Introduction
Voluntary accreditation in the American healthcare sector is a special program for assessing the quality and reliability of the work of a medical organization. A specially trained panel of reviewers is engaged in this practice, which also includes comparing the performance of the assessed company with previously established quality standards. These quality baselines have a positive impact on medical care by motivating hospital authorities to approach them and giving instructions on how to do so. Professional criticism given by specialists affects not only the level of service but also the well-being of the patient. Standardization of service while maintaining its quality underestimates the risks of improper or careless treatment of patients because it underplays the number of different options that can be used in therapy in various departments and different specialists.
It is important not only to comply with the standards that voluntary accreditation can bring. With its help, a medical institution has the opportunity to develop and improve on its own, obtaining the necessary set of methods for this. Speaking about the benefits brought by this practice to patients, it should be noted that the concentration on the subject receiving medical care is quite important in the accreditation process. The patient is the main reference point, the end recipient of which all changes and criticism of medical care are directed. Improving the quality of care also includes improving medical ethics, that is, concern for the needs and desires of the patient. The most important, the final task for producing this accreditation is the health of the patient, the need to reduce the likelihood of medical error. Thus, there is a strong ethical rationale for conducting voluntary accreditation – this evaluation process is necessary in order to ensure the greatest safety of the patient.
Accreditation Requirements
Accreditation requirements are those standards that turn out to be desirable and even necessary to meet the level of performance set as a reference by the accrediting commission. These standards allow one to maintain the quality of practice in a medical institution and through this ensure the safety of the patient every day. The first criterion for accreditation is traditionally the mission, which includes the hospital’s vision of itself as a conscious cell of a social institution. This term can be understood quite broadly, however, the correspondence between the theoretical calculation of the mission statement and the actions of the medical institution itself is important, therefore this statement should also be publicly available.
The mission must take into account two aspects – the diversity of society, under which medical practices must adapt, and the desire to help humanity, to do good to people. Proceeding from the humane attitudes underlying the mission, the second criterion arises – integrity. Integrity is understood as a stumbling block of true humanity, this quality embodies the desire for honesty and openness, the desire to help one’s neighbor. Integrity is also a standard and the ability to adhere to it, since the truly moral principles that make up the credo of a medical organization do not tolerate double standards and neglect, depending on the case.
Ethical and responsible behavior must be expressed in every segment of the work of the institution, from financial operations to personnel and tools. A fair, ethically verified attitude to the branches of functioning of a medical organization also applies to academic studies in the organization. Freedom of expression is given to specialists within the institution in the name of searching for the truth, its expression in both teaching and learning. Speaking about the academic competencies necessary for a positive assessment of the organization, one should mention the equivalence of the graduation programs of the institution to higher education. The medical organization must develop and maintain a methodology that is appropriate for educational programs, provide support to students and work with personnel professionally trained for a particular program. The training of specialists is a key stage in the work of an organization, therefore the desire to support and improve training programs is a key component of voluntary assessment. Finally, it is necessary to note the solvency of the institution, its financial well-being and the makings of economic planning. The presence of a strategy, consistency in the distribution of finances, aimed at improving the work of the organization, proves the effectiveness of the institution from a financial and conceptual point of view.
Accreditation and Regulatory Compliance
Now it is required to compare regulation and accreditation within the framework of the functioning of a medical organization. Accreditation means that the medical unit receives, in case of compliance with the requirements set by the commission, a seal of approval, a certificate of compliance with the standards described above. Regulation does not represent a quality standard, but rather requirements that must be strictly observed. Striving to meet the bar set by the evaluation committee can help raise employee awareness and have a positive impact on the quality of services provided. Thus, regulatory standards that fall below the accreditation assessment should be met as a basic condition providing a basis for further improvement. Managing an organization in accordance with accreditation standards gives an organization the opportunity to learn how to comply with basic laws and regulations in healthcare.
Given that the requirements of the accreditation commission are aimed at reducing the risk of medical error, this has a healing effect on the processes of diagnostics, patient maintenance, and their treatment. It should be remembered that medical errors or violations of standards can be extremely costly in the event of a lawsuit and cause great damage to the reputation of the organization. Risk management thus has a qualitative effect on compliance with standard medical regulations.
At the same time, it should be noted that regulatory standards can be associated primarily with the quality and safety of medical devices and instruments. Access to safe high quality equipment ensures that real patient care is delivered, which is the main and final principle by which medical organizations are evaluated and accredited. The regulation of medical devices is one way to improve the overall quality of healthcare. Thus, striving for accreditation standards helps to meet standard regulations, while controlling the quality of devices ensures that accreditation conditions are met. When linked, these standards turn out to be aimed at patient safety, reducing risks for them, introducing an overall increase in the level of patient support.
