The Effectiveness of the Joint Commission International Accreditation in Improving Quality at King Fahd University Hospital, Saudi Arabia: A Mixed Methods Approach

Abstract

Introduction Saudi Arabia has one of the highest numbers of health organizations accredited by the Joint Commission International. This study aimed to measure this process’s effectiveness in improving quality at King Fahd Hospital of the University in Khobar, Saudi Arabia. Additionally, the study investigated health providers’ perceptions of this process. Materials and Methods This research utilized a convergent parallel mixed method. For the quantitative analysis, an interrupted time series was conducted to assess the changes in a total of 12 quality outcomes pre- and post-accreditation. Thematic analysis was utilized to collect and analyze qualitative data from hospital employees and health providers. Results The quantitative results indicated that pursuing accreditation positively impacted nine out of 12 outcomes. The improved outcomes included: the average length of stay, the percentage of hand hygiene compliance, the rate of nosocomial infections, the percentage of radiology reporting outliers, the rate of pressure ulcers, the percentage of the correct identification of patients, the percentage of critical lab reporting, and the bed occupancy rate. The outcomes that did not improve were the rate of patients leaving the ER without being seen, the percentage of OR cancelations, and the rate of patient falls. The qualitative analysis suggested that the accreditation process was perceived positively by participants. Nevertheless, participants also highlighted some of the drawbacks of this process, including: the potential bias in observation-based key performance indicators, the focus on improving process without enhancing the hospital structure, and the increased workload. Conclusion International accreditation had a positive impact on quality and was received positively by providers. However, several issues need to be addressed by hospital administrators in future accreditation cycles. According to participants, the most notable issue during the first two accreditation cycles was the increased workload and paperwork, which can potentially distract from patient care.

The importance of hospital re-accreditation: improving the timeliness of laboratory critical value reporting

“…19 Study in a University Hospital, Saudi Arabia shows the percentage of laboratory critical value reporting within 30 minutes had high compliance (99,37%) as they already stick to the College of American Pathologists (CAP) Laboratory Accreditation Program. 20 It seems accreditation and the sequence like training could bring a good impact to the timeliness of laboratory critical value reporting.…”

Perception of Health Care Professionals Toward Hospital Accreditation at Johns Hopkins Aramco Healthcare

“…It was certainly perceived positively that accreditation improved different aspects of patient care, and believed that several issues need to be considered in future accreditation cycles. 1,[20][21][22] In addition, a descriptive-analytical study illustrated that the accreditation status is boosted due to the health care professional's understanding of accreditation standards and belief in its impact on early identification of performance gaps, especially in the essential safety requirements. 23 In our previous research study done by the accreditation division in JHAH, we used quality performance indicators to measure the impact of accreditation, where the compliance with JCI standards was measured by the performance of the 6 IPSGs, which was directly reflected in improving quality and patient safety over time.…”

“…National studies indicated that the JCIA positively impacted the participation, preparation, and quality of health care provided at the hospital, though the degree of impact contrasted among various health professionals. It was certainly perceived positively that accreditation improved different aspects of patient care, and believed that several issues need to be considered in future accreditation cycles 1,20–22. In addition, a descriptive-analytical study illustrated that the accreditation status is boosted due to the health care professional's understanding of accreditation standards and belief in its impact on early identification of performance gaps, especially in the essential safety requirements 23.…”

The impact of JCI accreditation on the clinical, operational, and financial performance of Chinese private hospitals

“…The effects of JCI accreditation on the quality of care and performance have been assessed in different countries since 2010. In one study, the author concluded that pursuing JCI accreditation positively impacted 75% (9/12) of a select list of clinical measures at the 550-bed King Fahd Hospital in Saudi Arabia [10]. In another study, 60% (3/5) of the studied performance indicators achieved signi cant improvements due to JCI accreditation; this was found by comparing two 133-bed accredited hospitals and two 115-bed unaccredited hospitals in Jordan [11].…”