The private hospital setting is considered to be one of the most profitable and flourishing industries in Jordan. A special attention was given to this industry due to the huge number of patients it treats, the exploration of the term “medical tourism”, and the growing number of expats in Jordan.
Experience Treating International Patients
In 2007 the value of the private healthcare sector was one billion dollars. The Jordanian private medical sector became a very important exporting sector; it is competing globally to receive patients from all different parts of the world.
The Oxford Business Report published in 2009 that Jordan treated 45,000 Iraqis, 25,000 Palestinians, 20,000 Yemenis, 19,000 Sudanese, 10,000 Syrians, 10,000 Libyans, in addition to 1,800 Americans, 1200 British, and 400 Canadian patients, making Jordan the first country in the region in terms of medical tourism and gave the private hospitals a motivation to enhance the quality of services provided to patients in every available way.
One of these world-wide known methods is International Accreditation, and for the purpose of this article, I will be focusing on JCI accreditation.
A Win-Win Scenario ~ Focusing on the Patient
We understand that international patients seek some sort of international standard set in place through accreditation, so we have made it a priority to ensure that facilities seeking to embrace the medical tourism industry and treat international patients invest in international accreditation.
It has become a win-win situation for us, as our local patient population also benefits from the high quality standards being put into place. The main benefits include having access to advanced medical institutions which have a pool of policies and procedures mastering the work processes and guarantee a safer delivery for the medical services from the providers to the patients.
International Accreditation ~ Quality Standards in Jordan
One of the greatest concerns of traveling patients, if not the greatest concern, is identifying the criteria to use when choosing the hospital that provides the best perceived quality care for patients. Patients need assurance that the medical treatment and the healthcare services they will receive, are delivered under the best international standards available.
We consider JCI Certification to be one of the best assurance tools within the medical tourism industry; therefore our hospitals utilize it to solidify their commitment to their number one priority, patient safety.
By applying such international accreditation standards, the hospital staff will also be immersed in a number of policies which will guide them to a best practices model, and they will have the opportunity to receive intensive training programs to help them perform in a more effective and safe way.
What we jokingly refer to as the “JCI fever” began in 2006. Leading private hospitals invested in this international accreditation and JCI certificates became a staple on the walls of the most coveted hospitals in Jordan. By 2010, Universities Hospitals followed suit. Currently, the total number of accredited hospitals in Jordan is 8, of which 6 are within the private sector.
JCI accreditation is now one of the most important factors in attracting patients to hospitals in Jordan for treatment. It encourages patients, particularly those from developed countries, who do their research before opting to travel for treatment to consider Jordan.
The Effects of International Accreditation on Medical Providers
The result of a study conducted in 2010 to measure the improvement on service’s quality in four JCI accredited private hospitals in Amman, reflected an improvement in the quality in terms of physician & nurses performance, documentation, medication errors, and infection prevention.
This improvement was a result of applying JCI standards as the statistic of these hospitals shows. The average decrease of the infection control percentage in three of the four studied hospitals was 0.18% after the accreditation; the documentation percentage has improved as well.
The documentation was the most improved aspect because of the JCI standards; the table below shows the exponential jump of commitment to documentation, the numbers in the table below shows the percentage of the perfectly completed medical records before and after the application of the JCI standards:
Medication errors were also improved following JCI implementation. The average percentage decrease of the medication errors was 0.19% due to the better training of staff along with the increased number of policies regarding this issue.
In order to understand how the application of the JCI standards affected the way they provide services to patients, 362 healthcare providers were surveyed as well. They responded to the study and gave the following rank for the effect of JCI standards on the quality aspects; number one rank was given to the most affected aspect by the JCI accreditation:
- Medication Use System
- Infection Control System
- Documentation System
- Doctors Performance
- Nurses Performance
In terms of the quality of doctors’ performance, 68% of the healthcare providers reported that after the application of the JCI standards, there was an evident focus and improvement in doctors in training, credentialing and privileges process.
Nurses are the “engine” of any hospital and with that being said, the JCI standards provided significant attention to nurses’ performance. A reported 89% of the participants improved after they followed the JCI standards, encompassing documentation, medication use, infection prevention, communication, and safety.
Infection prevention is among the most important issues in healthcare and one in which healthcare providers found that the establishment of JCI standards impacted the most. The majority of the studied sample reported that they are now armed with the tools of international standards, which in turn lead to an all around minimization of the infection rate by abiding by the policies and procedures regarding the infection rates and prevention.
Documentation is taking the lead among any other areas of improvement; patients’ medical records are the very most important communication tool among healthcare providers in terms of patients’ health and medical case and history. Of the sample of medical staff included in the study, 66% assured that the JCI standards helped them understand the documentation methods and as a result to better handle patient records.
The Importance of the Study Results
The surveyed sample consisted of doctors and nurses and urged the private hospitals’ management to provide a significant focus on accreditation certificates and in specific to the JCI accreditation; they recommended to apply these accreditation standards as a set of best practices that would enable them to work in an efficient, effective, safe and patient oriented environment, in turn increasing job satisfaction and creating a better atmosphere where they can work safely.
The health practitioners also encouraged the heads of the accredited hospitals to cooperate with non-accredited hospitals to spread the culture of accreditation all through the country, as they stressed that accreditation is not only a marketing tool, but more importantly it is a tool to improve and enhance the level of services quality provided to patients, whether these patients are local or medical tourists.
It is very important to mention, that in order to create a better understanding of the accreditation system and how it serves the patients, the accredited hospitals have embarked in a mission to disseminate information and education in the form of lectures, creating awareness for the public as well.
This piece of advice was given to the hospitals by members of the study sample, doctors and nurses in the accredited hospitals. They create awareness campaigns about the benefits of accreditation during the process of treating patients. This is done by talking to patients about their rights and responsibilities, by practicing medicine safely, and by providing the highest possible quality.
Several studies in numerous countries around the world were performed about the impact of JCI accreditation on the quality of services rendered, mainly showing a noteworthy improvement throughout all level of services.
Moreover, several lectures were given by JCI executives, supporting that JCI standards helped hospitals considerably improve their performance. This study is one of the very first, if not the only one, to test the impact of the accreditation standards on the quality in the Jordanian private hospitals from the standpoint of their very core; the providers of healthcare.
The results are in compliance with the previous studies, and reiterate that when accredited by an international accrediting body such as JCI, hospitals don’t simply purchase a marketing tool to polish their public image. This is an investment to improve existing methodology, raise their level of performance and apply best practices in order to offer all patients the best possible quality of care.
About the Author
Dr. Hashem Abu Sneineh serves as the International Marketing Coordinator in for world-renowned Specialty Hospital in Amman, Jordan. Dr. Abu Sneineh received his PhD in Business Administration with a focus on Quality in 2010. Forming an integral part of the Specialty Hospital since 2003, he has experience in areas including Human Resources Management, Patients’ Affairs Management, providing the background for his current position.
In addition to his work at Specialty Hospital, Dr. Abu Sneineh is a member of the Volunteer Team of the Private Hospital Association, where he generates strategies to internationally market the Jordanian hospitals and the country of Jordan as a viable destination for medical tourism.
Through his career, Dr. Abu Sneineh has gained vast experience in the quality field and in implementing quality standards from several accreditation bodies such as the Joint Commission International (JCI) and the Health Care Accreditation Council (HCAC), as well as receiving accolades including the King Abdullah Award for Excellence.