In a world where data fluctuates between showing the impact of accreditation on health care institutions and negating it, we, at the Health Care Accreditation Council (HCAC), were intrigued to take a look at whether the accredited healthcare institutions in Jordan were more ready to deal with the requirements of COVID19 or not?

In a country that boasts a very good medical and health sector, regulation and compliance to patient safety standards emerged as a weaker link. However, through the accreditation approach, Jordan has been able to push the envelope quite high and induce continuous improvements in health care organizations.

In early 2019, HCAC looked at a number of public, private and military hospitals that had baseline data vis-a-vis the HCAC hospital accreditation standards as well as data post accreditation. The initial assessment baseline data, encompassing more than 346 standards per hospital, showed that only 14% of the standards were met before accreditation, while it reached more than 95% after.

Quality improvement was evident in the hospitals that participated in the accreditation journey. Whether it was a lack of policy, program or plan , training, and infrastructural necessity, practice or behavior, HCAC accreditation has influenced improvements in all areas  ensuring that hospitals are well-prepared to respond to any type of emergency, internal or external, and maintain the provision of safer and high quality care and services , despite the challenges faced.

With the challenges brought by the pandemic, especially onto the health sector’s ability to cope, respond and be resilient,  it was quite interesting to look at data of accredited and non-accredited hospitals to gauge the readiness of hospitals to deal with COVID19 precautions in light of the accreditation requirements.

HCAC interviewed accredited and non-accredited healthcare institutions from the private, public and military sector in Jordan with focus on six areas including: (1) emergency preparedness; (2) infection control; (3) capacity building; (4) case management; (5) communication; and (6) laboratory, all of which we thought should be especially ready during the COVID19 pandemic.

The results showed many positive impacts of having had the hospital go through the accreditation journey. Findings eluded positively to:

• Having well-structured Infection Prevention and Control (IPC) Program which supported in upgrading the systems to deal with COVID19 cases,
• the presence of different committees in the hospital that were able to convene, decide, implement and monitor new approaches.
• having complete policies and procedures to support work and change along with the HCAC standards being a good reference for decision making
• Trained staff especially on IPC, occupational safety and risk management  as well as on protocols and protocol adoption
• The presence of an emergency preparedness plan that helps the hospital set out its next steps
• The availability of systems for quality monitoring and collection of data for performance indicators helped in collection of required data for COVID 19

It was also noted that the non-accredited hospitals within a network of hospitals leaned on the accredited hospitals in relation to the required systems and plans as it seems that the accreditation standards served like a roadmap during the management of COVID 19

HCAC took one additional step and looked at data from the satisfaction surveys filled by accredited organizations. It was not much of a surprise, but more of comfort to see that much of the feedback supported that indeed, accredited hospitals were more ready to address the adapt their systems and responses to the influence of the pandemic.  For example, the satisfaction feedback had commended the requirements of accreditation for a well-functioning hospital disaster management system, for enabling management and staff to develop their capabilities in setting and implementing strategic, quality risk and safety plans, for the spread of quality culture across all types of employees, for have well documented information and requiring risk assessments and empowering occupational safety and employee health and rights. The results also showed the organizations satisfaction in setting proper case management from triage to inpatient, which surfaced as a critical activity during the COVID19 world with more solid patient records and clinical data. 

Accreditation also elevated accurate and timely communication which in the world of emergency led to ensuring informed decision-making, effective collaboration and cooperation, public awareness and trust while streamlining the sharing of information between the hospital administration, department/unit heads, and facility staff. Catalyzed by the accreditation standards requirements, management and staff become more interested in patient complaints, while patients become more empowered, as they participate in decision making and are listened to. Last but not least, as prescribed by the accreditation standards, laboratory services maintenance and quality control improvement allow for the appropriate clinical management of both pandemic and other patients, as well as for the hospital-based surveillance of COVID-19. The satisfaction surveys reported that accreditation lead to increase in the safety measures in the laboratory and raised the safety awareness among laboratory staff.

There is no doubt that implementation of the accreditation standards influenced the care and services received by patients during emergencies, from improved inventory management of necessary materials and supplies, to communication to patient care. Accredited hospitals have stronger systems, programs, and capacities to deal with any type of emergencies.

For the full paper, please contact Ms. Roushda Saadoun by phone +962-6-5814100 extension: 102 or by email rsadoun@hcac.com.jo .