As Americans seek care in other countries, they look for reassurance that health care organizations abroad meet certain quality and safety standards they have come to expect. Therefore, hospitals abroad who hope to attract Americans to their institutions often seek Joint Commission International (JCI) accreditation, which is endorsed by the World Health Organization, because it demonstrates to the international community that the hospital has voluntarily sought an independent review of its commitment to safety and quality and has met standards that contribute to good patient outcomes.
But in addition, overseas hospitals tell us that they seek our consulting services and accreditation because our standards help them learn a common language – like that used by air traffic controllers – which ensures safety and consistency in the delivery of health care. Every hospital earning JCI accreditation must also set up parameters for a safe organization and meet JCI’s International Patient Safety goals.
JCI is part of Joint Commission Resources (JCR), an affiliate of the U.S.-based Joint Commission. The Joint Commission accredits over 90% of hospitals in the United States. JCI extends the Joint Commission’s mission, which is to improve the quality and safety of patient care, into the international arena through international consultation, publications, education, and accreditation.
JCI is Different from JC Accreditation in the US.
JCI accreditation standards are comparable to Joint Commission accreditation standards, but they are different. The difference is that the JCI standards and survey process were adapted for the international community and designed to be culturally applicable and in compliance with laws and regulations in countries outside the United States. For example, informed consent by patients is a JCI requirement, but different cultures handle this in different ways. In some cultures, patients fill out a form in front of a witness, while in others a family member may be the only one allowed to give consent. JCI accreditation allows for these differences.
JCI standards were developed by an International Standards Subcommittee made up of experts representing five major regions of the world. These standards address important topics such as the qualifications of doctors and nurses, properly assessing patients to match care to their identified medical needs, anesthesia procedures, and safe use of medicines.
In addition to accreditation, JCI has extensive international experience working with public and private health care organizations and local governments in more than 60 countries. Part of meeting JCI’s mission is helping individual countries develop their own accreditation programs. In many countries, JCI works with the ministries of health to develop their own standards and establish their own accrediting bodies. JCI’s standards have also become a model for standards developed by governments around the world.
We believe Americans can receive high quality care internationally, but first, patients needing care abroad must carefully research the physicians and health care organizations they are considering using and visit our website to determine if the hospital is accredited by JCI. Using a JCI-accredited hospital is basically a risk-reduction activity because when hospitals improve patient care and safety, patients are more likely to have good outcomes.
JCI accreditation standards are comparable to Joint Commission accreditation standards, but they are different.
Americans using JCI-accredited hospitals will also find other advantages. JCI accreditation requires that every patient is spoken to in a language and manner they can understand and that patients are involved in their care decisions. Patient rights must be protected, including confidentiality and privacy. When a patient prepares to leave the hospital and return home to his country, we require that the hospital transfer information to the patient and provide recommendations for follow-up care at home. All of these steps make it less likely the medical traveler will have some type of error or problem with his care.
How Accreditation Works
JCI accreditation is a rigorous process for which most hospitals prepare at least a year, if not longer. JCI accreditation is for a period of three years. After three years, JCI will conduct a full, onsite survey. Before accrediting a hospital, JCI sends in a team, usually including a doctor, nurse, and administrator, for a period of 3 to 5 days. Although at this time, the JCI surveys are announced visits, JCI may move to unannounced visits in the future.
Our surveyors use a tracer methodology, which is a systems approach, rather than just examining each department within a hospital. We believe the best way to gauge the quality of care provided by an institution is to trace the journey of patients as they move through the institution and examine how various departments work together to provide the care they need. Typically we trace 8 or more patients during our site visits.
JCI has approximately 300 standards which hospitals must meet and 1200 measurable elements which is what surveyors examine and score. Before leaving, surveyors conduct an exit interview with administrators and hospital leadership is given a copy of the preliminary report, which allows them to know whether or not they will likely receive accreditation. All reports are confidential; all we share with the public is a list of the hospitals currently accredited by our organization.
There are approximately 140 JCI-accredited hospitals in 26 countries. For the names of these hospitals or more information on JCI accreditation, you can visit our website at www.jointcommissioninternational.com.
Karen Timmons is President and Chief Executive Officer of Joint Commission International