Document 6520691

4dventisti#
Healtht
TsuenWan AdventlstHospltal
trE*rH
accreditation
Trent
andJCIhospital
Whatfor?Andwhyboth?
Report
by
Conference
FHAM
WONG
Yat-cheung,
MDFRCP
Dr.Charles
(TAS)
TrentAccreditation
Scheme*
a recentinternational
ThisarticleshareswhatI leamtfromchairing
is
reading.Merging
thesetwosources
frombackground
in addition
to whatwasdiscovered
conference,
purely
personal
representative
and
not
of
My
views
are
to
make
this
article
comprehensible.
essential
perspective
Adventist
Health
to theupbeat
lt provides
different
Health(AH)or anyof itshospitals.
Adventist
"Return
Newsletter
totheBasics".
Commission
Intemational.*)
June2007JCI(Joint
Attribute
of Photo:
onhisleft,withtheTASTeam,and
& Hospital
withMsManbo
MANof HKSanatorium
Dr.Charles
WONG,
fromthePhilipines
twoparticipants
knowledge
on TASandJCIAccreditation
Limitof my personal
Hospital
TsuenWanAdventist
to helping
waslimited
accreditation
on hospital
In the past,my knowledge
surveys.This
at the timeof accreditation
(TWAH)paediatrics
andattendance
servicein its preparation
therefore
not
that I was its chairman
opportunity
to learn. lt wasfortunate
was an excellent
conference
into
byresearching
formeto prepare
reqiiired
to deliveranypearlsof wisdom.Evenso,it wasonlyprudent
thesubject.
. "Garingfor Patients
Borders- Doingit wellandlettingpeople
acrossInternational
TheConference
University.
Management
knowyoudoit well"on 14thJuly1007attheSingapore
tooktheleadfortheTASteam.
England,
fromSheffield,
Disease
Consultant
SteveGreen,Infectious
Professor
Otherswerefromthe
wasfromSingapore.
The largestcontingent
aftended.
30 participants
Roughly
of
TwowerefromHongKong(HK),MsManboMAN,Director
BruneiandMacao.
Thailand,
Philippiires,
were
Many
aftendants
TWAH.
(HKS&H),
me
from
lhe
and
& Hospital
fortheHKSanatorium
Service
Nursing
of
withvarious
aspects
papers
position.
weremainlyconnected
Presenled
seniornursesin management
"selling'
medical
local
medical
treatment,
visitors
to
receive
in
overseas
to bring
meaning
"medical
tourism",
clients.
tooverseas
service
bybothTASandJCl,may
beingaretheonlyonescertified
Theuniquefeatureof AH,thatitstwohospitals
metochairtheConference.
thatTASinvited
havebeenthereason
requirement
andstatutory
HongKongprivatehospitalaccreditation
private
hospitals,
usingitsown
andlicense
to inspect
is responsible
Department
of Health
Thegovernment
HongKong
for
legal
requirement
in time,HongKonghasno
Atthismoment
standards.
setof un-published
accreditation
suchasJCIorTAS.Withnosuchstatutory
privatehospitals
anyformbf independent
to undergo
ofTASandJCIaccreditation.
flagellation
Health's
double
Adventist
manyhavequeried
requirement,
accreditation ,, fe"
of HongKongprivatehospital
Historical
background
aT{"-*'E',^&"5
the
suffered
& Hospital
According
to MsManboMAN,priorto 2000aroundthetimethattheHKS{natorium
and
private
lacking
supervision
were
hospit{b
HK
unit,localmediaalleged
its renaldialysis
accident-at
introduced
providing
standards.. -Sir Dr.HarryFANG,bfSt.Paul'sHospital
consistent
carewithout
dccrediiation
the
Trent
f6r
choosing
One
reason
partty
criticisms.
to
rebuff
thbse
asa tool
TASfromtheUK
tosuitthe
TASstandards
to modify
established
hospitals
toworkwithHKprivate
wasitswillingness
Scheme
HKprivatehospitals,
amongst
ofaffordability
Furthermore,
duetothelargevariation
localHongKongsituation.
