My Health and Wellness

 Worried about the destination choice ? 

After a person has decided to undergo treatment in abroad the next thing he should focus on, is the quality of service, technological advancements and standards, qualification and experience of the physicians, the hospital norms for controlling spread of infections. To know all these information, a person need not surf the net and read through the entire check list of norms and standards followed by the medical providers. Just relax!  And check only for the term “accreditation”. 

The term accreditation means the hospital fulfills all the basic standards and follows the list of norms for providing the best world-class care. Hospitals that are accredited subject themselves to a comprehensive evaluation and make an effort to improve the healthcare factors that may directly or indirectly involve the quality of the care and safety of the patients. 

“The act of accrediting is granting of approval to a hospital by an 

official review board after the hospital has met the specific code 

of practice for medical tourism.” 

Importance of Accreditation  

a.Patient’s perspective 

Entrusting life and health in the hands of a completely unknown physician in a far away country is really like inviting more troubles. Any patient entering a health care center deserves to know the quality of treatment provided, its facilities, maintenance of cleanliness, how well the physician and staff’s are trained, and what step they follow to minimize infection etc. It is always advisable to avoid non-accredited hospitals when opting for a medical trip. Accreditation assures the medical tourists that the hospital adheres to certain standards, medical code, professional ethics, and strives for excellence. It helps to weed out non-standard hospitals and unprofessional physicians. Also, many insurance companies refuse to pay back the cost of treatment that is undergone in a non-accredited hospital. Patients can always demand for accreditation information’s like – What type of accreditation the hospital has? When was it accredited? On what basis the accreditation was given? How the hospital maintains the standard of accreditation? Hospitals’ being transparent and honest to medical tourists about this fundamental information is very important. 

Few important standards which the accreditating organization look for are - patients care, physicians credentials, medication management and use, and confidentiality of information.  Always before flying for Medical Tourism make sure to carefully research the facilities provided by the health care center, and choose the health care center that are accredited by national or international accrediting organization. 

b. healthcare center perspective 

By gaining accreditation, the healthcare centers notify the people that it is providing good services. It also ensures the patients that the quality is continuously monitored and the institution is working to improve its services. There is always an opportunity to correct and improve the work done by the organization. Accreditation gains the hospital a world-wide recognition. International accreditation attracts patients from all over and promotes medical tourism. Due to rapid development of medical tourism industry, good annual revenue is earned by the accredited hospitals. The quality of services provided by an accredited institution is high and the chance of complaints from patients and staffs will be reduced. Many funding agencies also look for accreditation of the hospital. It also contributes to good staff-management relationship and improves staff morale and culture in the organization. Feedback from the accrediting organization often helps to increase the standards of the hospitals. 

c.funding agents perspective 

By funding an accredited hospital, the funding agents are confident about the return of investment compared to non-accredited service providers. In an accredited organization, regular auditing is not needed, an annual auditing is sufficient. Effectiveness, efficiency and client satisfaction are the key elements which a funding body always looks for and this is ensured to them in an accredited hospital.  

Accrediting Organizations 

Medical institutions providing quality health care and maintaining high standards of treatment are accredited by the international accrediting organizations. There are two different organizations that provides accreditation 

1. Organizations that accredit the healthcare centers such as The Joint Commission International (JCI), International Organization for standardization (ISO), Trent International Accreditation Scheme.
2. The umbrella organization “The International Society for Quality in health care (ISQua)” that certifies JCI, ISO,Trent organizations to accredit health care centers. 

a.The International Society for Quality in healthcare (ISQua) 

HDublin, Ireland, ISQua is a non-profit organization functioning over 70 different countries. In 1999, it launched its International Accreditation programme (IAP) to accredit the accreditors. The key role of ISQua is to provide service guidelines to health care professionals in all disciplines, researchers, agencies, national health care policy leaders, decision makers, administrators, clinical organizations, accreditation organization, healthy care networks, providers and consumer organizations. The mission of ISQua is to drive the organizations under it to continually improve the quality and safety of health care. 

b.Joint Commission International (JCI)

oint Commission on the Accreditation of Healthcare Organization (JCAHO) is an US based group which accredits hospitals in US. It has spread its arm globally as Joint Commission International (JCI). ISQua accredited JCI in 2007. The mission of JCI is to improve quality and safety of healthcare internationally through education, publications, consultation, evaluation and accreditation services. Since 1994, JCI has been working with healthcare organizations, ministries of health and global organizations in over 80 countries. The standards of JCI focus also on cultural, religious and legal factor of the country. It has accredited 300 organizations in 39 countries. For following an accreditation process in a specific country, JCI works in close collaboration with the hospital, government agencies, insurance company, legal expert, medical consultants and patients. JCI accreditation is considered as the “Gold standard” in international healthcare services. Accredited hospitals are monitored continuously for standards of healthcare provided.  

c.Trent International Accreditation Scheme

Another heavy weight non-profit organization accrediting hospitals worldwide is the Trent International Accreditation Scheme. Accreditation by this organization is done at an affordable price. Trent offers a self-evaluation tool through which the health care centers providing medical tourism can evaluate themselves and continue to develop and improve their service and standards equal to world class hospitals. The head office is based in UK, but accreditations are provided world-wide and not limited to UK. Trent accreditation gives importance to medical ethics. 

d. International Organization for Standardization (ISO)

ISO is a very commonly used word; it certifies the standard and quality of a product. Similarly, in medical tourism ISO accreditation is given to health care centers which provide quality and world class service. ISO is an international agent headed by central secretariat in Geneva, Switzerland 