The Joint Commission Standards
Joint Commission International is the leading provider of healthcare accreditation, holding 88% of the market. The vast majority of medical organizations apply to this commission, the scope of which is global, extending to more than 20,000 organizations in 100 countries. This global perspective allows for the most rigorous and standardized verification procedure, the reliability of which is underlined by the international level of compliance (Joint Commission International, 2021). To provide a healthcare standard, Joint Commission has a specially designed risk assessment program called SAFER Matrix (Survey Analysis for Evaluating Risk). With the help of this conceptual framework, it is possible to identify the most high-risk aspects of the organization’s work that require quality improvement. Also, this matrix allows one to create strategic plans to improve precisely the most lacking areas of medical care. This matrix evaluates any activity in terms of risk, ranging from low and rare to high, when harm can be caused in almost any situation. Such a model proves to be applicable to any scale, ranging from limited to widespread. That is, not only the probability of risk is assessed, but also its prevalence and frequency, while the task of the commission is to minimize the frequency and level of risk to the patient’s health.
It should be noted that in order to qualify for accreditation, a medical unit also needs to comply with a number of rules. With the patient’s safety first, the Joint Commission’s rules provide standards for access to treatment and duration of care that must balance the needs of the client and the services offered. A follow-up plan is an essential feature of well-coordinated patient care. The Patient and Family Rights Standard implies that the hospital is obliged to inform patients and their families of their rights during treatment, the right to refuse treatment and personal responsibility for this choice (Shaikh, 2018). Anesthesia and surgery standards are also part of the Commission’s assessment criteria and require that sedation and anesthesia procedures comply with professional and local standards and laws.
Accreditation Best Practices
Choosing the right time for accreditation is extremely important and requires planning ahead. Usually a few months are given before the arrival of the commission, which is sufficient time to prepare quite comprehensively. Self-study of the Joint Commission International standards is recommended to balance the procedures implemented in the hospital with the actual standards described in their guides. It is also recommended to create daily entries and logs in order to better control changing processes and practices. Storing detailed information is not only evidence of compliance with the data handling standard, but also a way to continuously improve and control positive dynamics.
The main segments that need to be considered as part of the improvement of practice before the commission are not only patient safety and duration of care, but also the management and organization of the clinic itself. Compliance standards include professional quality diagnostics using coding to establish diagnoses. Clinical practice must also be carefully observed, with particular attention given to vulnerable patients. Compliance with clinical guidelines, for example for diabetics, must necessarily be planned months in advance, and the same applies to other special and vulnerable patient groups. Record keeping is necessary not only to record progress, but also to prevent the aggravation of similar medical cases that arise. Documentation should record patients in detail using direct and official data sources, such as social security numbers. However, patient analyzes must also be carefully distributed to avoid confusion and medical error, thus reducing the risk to the patient.
The patient’s health records themselves must be kept in accordance with current legislation. The security of patient information is extremely important, as meeting the ethical standards of today is a natural condition for accreditation. Therefore, personal information of the patient that is not related to the course of the disease is subject to extremely careful handling and destruction if necessary (Drud Due et al., 2019). Patients should be provided with confidentiality of information and its complete confidentiality. Speaking about the information policy of the hospital, it is necessary to establish the full availability of specialists and administrators. Communication between patients and staff should be established around the clock, at least through the telephone service and online services. With regard to the accessibility of medical services, they must be provided with maximum efficiency in a manner that is regulated and specifically negotiated.
Management also constitutes a fundamental aspect in need of developing an effective medical service. Hiring of workers should take place only after detailed testing, which will identify the competencies necessary to perform the job. However, additional retraining and adaptation to the new workplace is required, which should be not only for new doctors, but also for those who have been serving in the hospital for a long time. Thus, the competence of employees will be balanced by constantly updating knowledge and skills in addition to recruiting new working potential, and there will be no discrepancies in approaches and methods between different generations of doctors and specialists. Effective management also involves coordinating patients in a clinic from one specialist to another, including collaboration with other clinics and the professionals working for them. Interaction with other clinics emphasizes the unity of purpose, the health of the client, with a variety of approaches that are in a single medical field.
Compliance with standards of patient care should be mentioned separately as an industry that always requires additional diligence due to the dominance of patient-oriented ethics in modern medical discourse. The ability to prioritize is important in any task performed by hospital staff, and at the micro level it is expressed in the ability to competently deal with the patient. In addition to the initial diagnosis of the patient, a constant qualified reassessment of their condition is required. The intervals at which this reassessment is done should be based on the patient’s condition so as to determine their body’s response to treatment. The ethical principle, based on the desire to reduce or even reduce the suffering of the patient, is to assess the condition of patients every time they experience any pain symptoms. Medical and nursing services must make practical use of the received information about the patient’s condition every time, responding to it with some form of therapy and medical intervention. These actions must be carried out in a prioritized manner in order to provide the patient with the most primary and currently needed services, thereby maximizing the effectiveness of hospital staff performance.
