Accreditation of Hospitals in Saudi Arabia
Accreditation of Hospitals in Saudi Arabia
Accreditation is the process of evaluating institutional functionalities to ensure efficiency and effectiveness and this evaluation process is globally recognized. It is aimed at improving the quality of services offered by these institutions by standardization. Health facilities are an example of institution that needs be accredited to ensure quality health services to patients. There have been cases of improper handling of patients, incorrect surgeries, and much more and these have facilitated the development of accreditation of hospitals. Hospitals will now be subject to satisfy the requirements of the accreditation agencies. Accreditation objectives are to ensure maximum utilization of the resources, commitment of the workers, to manage risk by minimizing errors among others. Various accreditation agencies have been formulated in the recent years to accredit hospitals on a global scale. Hospitals are allowed to enroll in any number of accreditation agencies but this poses a great challenge to them to implement requirements of all the agencies at the same time. Accreditation measures standards of patient care. Although it is a difficult process, many nations in the globe are adopting it in their hospitals to improve health-care. CITATION Qur12 l 1033 (Qureshi, Ullah, & Ullah, 2012). It is difficult to note the impact of accreditation in most of the organizations. However, In the third world countries the effectiveness of accreditation is evident and this is as a result of participation in accreditation programs. Saudi Arabia was one of the first developing countries to adopt accreditation (Al-Awa, et al., 2012).
The Central Board of Accreditation for Healthcare Institutions (CBAHI) and Joint Commission International (JCI) are the main agencies that regulate hospitals in Saudi Arabia (Shaw, et al., 2013). A large number of hospitals have enrolled in the accreditation process and since then, there has been a substantial improvement in health services. However, the government has faced a number of challenges despite these positive efforts they have put on the accreditation of hospitals (Almasabi, 2013).
Description of (CBAHI) and (JCI)
Central Board of Accreditation for Health Care Institutions (CBAHI) was formed in 2005. Its purpose was to recognize services offered in private and also in the public hospitals. Its standards were set by the collaboration of expertise from various health care organizations. However, very few organizations are accredited by this board. Even though Saudi Arabia government is majoring on improving health sector, financial problems and lack of qualified personnel is a major problem to them. While the government allocates a large amount of money to the health sector, ministry of health leaders still does not fully understand the reason behind improving the quality of the health care facilities. CBAHI is one of the accreditation programs which each and every health care organization ought to have. According to Alkhenizan and Shaw, CBAHI standards are not well organized. They also say that in the CBAHI standards there is no evidence of patients and the community as a whole being encouraged to participate actively CITATION Alm13 l 1033 (Almasabi, 2013). CBAHI accredits health care facilities and only a few organizations have managed to join this board while most of them are still in the process of joining CITATION Qur12 l 1033 (Qureshi, Ullah, & Ullah, 2012).
Joint Commission International (JCI) on the other hand is an international accreditation board. It was started in the year1994. Most of the health care organizations in the Kingdom of Saudi Arabia, both public and private have joined JCI at their own will unlike CBAHI which is mandatory. King Faisal specialist hospital and research center was the first to join this board. It majors on ensuring that the patients are safe. This can be done by managing risks where the board ensures that the patients gets services that are of high standard. Health care organizations that are accredited to these boards have the probability of getting a higher number of patients than those organizations which are not accredited. The reason being patients are guaranteed of better services when they attend an accredited hospital than an un-accredited one. In the last few years, the number of accredited hospitals has increased. In addition, some hospitals have accredited themselves several times while not even a single hospital has re-accredited itself (Qureshi, Ullah, & Ullah, 2012).
The impact on efficiency and effectiveness of organizations in Saudi Arabia.
From the discussion above it is evident that both the CBAHI and JCI accreditations improve the health-care services offered to patients and reduces the occurrence of risk. This leads to an increase in efficiency and effectiveness of the organizations. When an organization implements the accreditation of either of these bodies, it may bring about great change. This is evident with the health care organizations of Saudi Arabia.