UK
basedsurveyors
pocket
Most
of
the
only.
foroutof
expenses
TASagreedto chargeHKprivatehospitals
body.
a nonprofitmaking
time.TASremains
comelo HKusingtheirownvacation
costoftheaccreditation
shared
hospitals
in2000byTAS.Allprivate
wereaccredited
hospitals
All12private
for
specifically
evolved
of
standards
effort,
a
set
with
this
process,
Conlinuing
incostcontainment.
resulting
and
reviewed
to be
continue
Thesestandards
UKTASstandards.
fromestablished
HongKong,adapted
theTAS
into
account
taking
members,
private
two
committee
each
supplying
hospitals
revisld,withHK
Board's
inout..
Hong
thatgavebirthto theofficial
hospitals
wastheimpetus
of allprivate
m-operation
Thisunprecedented
atthis
attendants
thatinternational
I amdelighted
to report
Incidentally,
Association.
Hospitals
KongPrivate
co-operation
solidarity
and
and
the
of
this
organisation,
very
existance
the
admired
unreservedly
conference
within.
tourismfor HongKong
Medical
tourism
of notein HK.
thatthereis stillnomedical
I toldtheaudience
to theConference,
At myintroduction
I
issuealtogether.
Chinagivingbirthin HongKongis a different
frommainland
Theiunentfloodof molhers
patient
coinsurance
co-payment,
oveBeas
costsupersedes
service
believe
thatas longas HKmedical
fromwealthy
cover,patients
insurance
needto paydespitemedical
payment
beingtheahortfallthatpatients
tourism.
tocometo HKformedical
areunlikely
countries
litigation
tourismandnegligence
Medical
lhat most
- MedicalProtection
told the Conference
Society(MPS)representative
DoctorsBEWARE
a USor
Should
occurred.
likelylitigationwill start in the countrywherethe allegednegligence
thenMPScoverdoesnotapply.
citizensuein thecourtsof theusAor canada,
canadian
negligence
of medical
thequestion
whoanswered
solicitor
by its localSingapore
MpSwasrepresented
patients
fromabroad,
international
treating
coverfordoctors
insurance
tourism?
medical
byJCIor TAShelpedto promote
accreditation
Hashospital
withintheAsiaregion.
mstis notcompetitive
HKmedical
Cunent
to suggest;so.
No. Thereis noevidence
far
frombeing"firstworld
HK
is
class,
is
service world
qualityandstandard
of medical
HongKong's
Alihough
price
edge,
- it is"firstworldservice
competitive
the
Without
atfirstworldprice".
servicjatthirJworldorices"
pie,
medical
tourism
international
grab
very
small
of
the
a
share
to
it wouldbefutileforl-iongKongto attempt
The
body.
intemational
or notbywhichever
is accredited
ourhospital
oiwhether
at leastfornow,irrespeciive
price
advantage.
of
because
have
not
come
tourist
as
medical
fewwhocometoHongKong
body?
international
byanyindependent,
Sowhybotherwithaccredihtion
"BothJCIandTrentAccreditation
of TWAHputsit succinctly:
Officer("COO")
Mr.AlexLAN,ChiefOperating
from
andbestpractices
are toolsto imprwequalityof careandpatientsafety.Experience
Schemes
thequalityofcare
aswaysto improve
standards
intotheaccreditation
participating
areincorporating
hospitals
standards."
andsafety
of its guidingprinciples
to beusefulbecause
TAScontinues
.
lt is
clinicians.
byactivepracticing
runonhe basisof peerreview
organization
TASis a non-profit
inexpensive.
itself.lt remains
to"market"
onlynowbeginning
.
Thereisnowa
andmeasures.
hospital
standards
localized
tohelpestablish
committed
TASremains
reviewed
and
being
continually
to HongKongwhichis
thatisspecific
andmeasures
setof slandards
uodated.
