Globalization Makes Quality, Safety More Important than Ever

Ben Cole, for HealthLeaders Media , April 14, 2009

Although he was named the Joint Commission International's Middle East Managing Director less than a month ago, Ashraf Ismail, MD, MPH, is no stranger to quality initiatives.

His extensive resume includes a stint as president and CEO of Quality Associates, Inc., the largest healthcare quality training and consultation provider in the Middle East. He also served as a World Health Organization consultant in accreditation and healthcare quality, and is the founder of the Egyptian Society for Quality in Healthcare.

His new job at the JCI fits "perfectly" with his qualifications, experience, and career goals, Ismail says. Due to globalization and the availability of information via the Internet, improving healthcare quality and safety is no longer optional for organizations looking to improve their bottom line, he adds.

"If healthcare quality is not adequate in the nearby hospital, patients will look around for better quality," Ismail says in a recent e-mail interview. The public has become more and more aware of the safety issues. Healthcare organizations realize that if they do not improve quality and safety, they will lose their business."

The JCI's mission to improve quality and safety at healthcare organizations worldwide helps achieve these goals, he says.

"Accreditation is an excellent framework that helps organizations to achieve their quality goals in a systematic, measurable way," Ismail says. "Achieving JCI accreditation also provides the international and public recognition to organizations for their commitment to quality and safety."

Ismail admits that the healthcare industry in the Middle East "has a long way to go," and notes that accredited facilities in the region still represent a very small percentage of all hospitals.

Achieving the goals of JCI, and Ismail himself, of improving quality and safety will be vital to the development of healthcare business in the Middle East, he says.

"There is no way to develop business in healthcare without improving quality and safety, Ismail says. "Quality increases market share—hospitals build on their reputation."

To build their reputation, hospitals must put customers first and consider patient safety and quality objectives when outlining their goals, Ismail says. If they do so, market share will follow, he says, because patient safety saves lives and money, reduces costs, and in turn increases profitability.

"Quality and safety in healthcare organizations will create trust between clients and the provider," Ismail says. "This trust is the only guarantee to ensure survival in a very competitive environment."

A commitment by leadership is the key to quality and safety in any healthcare facility, Ismail says. He advises that the organization develop a strategic plan with a clear vision and mission that guides all operations.

One of the first steps is to ensure full compliance with the regulatory requirements for licensure. This is achieved by looking at the overall structure of the facility to see if it meets the standards of quality and safety—including the physical facility, its equipment, human resources, supplies, policies, and procedures.

"Quality and safety must be planned objectives," Ismail says. "Everyone in the organization is responsible and accountable for implementing those plans."

The organization should also plan and implement evidence-based practices, he says, but it is something that cannot be implemented once and forgotten about. Continuous education and training should be part of human resources development, and performance improvement "must be institutionalized in the organization."

"Measurement is essential for improvement and quality planning," Ismail says. "Patient safety must be considered the number one priority—organizations need to have effective and robust plans to implement patient safety goals and standards."

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Ben Cole is an associate online editor with HealthLeaders Media. He can be reached at




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