JANUARY / FEBRUARY 2005

FEATURES

Partner in India pursues international standards of quality

On the international health care scene, there can be little doubt that much of the focus and energy of leading health care providers has been on initiating quality improvement programs that raise the level of patient care while ensuring a satisfying hospital experience for patients, their families, and staff members. Since 1999, accreditation by the Joint Commission International (JCI) has served as the milestone for hospitals outside of the United States striving to meet an international standard of health care excellence. Nowhere is the drive to enhance the quality of care more intense than in India, where Sri Ramachandra Medical College & Research Institute (SRMCRI) is one of two organizations working with HMI to put the structures, processes, and monitoring systems in place to help them gain recognition as a health care provider meeting international standards of care.

The HMI team met with key members of SRMCRI’s senior leadership, administrators, members of the quality management team, and medical and nursing staff members.

In November, members of HMI’s health systems team traveled to India for a round of preliminary assessments of Sri Ramachandra Medical Centre in Chennai. The hospital’s leadership and clinical staff have been implementing performance improvement plans meant to address the specific criteria of the JCI. These standards cover every aspect of operating a hospital, such as the management structure, policies and procedures associated with direct patient care, and logistical points related to running a top notch facility that is safe and allows the staff to fulfill the hospital mission.

The HMI team met with key members of SRMCRI’s senior leadership, administrators, members of the quality management team, and medical and nursing staff members. “It was clear to us that a significant effort has been initiated, and much has been accomplished within the organization in a relatively short timeframe,” said Sharon Kleefield, PhD, director of health care quality at HMI. “We are very impressed by the commitment from the SRMCRI leadership, and the enthusiasm among the staff members working on quality improvement efforts.”

Multidisciplinary team brings all aspects of patient care into focus
In addition to Kleefield, the HMI team included Dr. Harvey Makadon, HMI’s vice president of health systems; Albert Gillis, RT, MBA, director of health care facilities development; and Elizabeth Brown, RN, MSN, director of clinical services. Dr. John Helfrick, who consults with organizations seeking JCI accreditation and has been a frequent collaborator on HMI’s JCI projects, joined the team and led the survey. Dr. Vijayrakshmi Kamat, the medical director at Sri Ramachandra Medical Centre, led the HMI team on a tour of the facilities. “This enabled the HMI team to interface with caregivers and take a close look at the operations and physical infrastructure,” said Gillis. The Medical Centre and teaching hospital house some 1,500 beds, posing a massive challenge to the group looking to implement a quality improvement system.

HMI’s Al Gillis discusses training with members of the hospital's emergency services staff.

At the end of the visit, the HMI team and the SRMCRI leadership agreed that the focus of their collaboration over the next six to nine months would be in six key areas: refinement of the organizational structure and quality management plan; the operating theater; medication management and safety; credentialing and privileging; physical facility management; and patient, family, and staff education.

Kleefield pointed out that going forward, a coordinated effort that cuts across the organization, with clearly delineated roles, would be critical to SRMCRI’s success. “We identified the key committees and areas of responsibility, and discussed how important it is for these committees to be interdisciplinary teams that will process issues within their areas and develop relevant solutions,” she said.

One key area of focus for Sri Ramachandra Medical Centre is the prevention and control of infections. An Infection Control Committee is already in place to raise the standard in what is one of the major quality markers for hospitals internationally. “Infection control is such an important area that many hospitals have difficulty closing the loop on,” said Brown. “For all clinical areas, the staff of the hospital must address issues like accessibility of gloves, access to waterless hand cleaners, waste management, standard precautions, and isolation of patients. Further, it’s important to implement a surveillance process that enables the staff to capture, report, monitor and make specific recommendations to address infection rates across the hospital.”

“This is extraordinarily important work to ensure not only that our partners are building quality facilities, but also that their core policies and procedures meet international standards of patient care delivery,” said Makadon. “We look forward to continuing our important work with their team over the next several months, and congratulate everyone for their leadership, perseverance, and hard work.”

The November visit to India also included a stop in Mulund, where HMI has been working intensively for two years with the staff of Wockhardt Heart Hospital, which is part of a network of hospitals operated by Wockhardt, Ltd. That initiative, which was profiled in HMI World last year, involves readying Wockhardt to seek JCI accreditation.

From left to right: Ryan Wildes (HMI project coordinator); Elizabeth Brown; Sharon Kleefield; Albert Gillis; Mrs. Radha Venkataachalam, Chief Executive Director of SRMCRI; Harvey Makadon; John Helfrick; and Krishna Seshadri, associate professor of internal medicine and endocrinology at SRMCRI, and the liaison officer of the HMI-SRMCRI partnership.

Copyright 2006 Harvard Medical International