders 34

35 System-Level Strategies Public Education and Patient Engagement Strategies for educating and engaging patients to take a more active role in the care process will complement to the efforts of health care organizations to become more patient-centered. Involving patients and families will also lead to increased pressure for organizational responsiveness to the need for patient-centered care Conti.. 35

36 Evidence suggests that decision-making approaches shared between patients and providers can lead to: Improved patient knowledge More realistic perceptions of potential benefits and harms, and Greater ease in reaching decisions that reflect patient values and preferences. 36

37 Public Reporting of Standardized Measures Measurement and reporting should be based on the best available scientific evidence and standardized to enable fair and accurate comparisons. Measures are useful not only for monitoring and guiding improvement within organizations, but for holding organizations accountable for their results through public reporting. 37

38 Accreditation and Certification Requirements Accreditation and certification programs have historically provided significant external incentives for health care organizations to improve 38

39 A hospital must embed patient- and familycentered care practices into the core activities of its system of care delivery not considering them stand-alone initiatives to truly meet the needs of the patients, families, and communities served. 39

40 Dr. Ashraf Ismail, MD,MPH,CPHQ Managing Director, Middle East Region