Book Description

Health cost is escalating. Today health care systems are responsible for a considerable proportion of public expenses. Patient safety became a major concern and evolved as a global problem with the increase in public perception on adverse events. As a result, improving the quality of care and measuring performance using effective measurement tools became major public and political issues challenging health care organizations. In response to this, considerable effort and expenses have been devoted to develop and implement quality initiatives in health care organizations. It is essential that the assessment of quality initiatives use evidence-based measurements to evaluate their outcomes. Joint Commission International (JCI), a wholly-controlled non profit affiliate of Joint Commission on Accreditation of Healthcare Organizations (JCAHO) was established with a goal to continuously improve the level of healthcare organizations by introducing international standards and indicators applicable to different countries around the globe. Anecdotal evidence and numerous testimonials suggest performance improvement, yet no empirical studies have been conducted to demonstrate the overall benefits of applying the JCI standards, in countries outside the US. This book presents a robust methodology to measure quality performance of health care organizations and evaluate the effectiveness of JCI standards in improving the quality of care. The book is based on a study that used a holistic performance measurement model to measure the effect of the newly developed JCI standards on the perceived quality performance and the progress toward organizational excellence of a 400-bed hospital in a developing country. The study used a longitudinal quantitative design over a period of 15 months. Structured questionnaires were used to collect data from 250 staff, 250 patients and families, 200 patients' medical records, and 60 self-assessment surveys based on the accreditation bodies' approach. The results showed a significant perceived improvement in the overall organizational performance index 15 months after the implementation of JCI standards. The results highlighted many areas of strength in the standards, mainly in their impact on organizational excellence, quality improvement and patients' safety, leadership and management performance, patients' satisfaction and delight, organizational learning, organizational ethical performance, and documentation. The results also identified opportunities for improvement in the JCI standards with respect to human resource management and the absence of standards that address issues existing in organizations with corporate structures.