Clifford Hospital has been successfully re-accredited by Joint Commission International (JCI). The good news came after the Joint Commission International Accreditation rendered an accreditation decision to the hospital on December 16th, 2015. The successful accreditation for the fifth time marks the hospital’s consistent compliance with world-class hospital management standards, as well as its leading role in the endeavor to go global, among hospitals in China.
JCI is a division of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and a global authoritative accreditation organization in evaluating healthcare quality. The accreditation commission is an international top-level accreditation organization recognized by the World Health Organization (WHO). JCI standards are world-class standards for medical quality and service, which represent the highest medical service and hospital management guidance.
Clifford Hospital was initially accredited by JCI in 2003, making it the first JCI accredited hospital in China. The hospital pioneered in bringing Chinese hospital management in line with international standards. To retain JCI accreditation, a hospital must undergo a triennial JCI accreditation re-survey. 2015 has witnessed Clifford Hospital’s successful JCI accreditation for the fifth time, in addition to its previous surveys taking place in 2003, 2006, 2009, and 2012. The successful accreditation this year has made Clifford Hospital the only hospital in China that has been granted the status of accredited by JCI on five consecutive occasions.
JCI surveyors and Clifford Hospital staff
“JCI is committed to patient-centered care, ongoing quality improvement, and patient safety. Clifford Hospital has been strictly in compliance with JCI standards, in terms of its policies, processes and procedures, and practices since its first JCI accreditation survey. Every member of staff is trained consistent with JCI standards at initial employment and regular re-training sessions. In addition, there are at least two on-site JCI consultations each year in the hospital, providing consultative advice on compliance with JCI standards. Hence, JCI standards have been integrated into everything we do at Clifford Hospital. The survey process is also an opportunity for learning and growth. ” said the Hospital Director Prof. Clifford L.K. Pang.
A JCI survey team with three surveyors evaluated Clifford Hospital on-site against JCI Accreditation Standards for Hospitals (the Fifth Edition) from December 7th to 11th, 2015. The team assessed the hospital’s compliance with over 1,000 measurable elements in 14 chapters of the JCI manual, including International Patient Safety Goals (IPSG), Access to Care and Continuity of Care (ACC), Patient and Family Rights (PFR), Assessment of Patients (AOP), Care of Patients (COP) , Anesthesia and Surgical Care (ASC), Medication Management and Use (MMU), Patient and Family Education (PFE), Quality Improvement and Patient Safety (QPS), Prevention and Control of Infections (PCI), Governance, Leadership, and Direction (GLD), Facility Management and Safety (FMS), Staff Qualifications and Education (SQE), and Management of Information (MOI).
The surveyors applied the most current tracer methodology in the five-day survey process. The survey was detail-oriented, involving all departments and services across the hospital. In addition to document review, quality tracer, leadership interview, and patient tracer, ensured the process covered a wide range of standards related to international patient safety, patient and family rights, patient care, medication management and use, patient safety, fire safety, infection control, health education, facility safety, and staff qualifications and education, etc.
JCI surveyor is interviewing the staff.
JCI surveyor is evaluating the staff qualifications and education.
“JCI continues to raise the bar for accreditation and to update the standards in each edition as it is dedicated to continuous quality improvement and patient safety, ” said Dr. Niu Lihua, Director of JCI Process Office in Clifford Hospital. She added that Clifford Hospital adopted the second, third, and fourth editions of JCI accreditation standards before the current fifth one. When evaluating hospitals against the same edition of JCI standards, the JCI surveyors have higher expectations for a hospital like Clifford Hospital undergoing multiple accreditation surveys previously, than a hospital requesting an accreditation survey for the first time. For example, supply chain management, a new standard in the fifth edition, requires a hospital to gather data and information not only on suppliers, product use, and adverse effects, but also on manufacturing and transportation of drugs or medical technologies, thus protecting patients and staff from contaminated, fake, and diverted products.
JCI surveyor is conducting nursing quality tracer.
With our commitment to improvement for over a decade, our hospital has been thoroughly grounded in our value of “quality and patient safety”. This value guides every decision we make, wherever we make them. For example, all mercury thermometers have been replaced by electronic ones to prevent a mercury spill. Curtains have been put in place between beds for privacy protection across the hospital. Toilets in all patient care settings have been equipped with an emergency nurse call button, which ensures rapid identification of and response to unexpected patient needs. Medication management and use are included in quality monitoring, ensuring medication safety for each patient. As part of our commitment to a culture of safety and proactive risk management, all staff are encouraged to report adverse events without fear of reprimand or punishment.
The JCI surveyors greatly appreciated and applauded our excellent performance in such areas as IPSG, ACC, and PFR at the exit briefing. “With such a clean and tidy environment in place, Clifford Hospital is the best hospital I’ve ever seen in terms of the seven FMS programs,” said the administrator surveyor Ms. Semrad.
“ We will build on the success of the fifth accreditation, bringing our performance further forward,” said the Hospital Director Prof. Clifford L.K. Pang. “As part of our efforts to ensure excellent and safe care for patients and their family, we will stay firmly committed to JCI accreditation standards and continuous quality improvement.”