Firstly, the accreditation of CBAHI and JCI in the health care organizations of Saudi Arabia has led to a better health care environment. A well maintained environment is usually safe for both the patients and the staff. This has been done by improving hygiene and thus the reduction of contagious diseases. Through accreditation minor injuries such as needle stick injuries are reduced. Secondly, there is an improvement in documentation of information. This is as a result of accreditation and it is through the introduction of technology (Shammari, Habib, Shubrami, & Rashidi, 2015). Thirdly, there is a reduction of mortality rate in Saudi Arabia since the health services were improved. Poor health services lead to a high mortality rate (Almasabi & Thomas, 2016). Lastly, when the services are improved. patients end up being satisfied.
Efficiency and effectiveness of accreditation have been studied by different scholars. A study conducted on 605 nurses from different backgrounds gave an insight about the impact of accreditation on hospitals. A large number of them stated that since the introduction of accreditation, there has been a significant improvement in safety of both patients and students. In addition, patients have grown a sense of safety after the accreditation (Al-Awa, et al., 2012). Patients in accredited hospitals reported having experienced a more satisfying encounter with physicians in the accredited hospitals. They state that the medical professionals expressed a sense of expertise when handling the patients. Since health institutions usually have long queues, patients from both hospitals complained about that. However, those from the accredited hospitals indicated that the waiting rooms of these hospitals were fitted with comfortable chairs and clean drinking water thus making them feel at home. The physicians also demonstrated to possess confidentiality attributes when it comes to sensitive information. In addition, the patients were given correct results from diagnosis. The nurses at the registration point also demonstrated care. The non-accredited hospitals also had some positive reviews. The lab technicians here demonstrated professionalism and interacted with the patients in a friendly manner (Al-Qahtani, et al., 2012)
Stakeholders in the Accreditation process
Accreditation of health institutions in Saudi Arabia involves a number of stakeholders. It is a quality assurance process that needs to be implemented in a systematic way to ensure accuracy and efficiency. The initial step is the evaluation of the existing health facilities to determine the services and health features they are lacking. This initial study also aims at reviewing the patient-doctor interactions and how satisfactory it is to the patients. Since the goal of these accreditation agencies is to ensure quality health-care to all patients and to enable hospitals make optimum use of their available resources, high standards were set to achieve these objectives.
Some of these stakeholders include the Saudi Central Board for Accreditation of Healthcare Institutions (CBAHI), Saudi Commission of Health Specialties (SCHS), Ministry of Health (MOH), Hospitals and Medical Services, Ministry of Foreign Affairs (MOFA) – in coordination with the Ministry of Education (MOE) and Ministry of Labor (MOL), Saudi Medical Societies and Council of Cooperative Health Insurance (CCHI) (Alwahabi, Bahloul, Almutairi, & Alsalhi, 2017). All these stakeholders play a significant role during the accreditation process. The CBAHI primary role is to accredit the health institutions, the SCHS to license the healthcare workers such as nurses and doctors and the MOH regulates the provision of the healthcare services. The MOFA, MOE and MOL play a significant role in verifying doctors and nurses for the job via the ‘Shamel’ platform. The CCHI is given the responsibility of facilitating payments to the hospital workforce (Alwahabi, Bahloul, Almutairi, & Alsalhi, 2017). After reviewing these stakeholders involved in the accreditation process, it is evident that it is a sophisticated process that requires a lot of resources for it to be successful.
Comparison and Contrast between facilities with and those without accreditation
There have been several studies conducted to investigate on the quality of health care services offered in both accredited and non-accredited hospitals, similarities and differences. The study conducted by Al-Qahtani, Al-Dohailan, Al-Medaires, Khuridah and Al-Dossary reveals that patients from both accredited hospitals and those not accredited report some level of satisfaction of the hospitals services. These services range from confidentiality of the patient’s information, excellent communication between doctors and patients, respect from doctors and overall professionalism in all medical areas. There seems to be a distinct similarity in the quality of services offered from both types of hospitals. Another similarity between the two types of hospitals is that patients from both hospitals reported having been satisfied with the genuine and quick responses they got from doctors and correct diagnosis of diseases. This indicates that some level of quality is being maintained even in those hospitals which are not accredited. Respondents from both types of hospitals reported having been delayed before seeing a doctor. This may be attributed to the long queues that are always present in hospitals (Al-Qahtani, et al., 2012). Nurses in the accredited hospitals additionally state that they have noticed improvement in health-care and safety of both patients and doctors since the hospitals were accredited (Al-Awa, et al., 2012).
