JCI Key messages(د/ أشرف الاباصيري)

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Information about JCI Key messages(د/ أشرف الاباصيري)
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Published on September 21, 2008

Author: ashrafalabasiry

Source: authorstream.com

Slide 1: J C I Key Messages By Dr.Ashraf AL-Abasiry,MBBCh,MSc Slide 2: Dr.Ashraf Al-Abasiry Slide 3: Dr.Ashraf Al-Abasiry WHAT IS THE J C I ? : WHAT IS THE J C I ? J C I is the international arm of the joint commission. J C I’s mission is to improve the quality of care and patient safety in the international community. Dr.Ashraf Al-Abasiry Slide 5: Dr.Ashraf Al-Abasiry International Patient Safety Goals : International Patient Safety Goals International Patient Safety Goals, are required for implementation as of 1 January 2008 in all jCI accredited organizations. The purpose of the International Patient Safety Goals is to promote specific improvements in patient safety. Dr.Ashraf Al-Abasiry International Patient Safety Goals : International Patient Safety Goals ►Identify Patients Correctly. ►Improve Effective Communication. ►Improve the Safety of High-Alert Medications. ►Ensure Correct-Site, Correct-Procedure, Correct-Patient Surgery. ►Reduce the Risk of Health Care-Associated Infections. ►Reduce the Risk of Patient Harm Resulting from Falls. Dr.Ashraf Al-Abasiry J C I Standerds for Hospitals : J C I Standerds for Hospitals Section I: Patient-Centered Standards 1-Access to Care and Continuity of Care. 2-Patient and Family Rights. 3-Assessment of Patients. 4-Care of Patients. 5-Anesthesia & Surgical Care. 6-Medication Management and Use. 7-Patient and Family Education. Dr.Ashraf Al-Abasiry J C I Standerds for Hospitals : J C I Standerds for Hospitals Section II: Health Care Organization Management Standards 1-Quality Improvement and Patient Safety. 2-Prevention and Control of Infections. 3-Governance, Leadership, and Direction. 4-Facility Management and Safety. 5-Staff Qualifications and Education. 6-Management of Communication and Information. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 1-Access to Care and Continuity of Care (ACC) : Section I: Patient-Centered Standards 1-Access to Care and Continuity of Care (ACC) ACC is a patient centered integrated system of services matching and co-coordinating an individual’s ongoing needs with the appropriate level and type of care, treatment, and service within a Health Care Organization (HCO), or outside the organization, including the plan of discharge, transfer, and follow up. The objectives are improved patient care outcomes and more efficient use of available resources. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 1-Access to Care and Continuity of Care (ACC) : Section I: Patient-Centered Standards 1-Access to Care and Continuity of Care (ACC) ► The organization has a process for admitting inpatients & for registering outpatient . ► Process design exists to coordinate care and provide continuity of care. ► Process exists to refer or discharge patients . ► Process to appropriately transfer patients to another organization. ► Transportation needs are considered for patients .   ► The Medical Transport system meets relevant laws and regulations and also is licensed when required. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 2-Patient and Family Rights (PFR) : Section I: Patient-Centered Standards 2-Patient and Family Rights (PFR) Excellence, for a healthcare organization, starts with the patients and ends with the patients. The rights of the patients and their families are an integral part of all of the activities that SSH is involved with. (PFR) at SSH are carried out by defined processes, related to how the organization provides health care in a balanced manner. Core documents can be found at \\sshfiling\Policies Dr.Ashraf Al-Abasiry Slide 13: Joint Commission International PFR standards are incorporated with the daily practice of SSH by: Hospital Management Committee monitoring performances of how the caregivers carry out processes. Processes addressed are:  Identify, protect, and promote patients' rights.  Inform patients of their rights. Include the patient's family, when appropriate, in decisions regarding care.  Obtain informed consent.  Educate staff about patients' rights.  Establish the organization's ethical framework. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 3-Assessment of Patients (AOP) : Section I: Patient-Centered Standards 3-Assessment of Patients (AOP) Patient assessment is an ongoing dynamic process that takes place in many settings and departments, and consists of : Three primary processes.  Collecting information and data on the patient’s physical, psychological, and social status, as well as health history. All patients cared for by SSH have their health care needs identified through an established assessment process. All patients are re-assessed by a qualified individual, at appropriate intervals. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 3-Assessment of Patients (AOP) : Section I: Patient-Centered Standards 3-Assessment of Patients (AOP) Getting compliance: a. Physician    On form SSH-2017 Physician's Admission History and Physical Examination - Adult.  DP-MED-012 Physician's Patient Assessment Intervals, provides guidelines for initial evaluation and re-evaluation of patients who require more frequent evaluations than the standard 24 hours as outlined in the Medical Staff Bylaws and Rules and Regulations. Dr.Ashraf Al-Abasiry Guidelines for at Risk patients: : Guidelines for at Risk patients: Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 3-Assessment of Patients (AOP) : Section I: Patient-Centered Standards 3-Assessment of Patients (AOP) b. Nurses  Form SSH-3019 Nursing Initial Assessment - Adult. Form SSH-3007 Nursing Initial Assessment - Pediatric.   