.
in HK's
toworkTASoutof itsparticipation
is unlikely
andmeasure
standards
ofhospital
Localisation
between
competition
of
healthy
level
remains
a
certain
there
because
surveys
accreditation
hospital
andfaimess.
neutrality
TASguaranteed
whichis-befH bytheindependent
hospitals
localprivate
tu^9",*;
Participating
for theirout of pocketexpenses.
are not paidbut onlyreimbursed
TASsurveyors
and
fortraining
expense
hospital's
theirownstaffat theparticipating
to supply
arerequired
hospitals
hospitals.
different
of
equivalence
"exchange
latter
standardize
The
helps
to
of
examiners".
eventual
Personal
on best practice.
"Exchange
of knowledge
also resultsin exchange
of Examiners"
for
exchange
from
this
potential
interests
of
conflict
on this issuetells me that
knowledge
senseof HKmedical
of thegoodcommon
because
carehavenotoccurred
of patient
improvement
professionals.
andnursing
withcontinual
ownhospitals,
at thesurveyors'
allyearroundstationed
surveyors
of trained
Presence
have
local
hospitals
of different
surveyors
between
contactwiththeTASBoard,andcommunication
alike,
andhospitals
surveyors
allparties,
benefited
notonlyfromtheUKto HK,
freshperspective
introduces
surveyors
in byoverseas
brought
Experience
butalsoviceversa.
WhyTASas wellas JCI?
of June2007didnotreveal
JCINewsletter
to theBasics"
Thorough
studyof alleightpagesof theAH"Return
Onthisissue,Mr,
TAScertification.
achieved
on JCIafterhavingsuccessfully
forembarking
the reasons
pushed
for
previous
JCIonthebasis
administration
of
the
that
the
CEO
explained
AlexLAN,COOof TWAH,
thanTAS,andalsobetterknownthanTASworldwide.The reasonfor
higherstandard
thatit demands
agreed
systemuniversally
is thatthe latteris an assessment
undergoing
bothJCI and TAScertification
may
hospital
pulling
by
any
out of thisagreement
andunilateral
all HongKongprivatehospitals
between
private
system.
accreditation
hospital
upsetthisSAR-wide
TASis UK based,thatAmerican
fromthe USAwhereas
alsoworthnotingJCI originated
It is probably
in theUS,
hadlivedandworked
AH
CEO
then
Hospitals,
Adventist
two
founded
the
Adventist
missionaries
in the USA,the
Organisation
Accredited
of a JointCommission
thenwasex-staff
of Nursing
the Director
is in the USAandthe list
the Churchheadquarter
wasthenAmerican,
Director
lmprovement
Performance
g o e s0 n. . . . . .
of
Theprocess
is notthecertification.
thatthe reasonto gainTASor JCIaccreditation
Mr.LANstressed
patient
and
services
thehospitals'
to improve
to bethemechanism
is acknowledged
accreditation
achieving
covered
have
preparation
to
is
likely
for
JCI
TAS,
than
is
more
stringent
JCI
thatsince
safety.He reasoned
doesnot arise. AH administration
certification
of redundant
thereforethe question
TAS requirements,
planned
for both
expansion
to the impending
will be applicable
standards
intended
that suchimproved
processes
and
of
as withany seriousinwardexamination
and not surprisingly,
hospitals.In practice,
safety.
service
andpatient
clinical
procedures,
is indeedimproved
theoutcome
JCI
forchoosing
insurers.
Onereason
negligence
UShospital
amongst
to TAS,JCIis wellknown
Incontrast
known
are
accreditation
JCI
of
the
outcomes
Some
provides
standards,
measurable
veryclearand
is thatit
thefollowing:
Theseinclude
to mebyhearsay.
