Assuring quality patient care

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Philhealth president Dr. Eduardo Banzon

What do we really mean when we say something is “world-class”? The term has been used over and over again for so many things—from equipment to resorts to hotels—that its meaning has become vague.

Fortunately, when it comes to hospitals and other medical facilities there really are precise standards that they can follow—so that they can truly be certified as world-class. The global organization for setting these standards for hospitals is the International Society for Quality in Healthcare (ISQua) which is based in Dublin, Ireland. The process by which a hospital meets these standards is called accreditation.

While ISQua itself does not accredit hospitals, it is the one that accredits or certifies the various accreditors that do accredit hospitals. Who are these accreditors? There are several accreditors recognized by ISQua and some of them are already familiar to the Philippine hospital sector: NABH International; JCI (Joint Commission International); Accreditation Canada: ACHS (Australian Council on Healthcare Standards). Closer to home is the MSQH (Malaysian Society for Quality in Health).

These accrediting organizations are recognized and authorized by ISQua to certify hospitals and other medical facilities. Certification by an ISQua-accredited accreditor is proof that a hospital’s quality of patient care and operations conforms to the worldwide standards set by ISQua. (ISQua is recognized by the World Health Organization as a partner in providing quality health care.)

Accreditation and the Philippines

What does the process of accreditation mean for the Philippines? Some are of the opinion that accreditation is an aid in medical tourism: a hospital with international accreditation is certified as being able to provide real world-class patient care.

Understandably, foreign patients’ main concern when it comes to traveling for health is the safety and effectiveness of the care they will receive from the country where they will be receiving treatment. The lower cost of medical care in the Philippines, for example, would be attractive to foreign patients but without an assurance of quality, foreigners would still shy away from the Philippines as a healthcare destination.

Therefore, medical travelers from overseas become confident that treatment at an accredited hospital by an ISQua-recognized agency will be safe and effective and would have international quality patient care this is equal to, if not better, than that in their home countries.

At present, there are already Philippine hospitals that are internationally accredited.  The Makati Medical Center, St. Luke’s Medical Center, The Medical City, and Chong Hua Hospital are accredited by JCI. The Philippine Heart Center and Manila Doctors Hospital are both accredited by Accreditation Canada.

PCAHO president Dr. Tomas Maramba

By 2013, it is expected that the Belo Medical Group will be accredited by NABH International—the first small healthcare organization/ambulatory clinic to be granted international accreditation. It should be noted, by the way, that NABH International accredits not only hospitals but also wellness centers, spas, diagnostic clinics, imaging centers, blood banks, dental clinics, and other health facilities.

It is hoped that more hospitals and clinics will be following suit as hospital owners and administrators understand the value of accreditation.

Benefits

What exactly are the benefits of accreditation? Some cynically think that accreditation is simply part of a hospital’s marketing effort to attract medical tourists.  However, according to ISQua Accreditation Council Vice-Chairman and Asian Society for Quality in Healthcare (ASQua) President, Dr. Bhupendra Rana, accreditation should mean more than this.

“Accreditation is not mean to be marketing. Rather, it is a way for hospital to upgrade the quality of their patient care and their operations so that its patients get the best care possible. That ought to be the main concern of any hospital seeking accreditation. Any other benefit to a hospital, like in terms of its business and profitability will come as a result of its commitment and effort to provide the best quality care for its patients,” he said.

Some of the benefits to patients would be improved quality of the diagnostic process as well as the day-to-day patient care they receive; an internationally accredited hospital would also be able to reduce its rate of hospital-borne infections; essentially, international accreditation would provide hospitals with benchmarks for upgrading equipment, improving the knowledge, training, and skills of its medical staff; and creating and implementing patient care protocols that reduce patient mortality, and result in more ideal clinical outcomes.

In some countries, internationally accredited hospitals are given certain incentives by the government if they are able to achieve and sustain their accredited status. For example, one incentive is the hospitals are given tax breaks or exemptions when purchasing medical equipment.

Furthermore, a hospital that is certified as conforming to international standards would be able to enjoy more profitability and greater savings. That’s because international standards also drive hospitals to be more efficient. This greater efficiency results in a much better management of resources, effort, and time.

Philhealth and PCAHO:  Local accreditation

ISQua Accreditation Council Vice-Chairman and ASQua President Dr. BK Rana

There are Philippine hospitals that are recognized by the Department of Health through Philhealth as Center for Excellence, Center for Quality, or Center for Safety.  These are hospitals, both public and private, that are certified as meeting the Philhealth Benchbook of standards in patient care.

In an interview with Philhealth president, Dr. Eduardo Banzon, he said however that Philhealth may soon be devolving the task of accreditation to third party accreditors.

“If you think about it, Philhealth is really a purchaser of medical care services for its members.  We talk to hospitals and ask them what services they are able to provide to Philhealth members. If they are offering treatments and services that our members can use, then great—Philhealth will draw up a contract with them.

“Of course, part of that contract is that the hospital or clinic must be providing quality, safe, and effective care.  If not, then of course Philhealth will not be contracting them. Accreditation is part of the process by which we determine whether or not a hospital or clinic is actually providing quality care to patients,” said Dr. Banzon.

On the other hand, there are those who are still vague about the role of PCAHO (Philippine Council for the Accreditation of Hospitals) as an accreditor of hospitals.  This was clarified by PCAHO President Dr. Tomas Maramba.

“PCAHO is focused on the accreditation of hospitals with regard to their fitness and capacity to provide for the special needs of medical tourists. What are these special needs?  For example, does a hospital provide interpreters to its non-English-speaking foreign patients? We have patients, you know, who come from the Middle East and other countries where people are not so fluent in English,” he said.

Dr. Maramba further explained that other all aspects of care specific to medical tourists are considered when PCAHO processes a hospital for accreditation.  This would include the quality of a hospital’s rooms; whether or not a hospital provides services like a tour package to patients who are combining a visit to tourist spots along with their treatments, etc.

“In short, medical tourists would have special needs whenever they come to the Philippines. It is PCAHO that gives certification or accreditation to hospitals that are able to cater to these special needs of medial tourists. PCAHO does not focus on patient care. That is already taken care of by Philhealth through its benchbook of standards in awarding Center for Excellence status to hospitals,” Dr. Maramba explained.

Just like international accreditation, local accreditation of Philippine hospitals ought to result in improved quality of patient care.

The future of patient care

Accreditation, it seems, is the way to go when it comes to improving our standards of healthcare. As Dr. Banzon noted, there is a quiet, slow, yet sustained increase in investments toward hospitals and other healthcare facilities.

“I’m not talking just about hospitals that are acquired by new owners and upgraded. There are also new hospitals being constructed even in the provinces,” he said. Hopefully, this development in the healthcare sector will also result in more hospitals getting both local and international accreditation.”

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HealthCORE, the center for global healthcare management and medical tourism research and communications, has been giving workshops to Philippine hospitals, clinics, and spas to help them learn the value of international accreditation (through ISQua accreditors) and the process of how to go about it. They are of the belief that the more Philippine hospitals get accreditation, it would be their patients, ultimately, who will reap the benefits. (www.healthcore.com.ph)

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