Complete within 2 hours of arrival in general units. In critical care areas, start within 15 minutes of arrival in the unit and complete within 2 hours. c. Clinical Support    DP-CDN-008 Nutritional Screening. DP-RT-002 Assessment and Reassessment of Patients. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 3-Assessment of Patients (AOP) : Section I: Patient-Centered Standards 3-Assessment of Patients (AOP) Qualified individuals conduct the assessments and reassessments. Laboratory services are available to meet patient needs. Radiology and diagnostic imaging services are provided by the organization or are readily available through arrangements with outside sources. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 4-Care of Patients (COP) : Section I: Patient-Centered Standards 4-Care of Patients (COP) Certain activities are basic to patients care. These activities include:  Planning and delivering care to each patient.  Monitoring the patient to understand the results of care.  Modifying care when necessary.  Completing the care.  Planning the follow-up  Many physicians, nurses, and allied health professionals carry out these activities. Each provider has a clear role in patient care. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 4-Care of Patients (COP) : Section I: Patient-Centered Standards 4-Care of Patients (COP) 1. The care provided to each patient is planned and written in the patient’s record. Requirements: The care for each patient is: 1- planned within 24 hours of admission as an inpatient. 2- individualized and based on the patient’s initial assessment. 3- written in the health record. 4- updated or revised as appropriate. Dr.Ashraf Al-Abasiry 2. Care of High-Risk Patients and Provision of High-Risk Services : 2. Care of High-Risk Patients and Provision of High-Risk Services Health care organizations provide a variety of services, some of which are considered high risk because of their age, condition, or critical nature of their needs. Requirements: Policies and procedures guide the use and care OF: *The emergency patient. ,Resuscitation services. Patients on life support *Handling, use and administration of blood and blood products. . *Patients with communicable disease and immunosuppressed patients. *Patients on dialysis,Elderly patients, disabled individuals, children and populations at risk of abuse. *Patients receiving chemotherapy or other high-risk medications. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 5-Anesthesia and Surgical Care : Section I: Patient-Centered Standards 5-Anesthesia and Surgical Care SSH has made sure that all JCI requirements are met and even exceeded when dealing with anesthesia and surgical care. The intent of the Anesthesia and Surgical Care Standards is to ensure an even safer environment for every patient and a clear record of the entire surgical and anesthesia process. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 5-Anesthesia and Surgical Care : Section I: Patient-Centered Standards 5-Anesthesia and Surgical Care New standards added relate to the overall organization and management of anesthesia services. This includes;- A qualified individual is responsible for managing the anesthesia services and that those services meet applicable local and national standards, laws, and regulations. Changes to moderate and deep sedation care , All moderate and deep sedation is practiced according to SSH policy. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 6-Medication and Management Use : Section I: Patient-Centered Standards 6-Medication and Management Use Medications are an important resource in patient care and need to be organized effectively and efficiently. Applicable laws and regulations relating to medication and management use are incorporated in the organizational structure, and an appropriate licensed pharmacist manages pharmaceutical services. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 6-Medication and Management Use : Section I: Patient-Centered Standards 6-Medication and Management Use To ensure efficient and effective use of medication, annual reviews are done on formularies. The review also includes evidence-based practices, internal quality data, and documented improvements to understand the need and priority of improvements in quality and safety. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 6-Medication and Management Use : Section I: Patient-Centered Standards 6-Medication and Management Use The Medication and Management Use include the Following Activities * Selection, procurement. * Storage. * Ordering and transcribing. * Preparing and dispensing. * Administration and monitoring of medications. Licensed staff adhere to SSH Medication Administration Policy, refer to IP-098 Ordering, Preparation, and Administration of Medication. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 7-Patient and Family Education (PFE) : Section I: Patient-Centered Standards 7-Patient and Family Education (PFE) Joint Commission International PFE standards are incorporated into the daily practices of SSH patient centered environment and embedded in our policies and guidelines in alignment with our mission, vision, values, PR, QI, and patient safety statements. SSH has a well-defined Patient Education program that promotes holistic care through a coordinated network of patient and family educational activities to meet their specific needs. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 7-Patient and Family Education (PFE) : Section I: Patient-Centered Standards 7-Patient and Family Education (PFE) SSH has identified in the job description of applicable healthcare providers (physicians, nurses, educators, etc.) that they are authorized to provide patient education within their specialty. utilizing resources that had been made available through the organization (i.e. Patient and Family Information (PFI), booklets, brochures, videos, policies, leaflets, handbooks, and visual aids). Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 7-Patient and Family Education (PFE) : Section I: Patient-Centered Standards 7-Patient and Family Education (PFE) During the discharge plan, the physician will evaluate the patient’s need for follow-up appointment after discharge. When the patient goes home, there is a follow-up call process in which specific questions are asked by the healthcare provider to the patient or family to evaluate the effectiveness of discharge, which includes the effectiveness of patient and family education. Dr.Ashraf Al-Abasiry Section I: Patient-Centered Standards 7-Patient and Family Education (PFE) : Section I: Patient-Centered Standards 7-Patient and Family Education (PFE) Dr.Ashraf Al-Abasiry Slide 31: Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 1-Quality Improvement and Patient Safety (QPS) : Section II: Health Care Organization Management Standards 1-Quality Improvement and Patient Safety (QPS) Quality Improvement and Patient Safety at SSH is leadership driven and is deployed by a multidisciplinary team approach. Joint Commission International QPS standards are incorporated into the daily practice of SSH by: Dr.Ashraf Al-Abasiry 1-Quality Improvement and Patient Safety (QPS) : 1-Quality Improvement and Patient Safety (QPS) *Constant monitoring of our performance by the Hospital Management Committee and the standing committee structure (Committee Manual-policies folder): ►Excutive Dashboard review of Key performance Measure ( KPMs) on monthly basis. ►Performance reporting to committees and linkage to executive leadership through Hospital Executive Committee, Hospital Management Committee as well as Hospital Operations Committee. Section II: Health Care Organization Management Standards Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 1-Quality Improvement and Patient Safety (QPS) : Section II: Health Care Organization Management Standards 1-Quality Improvement and Patient Safety (QPS) ► Outside entities such as the multiple accrediting bodies, (JCI), (CCHSA) and (ACHSI), (CAP), and American Association of Blood Banks (AABB). * The design of new systems and processes through quality principles:   Use of improvement methodology FOCUS PDCA. Root Cause Analysis and Failure Modes Effects Analysis. Dr.Ashraf Al-Abasiry F-O-C-U-S : F-O-C-U-S Find a process that needs improvement. Organize a team who is knowledgeable in the process. Clarify the current knowledge of the process. Understand the causes of variation. Select the potential process improvement. Dr.Ashraf Al-Abasiry P-D-C-A : P-D-C-A Plan the improvement/data collection. Do the improvement/data. collection/data analysis. Check the data for process improvement. Act to hold the gain/continue improvement. Dr.Ashraf Al-Abasiry Slide 37: Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 1-Quality Improvement and Patient Safety (QPS) : Section II: Health Care Organization Management Standards 1-Quality Improvement and Patient Safety (QPS) Individuals with appropriate experience, knowledge and skills, systematically aggregate and analyze data in the organization Example: Laboratory data –Laboratory Quality Coordinator Pharmacy- Pharmacy Quality Coordinator OVRs – RM Department Frequency is appropriate to the process Patient Admissions, Discharges, Bed Occupancy – daily. VRs – daily, monthly, Quarterly Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 1-Quality Improvement and Patient Safety (QPS) : Section II: Health Care Organization Management Standards 1-Quality Improvement and Patient Safety (QPS) SSH uses a defined process for identifying and managing Sentinel Events. Data are analyzed when undesirable trends and variation are evident from the data. Improvement in Quality and Safety is achieved and sustained. Improvement and Safety activities are undertaken for the priority areas identified by the organization’s leaders. Section II: Health Care Organization Management Standards 2-Prevention and Control of Infection (PCI) : Section II: Health Care Organization Management Standards 2-Prevention and Control of Infection (PCI) PCI.1 One or more individuals oversee all infection prevention and control activities. PCI.2 Designated coordination mechanism for all infection PCI.3 Infection control program is based on current scientific knowledge, accepted practice guidelines, and applicable laws and regulations. PCI.4 Organization's leaders provide adequate resources to support the infection control program. control activities. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 2-Prevention and Control of Infection (PCI) : Section II: Health Care Organization Management Standards 2-Prevention and Control of Infection (PCI) PCI.5 The organization designs and implements a comprehensive program to reduce risk of health-care associated infections in patients and health care workers. PCI.6 Establishes the focus of the health-care associated infections prevention and reduction program. PCI.7.1 Reduces the risk of infections by ensuring adequate equipment cleaning and sterilization and proper management of laundry and linen. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 2-Prevention and Control of Infection (PCI) : Section II: Health Care Organization Management Standards 2-Prevention and Control of Infection (PCI) PCI.7.2 Reduces the risk of infections through proper waste disposal. Example: This is part of the new employees orientation program.. The waste is segregated according to the MOH regulations. Biohazard waste is collected and disposed of through the Rotoclave process Radiological and general waste is disposed of in the landfill. cytotoxic/genotoxic and pharmaceutical waste are incinerated. Tracking of waste is documented and manifest copy retained. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 2-Prevention and Control of Infection (PCI) : PCI.7.3 Policy and procedure on the disposal of sharps and needles.      PCI.7.4 Reduces the risk of infections in the facility associated with operations of the food service and of mechanical and engineering controls. PCI.7.5 Reduces the risk of infection during demolition, construction and renovation. Section II: Health Care Organization Management Standards 2-Prevention and Control of Infection (PCI) Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 2-Prevention and Control of Infection (PCI) : Section II: Health Care Organization Management Standards 2-Prevention and Control of Infection (PCI) PCI.8The organization provides barrier precaution &isolation procedures. PCI.9 Gloves,masks,eye protection,soap,disinectant are available &used correctly when required. PCI.10 -Integration of the program with Q I & patient safety. PCI.11- Education of staff about the program. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 3-Governance, Leadership and Direction (GLD) : Section II: Health Care Organization Management Standards 3-Governance, Leadership and Direction (GLD) The GLD standards are clarified below together with examples of how they are addressed in SSH. The effectiveness of the governance structure is evaluated annually through an Organizational Effectiveness Survey. The Board evaluates governance and the senior leaders. The structure of the organization is displayed in an Organization Chart. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 3-Governance, Leadership and Direction (GLD) : Section II: Health Care Organization Management Standards 3-Governance, Leadership and Direction (GLD) Those responsible for governance : 1- Approve and make public the organization’s mission statement. 2- Approve the policies and plans to operate the organization. 3 - Approve the budget and allocate the resources required to meet the organization’s mission. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 3-Governance, Leadership and Direction (GLD) : Section II: Health Care Organization Management Standards 3-Governance, Leadership and Direction (GLD) 4 -Appoint the organization’s senior managers or directors. 5 - Collaborate with the organization’s managers. 6 - Approve the organization’s plan for quality and patient safety and regularly receive and act on reports of the quality and patient safety program. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 3-Governance, Leadership and Direction (GLD) : Asenior manager or director is responsible for operating the organization and complying with the applicable laws and regulations. Medical, nursing, and other leaders of clinical services plan and implement an effective organizational structure to support their responsibilities and authority.. Section II: Health Care Organization Management Standards 3-Governance, Leadership and Direction (GLD) Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 3-Governance, Leadership and Direction (GLD) : Section II: Health Care Organization Management Standards 3-Governance, Leadership and Direction (GLD) One or more qualified individuals provide direction for each department in the organization. The Directors of each clinical department : Identify in writing, the services to be provided by the department.   Recommend space, equipment, staffing, and other resources needed by the department or service.  Recommend criteria for selecting the department or services professional staff and choose or recommend individuals who meet those criteria Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 3-Governance, Leadership and Direction (GLD) : Section II: Health Care Organization Management Standards 3-Governance, Leadership and Direction (GLD)  Provide orientation and training for all staff of the department or service appropriate to their responsibilitie.  Monitor the departments services performance as well as staff performance. The organization establishes a framework for ethical management that ensures that patient care is provided within business, financial, ethical, and legal norms and that protects patients and their rights. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 4-Facility Management and Safety. : Section II: Health Care Organization Management Standards 4-Facility Management and Safety. Health care organizations work to provide a safe, functional, and supportive facilicy for patients, families, staff ,To reach this goal, the physical facility, medical and other equipment, and people must be effectively managed. In particular, management must strive to *Reduse and control hazards and risks. *Prevent accidents and injuries. *Maintaine safe conditions. