Global Health Care Services

3. Global Health Care Services Dr. Ali Hojjati MD, MPH December 18 , 2012

4. The Third Conference on Health Tourism in Islamic Countries

5. Global Healthcare – A Reality Medical Tourism Wellness Travel Medical Travel Health Tourism Travelling patient International Patient QUALITY SAFETY

6. Global Healthcare – A Reality Medical Tourism Wellness Travel Medical Travel Health Tourism Travelling patient International Patient QUALITY SAFETY

7. Health

8. Risks • Medical information • Travel, transfer points • Referrals, continuum of care, follow-up • Language, cultural differences • Assurance of expertise • Insurance coverage • Legal rights • Privacy and access to information

9. Need for Standardization Processes & Standardsare needed to Mitigate Risk and ensure Quality

10. Standards , Quality and Errors State of Health High Quality of Care Disease Harm Adopted from Donabedian 2003 Time

11. Standards – Do we still need them??? National Standards International Standards

12. Standards – Do we still need them???

13. What is Accreditation? Accreditation and Standards

14. Defining Accreditation A measure of an organization’s services compared against international standards of excellence A tool to identify areas for improvement A process for organizations to regularly and consistently examine and improve their services 14 Digitalart, Master Isolated Images, Renjith Krishnan/FreeDigitalPhotos.net

15. Accreditation helps to… Increase credibility and demonstrate accountability Show commitment to quality and patient safety Increase capacity and lead to quality improvement

16. Accreditation Defining Healthcare Excellence Accreditation helps organizations achieve excellence: • Aproactive and continuous process toregularly and consistentlyexamineandimproveservices • A strategic change and risk managementtooltoidentifystrengths and areasforimprovement • A measure of success against standards of excellence

17. Accreditation is credible when…. • Engages all stakeholders ex: clients, staff • More than a checklist • Based on best practice and evidence • About sharing experience • Internationally recognized • Appropriate methodology is used to assess compliance • Program overseen by independent body ex: ISQua

19. Surveyors • Independent, impartial peer reviewers removed from outside influence and interest • Experienced and trained to look for and identify organization strengths, areas for improvement, and risks • Recommend actions for quality improvement

20. GLOBAL HEALTHCARE SPECIFIC STANDARDS

21. International Client Standard Discharge And Follow-up Planning for Care and Treatment Preparation Care and Treatment Monitoring And Quality Improvement Monitoring and Quality Improvement

22. Planning for Care and Treatment • Assessment of international client needs • Development of services according to the needs • Ensuring the team’s staff are educated, trained, qualified, and competent • Enhancing wellbeing and worklife balance of staff

23. International Client Standard Discharge And Follow-up Planning for Care and Treatment Preparation Care and Treatment Monitoring And Quality Improvement Monitoring and Quality Improvement

24. Preparation • Providing clients information on services offered • Communicating with the client’s primary physician • Gathering information on client’s history and current medical condition • Pre-operative instructions and timelines • Travel, accommodation and transportation services • Pre-travel screening

25. International Client Standard Discharge And Follow-up Planning for Care and Treatment Preparation Care and Treatment Monitoring And Quality Improvement Monitoring and Quality Improvement

26. Care and Treatment • Team coordinates services on client arrival • Assessment • Procedure • Discharge planning • Transition to retreat area • Monitoring medical condition • Preparation for client’s return

27. International Client Standard Discharge And Follow-up Planning for Care and Treatment Preparation Care and Treatment Monitoring And Quality Improvement Monitoring and Quality Improvement

28. Discharge and Follow-up • Evaluating and addressing client’s medical and support needs for traveling after the procedure • Communicating with clients on their return home • Monitoring compliance with discharge plan • Follow-up with client’s primary physician

29. International Client Standard Discharge And Follow-up Planning for Care and Treatment Preparation Care and Treatment Monitoring And Quality Improvement Monitoring and Quality Improvement

30. Monitoring and Quality Improvement • Quality improvement program to enhance service delivery • Performance management • Client feedback • Benchmarking

32. Accreditation Canada International • Objective, independent, 3rd party, peer evaluation • Transparent and rigorous analysis • Performance measurement & management • Client and patient safety • Quality improvement • Risk prevention • Governance • Education