'
insurance
negligence
on hospital
25%discount
thattherewillbe an automatic
The assumption
in theUSA,didnotturnout
hospitals
accredited
Commission)
premium,
to JACO(Hospital
applicable
forHK.
to beautomatic
.
g0 downafterinsurers
cameto inspect
premium
costdideventually
insurance
negligence
Hospital
passed
theirJCIaccreditation.
afterthehospitals
firsthandforthemselves
thehospitals
accreditation
to achieve
of improvement
of tellingstaffthattheprocess
education
extensive
Despite
noonewantsto beculprit
because
outbytheJCIsurveypreparation
wastheaim,staffwasstressed
thatit is
a student
of
telling
futility
to
the
is
analogous
This
foraccreditation.
forfailinganassessment
andtheself
is in thelearning
thevalueof theexamination
scorethatcounts;
nottheexamination
process
thattookplacebeforehand.
improvement
thatof TAS.
fargreater
remains
inevitably
Costof JCIaccreditation
include
currentlocalHKdevelopment
O(herrelevant,
.
publichospital
is usingitsownstandards
service,
massive
HongKong's
operating
Authority,
Hospilal
plantogofor
Thereis noimmediate
andmeasurements.
cbupbdwithJCIstandards
andmeasures,
(hearsay).
fullaccreditation
independent,
formal,
.
JCI.
isalsoaftempting
Hospital
TheHKBaptist
.
scheme
anAustralian
withTAS,butadding
continuing
accreditation,
double
iscontemplating
HKS&H
.
toTAScertification.
inaddition
ISO9000standard
haveacquired
andUnionHospital
BothMatilda
onthis
moreknowledgeable
- Hospital
is hereto stay.As HongKongbecomes
accreditation
FUTURE
re'evaluation.
continual
wanants
issue,coshbenefitand in particularduplicatedaccreditation,
asthiswill ruinthehardearnedsolidarityof theHongKong
BreaiingawayfromTASis unthinkable
Hospitals,
of Private
Association
tochairthisC'onference.
theautholstripto Singapore
suppofted
financially
TWAH
Declaration:
of JCI/TAS:
summary
Overview
JCI
- http://www.jointcommissioninternational.com/
23.08.2008
TakenfromJCIwebsite
of
andquality
improve
thesafety
istocontinuously
International
"Themission
ofJointCommiss:on
and
services
andconsultation
ofeducation
theprovision
through
community
careintheinternational
United
in
the
careorganizations
ofhealth
accreditor
thelargest
......Today
accreditation
intemational
programs
a voluntary
through
health
care
20,000
nearly
surveys
states,
theJointcommission
corporations."
not-for-profit
both
process.
are
anditssubsidiary
TheJointCommission
accreditation
for
scope
institution,
JCIstatesitsspecific
ofthehealthcare
departments
note:Fordifferent
Author's
andMeasureable
process
Intent
intotwosections,
theaccreditation
andthendivide
thatdepartment,
Elements.
..
TAS - http://www.trentaccreditationscheme.org/
23.08.2008
Taken
fromTASwebsite
the
fromwithin
andmanagers
bypractitioners
hasbeendeveloped
Scheme
TheTrentAccreditation
evolve
to
is
continuing
its
users
and
by
andownership
credibility
capability,
ensuring
TrentRegion
develoo.
and
Benefits
Scheme
andproviders
staff,commissioners
topatients,
ofservice
thequality
o assures
ofstandards
a benchmark
o provides
information
quality
monitoring
o provides
n
o
o
B
of people
andorganisations
facilitates
thedevelopment
for
change
environment
a
dynamic
creates
provides
networking
opportunities
contacts.
overseas
CoreElements
o peerreview
Board
awards
byanindependent
o accreditation
tr newsletter
opportunities
andnetworking
in thescheme
andsurveyors
tr training
eventsforparticipants
visits
tr pre-survey
if desired
fortheorganisation
tr mentoring
process
of development
a continuous
fromthoseof theUnited
different
note: Healthcare
institutions
of HongKongareinherently
Author's
enables
the
in itsCoreElements
TAS'builtinflexibility
country.
Kingdom,
thescheme's
originator
partners,
specific
set
of
evolve
a
to
adapt
then
its
Kong
with
Hong
with
continual
consultation
TAS,
standards
applicable
to HongKong.