However, patients from the accredited hospitals reported having a better experience while waiting for their turn to be treated. The waiting rooms of the accredited hospital had better chairs than those of the accredited hospital, and provision of clean drinking water which is also absent in the non-accredited hospital. Despite both hospitals having long queues of patients waiting to be treated, the patients from the accredited hospital seemed more comfortable with the waiting room environment than those from the non-accredited one. In addition, the accredited hospital nurses seemed to express more respect and affection when patients are registering for treatment. However, patients from the non-accredited hospitals reported to have experienced friendlier encounter with lab technicians than those from the accredited hospital. Patients from the non-accredited hospitals complained of being treated by interns instead of the professional doctors hence receiving insufficient treatment. No such response was heard from patients of the accredited hospitals. These respondents from the non-accredited hospitals were impressed with the way the lab technician handled them and also the way they did their professional procedures in diagnose the patients’ illness. They reported a higher level of respect than those patients from the accredited hospitals. However, there are other factors that may alter the patient’s satisfaction of the quality of service offered such as level of education and the amount of income they get. Some issues are not clearly mentioned in both CBAHI and JCI standards. These include but not limited to patient and family rights and the patients’ rights to privacy. Amendment of these standards should focus on these issues CITATION Sha17 l 1033 (Shaikh, 2017). This study by (Al-Qahtani, et al.) clearly indicates that there are significant differences and similarities between the quality of services offered at both hospitals (Al-Qahtani, et al., 2012).
From the research, it is evident that accreditation of health facilities has had a positive impact on the health-care services offered. It has improved patient satisfaction and contentment of the services offered. However, accreditation does not bring the changes instantly. It is just the first step; therefore more emphasis should be laid in implementing the requirements of the accreditation agency.
BIBLIOGRAPHY Al-Awa, B., Devreux, I., Al-Noury, K., Habib, H., Mazrooa, A. A., Rayes, O., . . . El-Deek, B. S. (2012). Benchmarking the post-accreditation patient safety culture at King Abdulaziz University Hospital. Article in Annals of of Saudi Medicine, 143-150. doi:10.5144/0256-4947.2012.143
Almasabi, M. H. (2013). An Overview of Quality and Accreditation in the Health Sector within Saudi Arabia. International Journal of Health Research and Innovation,, 1, 1-5.
Al-Qahtani, M. F., Al-Dohailan, S. K., Al-Sharani, H. T., Al-Medaires, M. A., Khurida, E. N., & Al-Dossary, N. M. (2012, October). The impact of the status of hospital accreditation on patient satisfaction with the Obsterics and Gynecology Clinics in the Eastern Province, Saudi Arabia. Journal of Medicine and Medical Sciences, 3, 665-673.
Alwahabi, S., Bahloul, A., Almutairi, Y., & Alsalhi, H. (2017). A Whitepaper by the Saudi Central Board for Accreditation of. (R. McDermott, A. Masoud, & M. Khoury, Eds.)
Almasabi, M., & Thomas, S. (2016). The impact of Saudi hospital accreditation on quality of care: a mixed methods study. The International Journal of Health Planning and Management, 32(4).
Qureshi, A. z., Ullah, S., & Ullah, R. (2012, January). Brief Communication. The trend of hospital accreditation in the Kingdom Of Saudi Arabia, 33, pp. 1350-1351.
Shammari, M. A., Habib, S. a., Shubrami, D. A., & Rashidi, M. A. (2015). Impact of Hospital’Accreditation on Patient Safety in Hail City, Saudi Arabia: Nurses’Perspective. IOSR Journal of Nursing and Health Science (IOSR-JNHS), 51-55.
BIBLIOGRAPHY m Sha17 l 1033 Shaikh, Z. M. (2017, July). Critical Analysis of Patient and Family Rights in JCI Accreditation and Cbahi Standards for Hospitals. International Journal of Emerging research in Management & Technology, 6(7).