Other Accrediting Organizations
Despite the fact that Joint Commission International is a virtual monopoly in the field of accreditation of medical institutions at the moment, there are other organizations with similar tasks and a high level of professional approach. The Accreditation Association for Ambulatory Health Care (AAAHC) has been an organization since 1979 that has been evaluating and accrediting ambulatory health care organizations, that is, those that provide care to patients at home or to specially visited organizations for medical care. These organizations include outpatient surgical centers, endoscopy clinics, college health centers, and health support organizations that provide patients with regular diagnosis and care for an annual fee.
At the heart of the research model of the Association for Ambulatory Health is the parameter of cooperation and learning. Professionals who evaluate the performance of organizations within the framework of the AAAHC model are themselves deeply involved in the activities of ambulatory healthcare, that is, they have practical experience and therefore undoubted competence in understanding the problems. Like the JCI, this association is constantly updating and improving its regulations in order to be the most progressive player in the healthcare industry. Also similar to the Joint Commission, this Association aims to cover the international market – a few years ago they started working in Peru. They also developed a special accreditation program for small hospitals. With this, the Association seeks to cover both less wealthy countries and provide professional assistance to low-income medical facilities within the country. This Association, despite the monopoly of the JCI, is a wide set of 18 subordinate sub-groups that cover most aspects of professional health care. Among them are surgeons, cosmetologists, dentists, anesthesiologists, dermatologists, gastroenterologists and many other specialists.
All this points to the high specialization, thoroughness and detail of the assessment made within the framework of this association. It is important that many of the Association’s employees are volunteers – being extremely involved in outpatient healthcare, these people are not only specialists but also true adherents of their vocation. Due to the fact that the standards put forward by the Accreditation Association are regularly supplemented and transformed, the term of the issued accreditation license for the hospital lasts only three years and subsequently requires renewal. Also, within the framework of this organization, there is a non-profit institute engaged not only in assessment, but also in theoretical and practical developments in the field of improving the quality of healthcare and training future managers and specialists in the organizational healthcare field.
Conclusion
At the end of the briefing, it is required to give a financial assessment of the need to conduct accreditation, calculate the benefits in attracting toy or another organization to this. The Accreditation Association for Ambulatory Health Care operates on an annual fee basis for each organization they cover. An annual subscription to the Association’s services costs $600 for medical units not previously involved in the company’s accreditation programs. If a subscription has already been made and the hospital has already been accredited, updating information through a further assessment will cost $525 per year (AAAHC, 2022). However, this payment regulation should be strictly observed, since in case of missing the annual payment, penalties follow in the form of fines for shifting the schedule. In this way, the Accreditation Association for Ambulatory Health Care wishes to express its commitment to the timeliness of updating both information and procedures within a medical organization to meet their healthcare standards. This amount and payment rules seem to be well-balanced for the services they provide and provide motivation to improve work within the hospital.
The reputation of the Joint Commission, monopolists in their field, is so high that the prices of their services are appropriate. JCI is clearly not a volunteer or non-profit organization, generally offering the hospitals they evaluate $46,000 a year to get accredited (Health Tourism, 2022). Of course, this is due not only to the international popularity of the organization and its really extremely detailed and high standards, but also to the scale of the organizations with which they cooperate.
Despite the prestige of this organization and the really elaborate requirements that it puts forward, comparison with the prices offered by other accreditation organizations does not speak in favor of JCI. However, the very status that is assigned to the hospital after such a qualification can serve as an impetus to the growth of the popularity of the institution itself, to raise its prestige through accreditation. Thus, depending on the financial capabilities of the hospital and the further business plans of its superiors, the need to resort to the services of the Joint Commission or other, significantly more profitable organizations depends.
References
AAAHC. (2022). Benchmarking Studies. Web.
Drud Due, T., Thorsen, T., & Kousgaard, M. B. (2019). Understanding accreditation standards in general practice – a qualitative study. BMC Family Practice, 20(23), 1-12. Web.
Health Tourism. (2022). JCI Accreditation. Web.
Joint Commission International. (2021). Joint Commission International accreditation standards for hospitals.
Shaikh, Z. (2018). Critical analysis of patient and family rights in JCI accreditation and CDBAHI standards for hospitals. International Journal of Emerging Research in Management & Technology, 6(7), 324-330. Web.