Md. Mahbubur Rahman :
Health Care or healthcare is the maintenance and improvement of physical and mental health, especially through the provisions of medical services. It is a collective professional approach delivered in different phases of primary, secondary, and tertiary care, as well as in public health. Plenty has been said on this topics. Yet the topic is wide and important, a few more words on it are always appropriate. Setting standards for healthcare started in the early 2000. United States first introduced quality standards for hospitals and other medical facilities. It was “Minimum Standard for Hospitals” developed by the American College of Surgeons in 1917. Accreditation, official recognition for competence of the conformity assessment body, started a little bit letter in the United States with the formation of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) in 1951. Gradually this model spreaded across the world and also evolves with the span of time. It was adopted in Canada and Australia in the 1960s and 1970s and reached Europe in the 1980s. Accreditation programs spread all over the world in the 1990s.
At present accreditation process is an integral part of health care systems in over 70 countries. In some regions, the accreditation of health care organizations remains voluntary, while in others it has become government mandated. Its rapid growth over the last 40 years is partially attributable to media reporting of serious inadequacies in the quality and safety of health care services, and an escalating focus on patient safety.
Medical laboratory service is essential for any stage of healthcare and public health. The aim of a medical laboratory is not limited only to provide accurate results, it covers more. It has a wide range of activities to meet the needs of all patients, clinical personnel responsible for patient care and any other interested parties. For the safe clinical management of the patient it should have appropriate quality and technical management system in place and maintain the system with a respect for ethics, impartiality and confidentiality.
As we said before accreditation of medical laboratory to ISO 15189 is voluntaryall over the world. But considering health and safety of the people many countries have moved toward government-mandated accreditation. In Canada, accreditation is mandatory in Quebec (public and private health care organizations) (Government of Quebec, 2011) and Alberta (Government of Alberta, Dept. of Health and Wellness, 2008). Other provinces, such as Manitoba, are considering this direction. Department of Health, United Kingdom has adopted an accredited certification scheme to support people in using health and social care information and help the people to inform decisions about their health and social care. Accreditation does not limit only to a medical service for the ambulant patients. Recently the Medicines and Healthcare products Regulatory Agency (MHRA) UK advised any site or medical laboratory providing a Point of Care Testing (POCT) service in UK to get accreditation by a competent accreditation body.
In many countries accreditation of medical laboratory are considered as provisions for licensing with the authority. Health Authority in Dubai (DHA) requires that to be licensed all clinical laboratories are required to be accreditedto ISO 15189 by Dubai Accreditation Center (DAC).
Several Eastern European countries are beginning to use accreditation as an extension of statutory licensing for health care institutions.
Above examples are directly related with the medical laboratory services. There are many health sectors already undergone in accreditation process within their scope of activities. The U.S. General Services Administration requires star of life ambulances procured by the U.S. government to be tested by an independent laboratory accredited in accordance with ISO/IEC 17025 by an ILAC MRA signatory accreditation body.
At present some regional economic community of the world are also seriously considering accreditation as a mechanism for mutual recognition and confidence. Association of Southeast Asian Nations (ASEAN) member countries have agreed to establish the ASEAN Economic Community (AEC) to create a flow of goods and services flow freely in the ASEAN region with the expectation of improving the economy of the member countries of the sector ASEAN. One of ASEAN integration sector priorities is medical equipment. The AEC agreed to arrange this using a Medical Devices Directive (AMDD).
There are a lot of examples on upgradation and development of healthcare system using accreditation. In the current era of heightened fiscal responsibility, transparency, accountability, and escalating health care complexity and risk, accreditation contributes to ensuring that care meets the highest standards of health care decision-making and provision. Accreditation can serve as a risk mitigation strategy, and it can also measure performance; it provides key stakeholders with an unbiased, objective, and third-party review. It can constitute a management tool for diagnosing strengths and areas for improvement, as well as for facilitating the merger of health care organizations by stimulating the emergence of common organizational identity, culture, and practices. Organizations that participate in accreditation confirm their commitment to quality improvement, risk mitigation, patient safety, improved efficiency, and accountability. It sends a powerful message to key decision-makers and the public. This performance measure contributes to the sustainability of the health care system in any country.
Now a days accrediting entire healthcare system is becoming more prevalent, concurrent with the shift toward a population health approach. In some cases, voluntary accreditation is being replaced by government-mandated models of health care accreditation.
Now it is time to think of the healthcare system and implementation of those modern concepts for the health and safety of the people. Policy makers, regulators and stakeholders organization can play a vital role for the upgradation of our healthcare system at per international standards.
(Deputy Director (Laboratory and Inspection), BAB, [email protected])
