© Copyright, Joint Commission Resources “Essentials” Joint Commission International’s Essentials of Health Care Quality and Patient Safety by Joint Commission.

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“Essentials”Joint Commission International’s

Essentials of Health Care Quality and Patient Safety

by Joint Commission International (JCI)

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The State of Global Health Care

Each year 1 million people

die from complications

following major surgery Nearly 1 in 10 patients is harmed as a result

of a medical error Estimated that 50% of complications and

deaths could be avoided if certain basic standards of care were followed

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Adverse Events in Healthcare

– The problem of adverse events in health care is serious– 10% of hospital patients suffer an adverse event each

year (UK, New Zealand, Canada and Europe)

– 16.6% of hospital patients suffer an adverse event (Australian study)

– 98,000 hospital deaths every year through error (USA) – 1.4 million hospital patients worldwide acquire HAI (at any

given time)

– UK: 100,000 cases of HAI lead to 5,000 deaths a year– USA: 1 out of every 135 hospital patients acquires HAI

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Economic Impact of Patient Safety Problems

– The economic impact is important:– UK: costs as high as US $6 billion a year– USA: about US $29 billion a year

– The problem of adverse events in health care is even more serious in developing countries.

– Less data is available

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JCI Mission Improve the safety

and quality of care

in the international

community–through the provision of education,

publications, consultation, evaluation, and accreditation services

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How We Meet Our Mission

Accreditation of health care

organizations worldwide Assisting Ministries of Health

and governmental agencies to

strengthen the role of quality

oversight at the country level “Essentials”

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Organizational Base

– Joint Commission International (JCI) is the international arm of The Joint Commission (USA).

– Both organizations are independent, non-profit, non-governmental agencies

– Since 1994, JCI staff have worked in 80 countries to provide education, consultation, and/or accreditation services

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Essentials

– Quality and safety improvement framework designed to help organizations focus on the risk areas that have the greatest impact on patient safety

– JCI can better serve organizations at every stage in their journey to higher quality care

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Essentials

Essentials can help to: Determine levels of risk to patient safety in a health

care organization Develop strategies to mitigate risks Better allocate resources to improve quality and

safety

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Essentials System Design Essentials was designed for use by:

–Governmental organizations (Ministries of Health, regional or municipal health authorities)

–Multinational organizations, such as international insurance providers

–Hospital systems –Intergovernmental organizations

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How Essentials Is Applied

Essentials will help an organization to:–Identify the risks that have the greatest

impact on safety–Design an approach for addressing these

risks–Implement changes–Periodically reassess the impact of these

changes

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Why JCI Developed Essentials

– Provide objective information that will guide strategic and financing decisions

– Provide the tools to gather and analyze the level of risk

– Enable health care purchasers and insurance companies to direct patients to lower risk healthcare settings

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– Many healthcare organizations frequently lack the fundamentals to begin the quality journey

– Essentials helps provide direction and a framework for implementing other JCI quality improvement and patient safety tools

Why JCI Developed Essentials

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JCI Methodology / Framework– Builds upon scientific research, best

practices and Joint Commission experience in developing evidence based standards for evaluating level of risk in its organizations

– JCI uses a similar approach in development of other solutions based programs and services

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How Essentials & Accreditation Differ

– Essentials is different from JCI accreditation, which recognizes hospitals meeting the highest standards for care

– Essentials is a resource for developing organizations working on more fundamental elements of quality and safety

– No formal recognition – such as accreditation or certification -- given to hospitals using the Essentials framework

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Overview of International Essentials for Quality and Patient Safety

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Essentials Address Five Risk Areas

– Developed from extensive international healthcare literature and experience

– Ten Criteria for each Risk Area provide clear and achievable risk reduction strategies

– Progressive “Levels of Effort” are identified for each Criterion

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Overview of Five Risk Areas

Five widely recognized domains of risk 1. Leadership Process and Accountability

2. Competent and Capable Workforce

3. Safe Environment for Staff and Patients

4. Clinical Care of Patients

5. Improvement of Quality and Safety

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Risk Area #1: Leadership Process and Accountability

– Responsibilities and accountabilities identified

– Leadership for quality and safety– Collaboration and cooperation at all levels– Quality requirements in contracts– Quality, patient safety, and risk

management are integrated

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Risk Area #2: Competent and Capable Workforce

– Personnel files and job descriptions

– Review of credentials of physicians

– Review of credentials of nurses

– Review of credentials of other health professionals

– Staff are oriented to their jobs

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Risk Area #3: Safe Environment of Staff and Patients

– Regular inspection of buildings

– Control of hazardous materials

– Fire safety program

– Biomedical equipment safety

– Stable water and electricity sources

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Risk Area #4: Clinical Care of Patients

– Correct patient identification– Prior to medication or blood administration,

procedures, surgery

– Informed consent– Before surgery, anesthesia, use of blood

products, and other high risk procedures

– Medical and nursing assessments for all patients – Standardized and timely

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Clinical Care of Patients continued

– Laboratory services are available and reliable

– Diagnostic imaging services available, safe, and reliable

– Planned and provided care is written– Guidance on uniform documentation and

care planning– Monitoring data are used to improve care

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Clinical Care of Patients continued

– Anesthesia and sedation are used appropriately– Policies and procedures– Data on complications and incidents used to

improve– Surgical services appropriate to patient needs– Medication use is safely managed

– Complex set of processes; selection, storage, prescribing, dispensing, administration, and monitoring

– Patient are educated to participate in their care

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Risk Area #5: Improvement of Quality and Safety

– There is an adverse event reporting system

– Adverse events are analyzed

– High risk processes and high risk patients are monitored– Examples: emergency care, resuscitation– Patient examples: immune-suppressed or ,

comatose patients

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Implementing the Essentials

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How Can JCI Help? – JCI will assist organizations through

education programs, and if needed, expert assistance and advice

– JCI will help organizations collect their data and compare it with other similar organizations

– JCI will use an on-line collection and database tool

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For more information:

The Joint Commission Resources Web Sitewww.jcrinc.com

The Joint Commission Internationalwww.jointcommissioninternational.org

Joint Commission International Center for Patient Safetywww.jcipatientsafety.org

[email protected]