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 4-Facility Management and Safety. : Section II: Health Care Organization Management Standards 4-Facility Management and Safety. Effective management includes planning, education, and monitoring as follows: Written plans are developed & consider the following areas when appropriate to the facilitiy& activities of the organization. 1- Safety&security. 2- Hazardous materials-handling ,storage,use of radioactive materials,hazardous material is safely disposed. 3- Emergency management-response to epidemics,disaster,& emergencies is planned and effective. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 4-Facility Management and Safety. : Section II: Health Care Organization Management Standards 4-Facility Management and Safety. 4- Fire safety –property&occupants are protected from fire & smoke. 5- Medical equipment –equipment is selected ,maintained,and used in manner to reduse risks. 6- Utility systems- Electrical,water,&other utility systems are maintained to minimize the risks of operating failure. Laws&regulations,and inspection by local authorities determine in large parts how a facility is designed,used and maintained. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 5-Staff Qualifications and Education (SQE) : Section II: Health Care Organization Management Standards 5-Staff Qualifications and Education (SQE) Joint Commission International SQE standards are incorporated into the daily practice of SSH by each of the examples stated below, which follow each Standard. 1-Organization leaders define the desired education, skills, knowledge, and other requirements of all staff members. 2 - Each staff member's responsibilities are defined in a current job description. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 5-Staff Qualifications and Education (SQE) : Section II: Health Care Organization Management Standards 5-Staff Qualifications and Education (SQE) 3-Organization leaders develop and implement processes for recruiting, evaluating, and appointing staff as well as other related procedures identified by the organization 4- The organization uses a defined process to ensure that clinical staff knowledge and skills are consistent with patient needs. Examples: Staffing Plans, Scopes of Service, and Duty Rosters are used in conjunction with the Employee Performance Appraisal Program (EPAP), and identified hospital needs. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 5-Staff Qualifications and Education (SQE) : Section II: Health Care Organization Management Standards 5-Staff Qualifications and Education (SQE) 5- There is documented personnel information for each staff member. 6- A staffing plan for the organization, developed by the leaders, identifies the number, types, and desired qualifications of staff. reviewed and updated as necessary. Examples: Senior Management regularly reviews Staffing Plans, in particular in conjunction with Plans for new services. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 5-Staff Qualifications and Education (SQE)) : Section II: Health Care Organization Management Standards 5-Staff Qualifications and Education (SQE)) 7-All clinical and nonclinical staff members are oriented to the organization, the department or unit. 8- Health care provider staff are trained in resuscitative techniques. 9-The organization provides facilities and time for staff education and training. 10-The organization provides a staff health and safety program. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 5-Staff Qualifications and Education (SQE) : Section II: Health Care Organization Management Standards 5-Staff Qualifications and Education (SQE) 11-The organization has an effective process for gathering, verifying, and evaluating the credentials (license, education, training, and experience) of those medical staff permitted to provide patient care without supervision.   Examples: Established process through the Saudi Council for Health Specialties (MOH), Saudi Educational Attachés/Foreign Affairs, as well as the SSH based on-going process of Primary Source Verification efforts. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 6-Management of Communication and Information. : Section II: Health Care Organization Management Standards 6-Management of Communication and Information. The organization communicates with its community to facilitate access to care and access to information about its patient care service.  The organization informs patients and families about its care and services and how to access those services.  Patient and family communication and education are provided in an understandable format and language. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 6-Management of Communication and Information. : Section II: Health Care Organization Management Standards 6-Management of Communication and Information.  Communication is effective throughout the organization.  The leaders ensure that there is effective communication and coordination among those individuals and departments responsible for providing clinical services. Dr.Ashraf Al-Abasiry Section II: Health Care Organization Management Standards 6-Management of Communication and Information. : Section II: Health Care Organization Management Standards 6-Management of Communication and Information.  Information about the patient’s care and response to care is communicated among medical, nursing, and other care providers during each staffing shift, and between shifts.  The organization plans and designs information management processes to meet internal and external information needs. Dr.Ashraf Al-Abasiry Slide 63: THANK YOU!!

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