I recently got a call from a potential client who was interested on quality improvement. The first consultation is always interesting as I try to find out what the motivation is behind striving for change. Apparently after the call for focus on quality by WHO most healthcare organizations are finally paying attention. As if that’s not enough, there is a new dynamic in town [ in Africa anyway] called accreditation and facilities that have achieved it are smiling all the way to the bank as they can prove publicly that they provide high quality of care. This is translating to patient numbers which means increased revenue. Of course, where there is mention of increased revenue and reduced costs, investors and owners of private entities sit upright.
My potential client had only one question in his mind? How fast can I get this accreditation so I can make it public to increase my visibility in the very competitive healthcare market? My question to him was also simple: Before we look at external evaluation to get accreditation, what are the internal standards, processes and procedures you have and how do you evaluate them?
Simply put, accreditation in healthcare is a form of external review that shows that a healthcare provider is meeting regulations and standards set by an external accreditation organization. In most developed countries, this process is not voluntary and each healthcare organization MUST adhere to the regulations or face massive penalties which include public announcements of non-compliance. Unfortunately, in Africa, most countries are still in the stage of developing their own internal standards and/or even more importantly evaluating themselves against these standards leave alone invite external parties to come and evaluate them. Some of the popular accreditation bodies are JCIA [ Joint commission of international accreditation], COHSASA [The Council for Health Service Accreditation of Southern Africa] among others. Of course, there is always the question of whether the standards meet the context of healthcare in Africa and that has led to development of simpler standards that are user friendly e.g. the SAFECARE standards.
In order for a healthcare organization to achieve accreditation, they must prove compliance with the standards. This usually involves a rigorous review process, in which industry experts survey the organization’s structures and policies to ascertain the degree to which the organization does what it says it does and the evidence to prove it. The standards cover everything from training materials, to data retention, to equipment maintenance. This usually cuts across all departments in the organizations i.e. Administration and finance, Human resources, patient care in different aspects, patient safety, infection control, security Etc.
To prepare for accreditation, organizations must do a comprehensive assessment of processes, policies, and procedures, and anything else related to accreditation standards. This allows them to identify any areas where there are gaps in compliance. The organization’s leaders can then make changes to ensure that the structures meet standards and regulations. Unfortunately, the process of accreditation is very expensive as it means structural changes among other things to meet the set standards. It is always advisable for the facility to initially adapt the set standards and work towards compliance internally before engaging external evaluators.
Once the organization is prepared, external surveyors will conduct an on-site survey to decide whether to approve the organization for accreditation.
To maintain accreditation, the organization will have to undergo review every few years to ensure continued compliance. This is normally the tricky part as most health organizations tend to relax after achieving accreditation leading to the danger of being de-accredited which is normally done in public the same way accreditation is announced.
In the end, achieving accreditation in healthcare comes with many important benefits for your organization: This include:
- Achieving accreditation requires holding staff to high standards for patient care which in turn improves the overall quality of care in healthcare facilities.
- In certain specialty areas, accreditation programs even improve patient outcomes.
- Standardized processes decrease variations in the ways different staff members and departments care for patients therefore maintaining quality of care throughout.
Yes, I acknowledge the fact that in Africa we still have a long way to get there but I do know that each healthcare organization can start the process on their own to achieve internal benefits which will ultimately benefit the patient who remains the focus of this whole exercise. The right leadership in place makes or breaks the outcome of the process on establishing standards of patient care even in the smallest unit of healthcare.
The beauty of the whole thing is that you don’t even have to think about the standards as they are already available. As someone who has worked in both contexts of standards and lack of them, I can tell you for free that as a healthcare worker, the presence of standards makes our work much easier with less burnout.