In the globalized world, quality and safety in the field of healthcare have become a worldwide mandate. To hospital administrators, patient care, operating efficiency and compliance with regulations are of utmost priority. At the same time, in terms of the growing number of medical patients, identifying healthcare facilities that meet strict international standards is crucial for making informed decisions about their treatment abroad.
This article delves into a comparative study of three major international healthcare accreditation organizations, the Joint Commission International (JCI) of the USA, the National Accreditation Board for Hospitals & Healthcare Providers (NABH) of India, and the Australian Council on Healthcare Standards International (ACHSI) of Australia.
By examining their similarities, differences, and unique philosophies, the article will provide useful insights for both healthcare providers seeking accreditation and medical tourists navigating the global healthcare landscape.
Healthcare Accreditation explained
Accreditation in healthcare is an external peer review process of assessing the organization (healthcare) with respect to the set standards in terms of qualifications and safety. The process is voluntary and its completion is an indication of committing to constant improvement of quality and following best practices. These are the main objectives of accreditation:
- Improving Patient Safety: Introducing effective measures to reduce the chances of risks and other negative conditions.
- Ensuring Quality of Care: The services provided are of high standard and at least according to the benchmarks set.
- Increasing Confidence: Giving a sense of security over the quality of care to the patients and the community.
- Promoting Continuous Improvement: Building a foundation in terms of continuous self-evaluation and improvement.
Comparing Global Healthcare Accreditation Bodies
1. Joint Commission International (JCI)
Joint Commission International is the oldest and largest healthcare accreditor in the United States. JCI was formed to reach across borders with the mission of advancing the care and safety of healthcare throughout the world. JCI is established with background in the highly regulated and quality-concerned U.S. healthcare system, and soon became a world leader in the healthcare accreditation sector. It has licensed thousands of medical organizations in more than 100 countries, which is why it is a potentially recognized international healthcare accrediting organization. It occupies a particularly good position in the Middle East, Asia, and Latin America, where its presence has not only come to largely dominate a number of facilities, but a large number of them strive to gain the JCI accreditation in order to demonstrate their strategies regarding Western standards of care.
The Central Standards and Focus Areas
The basis of the JCI standards lies in comprehensive, evidence-based criteria that are intended to be applied across the various healthcare settings, such as those in hospitals, ambulatory care centers, laboratories, and long-term care facilities.
International Patient Safety Goals (IPSGs):
There are six goals presented as the core of JCI framework that impact central issues of patient safety as patient identification, efficient communication, drug safety, surgical site safety, decreased HAIs, and decreased patient harm from falls.
2. National Accreditation Board for Hospitals & Healthcare Providers (NABH)
National Accreditation Board for Hospitals & Healthcare Providers (NABH) is one of the constituent boards of the Quality Council of India (QCI) to conduct accreditation programs for healthcare organisations. NABH is strictly aimed at giving national dimensions to quality assurance in Indian healthcare. Even though its main area of interest lies in the Indian subcontinent, NABH is now starting to gain recognition in the surrounding regions and among the regional medical tourists.
The Central Standards and Focus Areas
NABH standards are broad and they span the spectrum of healthcare services, including patient care processes, organizational management, etc. They are divided into two large sections: Patient Centered Standards and Organization Centered Standards.
3. Australian Council on Healthcare Standards International (ACHSI)
Australian Council on Healthcare Standards (ACHS) is the green imperial of healthcare accreditation undertaking in Australia. ACHSI is globally extending its expertise and accreditation programs. In Asia-Pacific, ACHSI has a strong presence in Hong Kong, Singapore, Malaysia, and other locations as it has fielded a stable and flexible system of accreditation. Its style focuses on the continuous improvement of quality between the healthcare organization and the rest of society.
The Central Standards and Focus Areas
ACHSI is defined by the continuous and holistic quality improvement concept and is less prescriptive than JCI. It does not prescribe certain means that organizations should follow to comply, but pushes them to prove how they could achieve the standards with their own systems and processes.
Comparative Analysis: Similarities and Differences
Although JCI, NABH, and ACHSI have diverse backgrounds and focus on different regions, they have a common link, as well as significant differences in their healthcare accreditation strategies.
Similarities
- Core Purpose: The overall aim of all three bodies is to enhance quality and safety of healthcare services. They want to minimize medical errors, improve patient satisfaction, and establish the trust of the populace in health care institutions.