33. Accreditation Canada International CANADIAN TRADITION OF QUALITY HEALTH CARE 5000+ 54 years 1000+ Bermuda Hospital First International Hospital 45 years ago ACCREDITED BY ISQUA GLOBAL PRESENCE LOCAL SOLUTIONS 1958 1967 2012 Master isolated images / FreeDigitalPhotos.net jscreationzs / FreeDigitalPhotos.net

34. Global Presence Latin America Brazil Chile Colombia Costa Rica Mexico Caribbean Anguilla Barbados Bermuda St. Lucia Trinidad & Tobago Turks and Caicos Europe France Italy Ireland Eslovenia Middle East and North Africa Bahrain Egypt Iran Kuwait Lebanon Qatar Saudi Arabia Tunisia UAE Oman Asia Kazakhstan Philippines jscreationzs / FreeDigitalPhotos.net

35. Accreditation Canada International One third of all new accreditation programs and standards developed worldwide have taken the lead from Accreditation Canada Charles D. Shaw , ISQua

36. Accreditation in Canadian and international Health Care AIM – Achieving Improved Measurement Client Centered Program Qmentum/ Qmentum Intl Structure Introduced in 2010 emphasis has shifted to health system performance, risk mitigation and prevention planning, client safety, performance measure, and governance. Introduced in 2001 requiring organizations to measure the outcomes of health care as well as other components including continuous learning and improvement cycle and are we improving the health status of the population. Introduced in 1995 forcing organizations to understand who were their clients, their needs & how to improve services. Strong focus on structure i.e. policies, procedures, fire safety, etc. 2010 2001 1995 36

37. Accreditation in Canadian and international Health Care Why is it constantly changing? Change is necessary to remain relevant in our ever-shifting health care environment.

38. The leader in raising the bar for health quality

39. What does “Qmentum” Mean? Quality + Momentum = Qmentum

40. Accreditation Canada International: Services Accreditation Advisory Services Education Ambro / FreeDigitalPhotos.net renjithkrishnan / FreeDigitalPhotos.net

42. How Accreditation Canada International can help? Level of Quality Readiness Assessment Report From Current Situation to Desire level of Quality Self Assessment Tools Review Standards in Teams Gap Assign an Account Manager for Each Hospital Consultation Education Advisory Services Current Situation in organization

43. SUSTAINABLE GOVERNANCE EFFECTIVE ORGANIZATION SERVICE EXCELLENCE POSITIVE CLIENT EXPERIENCE Qmentum International Standards Public Health Ambulatory Care Acute Care • Ambulatory Care • Blood Bank and Transfusion • Biomedical Laboratory • Cancer Care • Diagnostic Imaging • Laboratory and Blood • Operating Rooms • Rehabilitation • Surgical Care • Public Health • Animal Health and Food Safety • Ambulatory Care • Blood Bank and Transfusion • Biomedical Laboratory • Cancer Care • Critical Care • Diagnostic Imaging • Emergency Department • Emergency and Disaster Preparedness • Global Health Care • Laboratory and Blood • Medicine • Mental Health • Obstetrics/Perinatal Care • Operating Rooms • Rehabilitation • Reprocessing and Sterilization • Surgical Care • Primary Care STANDARD AREAS Primary Care Public Health • Primary Care • Blood Bank and Transfusion • Diagnostic Imaging • Biomedical Laboratory • Laboratory and Blood Community Care Nov 2012 Release • Home Care • Mental Health • Developmental Disabilities • Semi-Residential and Residential • Substance Abuse and Addiction Independent Laboratory • Independent Medical/Surgical Facilities • Assisted Reproductive Technology • Populations with Chronic Conditions • Hospice Palliative Care • Blood Bank and Transfusion • Biomedical Laboratory • Laboratory and Blood Medication Management – Infection Prevention and Control

45. Qmentum International Monitoring outcomes; Using evidence and best practices to improve service Diamond level Client-centred care; Consistency of service delivery Platinum level Gold level Foundational elements of quality and safety

46. Standards format SUB-SECTION HEADING Standard CRITERIA Level Each criterion is associated with a Quality Dimension

47. Accredits the Accreditors ISQua The International Society for Quality in Health Care

48. ISQua • Accredited Organisations • Accredited Standards • Accredited Surveyor Training Programme

49. Conclusion • Standardization is key as global healthcare has multiple interfaces • Robust, sustainable accreditation programs are urgently needed in current environment • Accreditation assures the quality and safety of care to the international client