The members of ISO are from 157 different countries. Among the list of series ISO: 9001 is a set of requirements focusing on the quality management, it helps to ensure quality and uniformity in all aspects of business, ISO: 2000 certifies good follow up and practice of management and ISO: 14001 are for environmental management system. ISO assures that the health care centers are strictly following the international standards put forth. As people are more aware and demand a quality health care now-a-days, it is mandatory that every hospital is well managed and efficient. ISO is often mistakenly considered as an international health care accreditation scheme, where it is not so, an ISO accreditation assures only technical quality.  

e.The Society for International Health Care Accreditation (SOFIHA)

SOFIHA is a free-to-join group located in Sheffield, UK, which provides a platform that enables different organizations to contact each other, for discussion and sharing views about good health practice by the providers of international health care. This organization mainly concentrates on safe environment of the health care center.

f.  Health Care Tourism International

This is the first US based non-profit organization that focuses on the non-clinical aspects of medical tourism. It concentrates on safety of the patients during their medical travel. This organization works toward the improvement of safety and reputation of the health care travel industry. This also ensures providing best service in fields such as language issues, business practices, and avoiding false or misleading advertisements. Accreditation also includes facilities like hotels, medical tourism booking agencies and recovery facilities. 

g.The International Medical Travel Association (IMTA) 

IMTA, a non-profit organization functioning from Singapore which addresses issues like standard and quality, legal issues, continuity of care for patients. Another non-profit organization called the Medical Tourism Association (MTA) which includes medical travel facilitators, health care providers, top international hospitals, insurance companies and other affiliated companies. This organization mainly concentrates on the quality, transparency and pricing of the health care center.  

Alliance for Patient Safety 

As said rightly “Clean care is safer care”, based on this, WHO formed an organization called World Alliance for Patients safety. This organization accredits hospitals which strive for global patient’s safety, involvement of patient in the all decisions of health care provided to him, developing norms for patient’s safety, solution to reduce risk of infection. 

Country Specific Accreditation 

An increased public recognition of the standards of accreditation has led to the improvement of many health centers. There are many country specific accrediting organizations, which assures quality and safety.  

a.National Accreditation Board for Hospitals & Healthcare Providers (NABH)

NABH is an institutional member of ISQua. NABH is an organization functioning as quality council in India. This was formed to accredit hospitals in India, which followed the prescribed standards of quality and sets a benchmark for progression in health industry. The NABH contains a complete set of standard guidelines that are checked during evaluation of hospital while considering it for accreditation. The standards include framework for quality assurance and improvement. The standards are focused in giving safety and quality care to the patients. Continuous monitoring of the health center is done by the organization to ensure quality culture at all levels and across all functions.

b. The Malaysian Society for Quality in Health (MSQH) 

The Ministry of Health Malaysia (MOH), Association of Private Hospitals of Malaysia (APHM), Malaysian Medical association (MMA) together formed the Malaysian Society for Quality in Health (MSQH). Importance of quality health care was always a major agenda for MSQH. This non-profit organization functions along with healthcare professionals to ensure safety and quality improvement in services provided in the health care sector of the country.  

c.The Singapore Accreditation Council (SAC)

The national accrediting body in Singapore is SAC, a non-profit organization funded by government of Singapore. SAC has gained a recognition and acceptance in many Asia-Pacific regions and also globally. This council functions under Standards, Productivity and Innovation Board (SPRING) a statutory board of the Ministry of Trade and Industry. SAC accredits national hospital after evaluating services such as testing, calibration, inspection and certification.

d.  The Health Sciences Authority (HSA) 

Another accrediting agency in Singaporeis The Health Sciences Authority (HSA). HAS is a statutory board dedicated to regulatory, scientific, and excellent services. Their services extend in providing the national regulatory framework to pharmaceuticals, medical devices, complementary medicines and other health products. The blood bank society, forensic medicines and services in analytical science also comes under HAS.

Accreditation Process  

Initially lots of questions were raised over How to provide the best environment for the clinicians to work? How to provide standard quality treatment for the patients? How to ensure people that the hospital follows quality diagnosis, treatment and hygienic environment? These questions subsequently ended in a standard process called “Accreditation”. If a healthcare facility wants to provide quality medical care to its patient or it wishes to attract medical tourists, depending up on their interest, they choose for national or international accreditation. 

Method of assessment

1. Hospital requests for a survey application.
2. Self-assessment about performance is done and the form is submitted.
3. Desk review is done after self-assessment.
4. Now a complimentary copy of “Comprehensive Accreditation Manual for Hospitals (CAMH)” is received by the hospital.
5. Surveyors inspect the premises, documents etc, interview the staff, and observe processes, reviews their records.
6. A brief initial feedback by the surveyor to the management is given at the end of the day, to ensure no surprises in accreditation reports.
7. Quality assurance of the surveyors finding is given.
8. A formal notification which includes feedback regarding standards met and deficiencies is given.
9. The surveyor evaluates the standards and quality followed by the hospital on a score of five. The score for each area is initially summarized. These scores are later consolidated into a single performance area score.
10. Detailed accreditation result is notified.
11. The applicant’s performance regarding fulfillment and of requirements is monitored.
12. Periodic re-accreditation is doen.
13. Regular self-assessment must be done by the hospital to enjoy continuous accreditation. After accrediting a hospital, the accrediting organization continuously monitors the health care providers.