- Patient Safety Emphasis: Patient safety is a core element of all three. All of them contain their standards in such critical areas as infection control, medication management, safe surgery, and patient identification.
- Continuous Quality Improvement: Both of the frameworks encourage a culture of continuous quality improvement where organizations should conduct regular reviews of their performance and should detect their areas of weakness and take the necessary corrective measures.
- Broad Scope: Their criteria apply to a wide scope of healthcare processes covering clinical care processes, support services, human resources and facility management or operation.
- Evidence-Based Standards Evidence-based standards are those standards that are formulated by these organizations, and they are mostly founded on international best practice, evidence, and expert assessment.
- Voluntary: Accreditation by these bodies is usually voluntary, and an organization needs to be committed to perform excellently, and wants an outsider to say that it perform excellently.
Differences
Geographic Reach and Influence:
- JCI: Has the most extensive reach as far as global knowledge and brand identity, which is especially strong in places with a broad base of international patients. Its brand value regularly places it as a favoured option for facilities that are striving for an international reach among medical tourists.
- Nabh: Its Interest is mainly centred around India, making it particularly pertinent for local patients and regional medical tourism.
- ACHSI: Dominant in Asia-Pacific region, it is an alternative to JCI that is highly respected for organisations operating in this geographical location.
Standard Development and Philosophy:
- JCI: Tends to be more prescriptive by providing specific guidelines and often detailed methodologies for compliance. This could offer some sort of clarity, but in some cases could limit flexibility. The United States model of healthcare greatly influences their standards.
- NABH: Striking a balance between international quality and local feasibility, NABH works on international benchmarks, adapting them to Indian context. It offers a practical approach, looking at the entire Indian healthcare geography.
- ACHSI: This has an emphasis on less prescriptive and more outcomes-focused approach. They require organizations to show quality outcomes and how they achieve the same through their internal systems, which promotes innovation and a strong, continuous improvement culture.
Accreditation Process and Duration:
- The perceived intensity and duration of the preparation phase can differ. JCI’s methods tend to be very intensive and demanding in the documentation and preparation phases.
- NABH, ACHSI also require extensive preparation, but they might allow more flexibility, which allows for better integration with the existing quality management systems.
Cost Implications:
- JCI: Their rigorous procedures alongside their global infrastructure and brand value make them the most expensive option. These costs include survey fees, travel for surveyors, and possible consulting fees.
- NABH: For Indian healthcare providers, this is usually the most economical option out of the three.
- ACHSI: It is positioned between the two other options. Providing a reputable accreditation at a relatively lower cost compared to JCI, particularly in its primary region of operation.
Cultural and Regulatory Alignment:
- JCI: Their standards are adaptable, however, for non-Western organizations, the frameworks may require substantial operational and cultural shifts.
- NABH: Tailored to the Indian regulatory landscape and sociocultural settings, this makes it easier for local facilities to implement.
- ACHSI: Australian healthcare values are visible in the program, focusing on partnership and consumer participation alongside robust clinical governance, which also appeals to the Asia Pacific’s healthcare systems.
Focus on Specific Areas
- JCI places almost singular emphasis on International Patient Safety Goals.
- ACHSI’s strength is in clinical governance and consumer participation, viewing quality as a whole-of-system responsibility that involves all stakeholders.
- NABH’s approach is a balance of patient-centered and organization-centered standards, describing an all-encompassing quality approach set within the Indian context.
Final Thoughts: Choosing the Right Accreditation Body
The accreditation landscape is diverse globally with bodies such as JCI, NABH and ACHSI. These organizations have made significant strides in improving the standards of care globally. While JCI is well-known for its broad international recognition and prescriptive style, NABH provides a relevant and affordable pathway to quality within India. ACHSI provides more flexible, outcomes-based reviews with a focus on continuous improvement, especially in the Asia-Pacific region.
In the view of most hospital administrators, the choice of accreditation body is a tactical decision that ought to align with strategic long-term quality aspirations. For an increasing number of medical travelers, comprehension of these accreditations is imperative to make informed and safe decisions regarding their healthcare journey.
At the end of the day, whether a facility is JCI, NABH or ACHSI accredited, the commitment to patient safety, continual quality improvement and ethical care provides a common denominator for all, with the aim of fostering a unified world in which patients can seek and confidently receive high-standard medical services.
