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The new Dubai Health Authority directives are aimed at ensuring that all day-care centres operate according to the highest standards of medical care and safety procedures. Image Credit: Supplied

DUBAI: Following the incident of an Emirati woman slipping into a coma during a septoplasty at a day care centre in Dubai in May, the Dubai Health Authority (DHA) has mandated that all day care centres should obtain international accreditation.

It may be recalled that the 24-year old Emirati woman slipped into a coma following a septoplasty that went horribly wrong in May 2019. The patient suffered a cardiac arrest on the operating table and had an oxygen deficit to the brain that resulted in brain damage and coma. The day care centre staff were not trained in Advanced Cardiac Life Support (ACLS) procedure that all accredited faciltiies have and that could have prevented the coma. The patient was flown to a long term care hospital in Chicago where she continues to be under treatment.

The centres have been given until the end of 2020 to get fully accredited. This move will ensure that all day care centres, which treat and discharge patients the same day) will operate according to the highest standards of medical care and safety procedures, bringing them on par with the hospitals in Dubai that are already compliant with international accreditation.

The cost of accreditation varies between US $3000-10,000 (Dh10,800 to Dh36,0000) minimum per annum but adherence to international standards can ensure high medical standards and eliminate any room for negligence.

Patient’s choosing a health care facility can check on the hospital or day-care centre’s website to know if the facility has an international accreditation. Additionally, the certification is displayed at the reception and patients can also enquire at the reception about the accreditation. For example, DHCC’s Hasan Surgery Centre, which is the first day care centre in the UAE and GCC to obtain an accreditation, prominently displays its AAAASD accreditation at its facility. All day care centres working to meet the 18-month deadline for international accreditation will also be able to add that detail to their facility’s website.

Why is International Accreditation so important?

The accreditation bodies set stringent standards for patient safety, hygiene and competency and undertake continuous monitoring and supervising of the centres to see that the standards are being maintained.. If the centres are found to be noncompliant, the bodies advise the centre to take steps to reimplement systems. If the centre is found failing in its effort, the accreditation is withdrawn. The gold standard in such accreditations are the American Association for Accreditation for Ambulatory Services Facilities (AAAASF), the Joint Commission International (JCI) or Health Standard Organisation (HSO) accreditation from Canadian health care regulatory body. There are recognised certifications from Australia or UK too.

DHCC’s first day care centre with American accreditation in UAE

The Hasan Surgery centre at the Dubai Health Care City (DHCC) is the first day care centre in the UAE and the entire GCC countries to have the AAAASF accreditation since 2016, much before it was made mandatory. It also has a local accreditation from the Dubai Health Care Regulatory authority (DHCR).

Dr Hasan Ali, European-board certified plastic surgeon and medical director of the centre, spoke to Gulf News about the necessity of this international ratification. “I think having one international accreditation is extremely important as it not only provides reassurance to patients but the stringent demands on high standards of safety, hygiene and competence ensure the centre is ever-vigilant and focused on patient safety. This is the best way to reduce the margin of error and strive towards excellence,’” Dr Ali said, whose centre recently renewed its AAAASF accreditation for the third year.

150 centres in Dubai Health Care City accredited

The DHCC has already begun implementing the mandatory accreditation criteria. Dr Ramadan AlBlooshi, Chief Regulatory Officer, DHCR, said “International accreditation has been mandated by the UAE Government for all hospitals, and in line with Vision 2021, health authorities are working to ensure that all public and private hospitals are accredited. As a regulator, we have been driving efforts in the field, and have accredited 150 outpatient facilities so far. It is encouraging to see a DHCC-based clinic such as Hasan Surgery that specialises in aesthetic surgery lead the way in seeking additional international certification and recognition for their standards.”

Thomas S. Terranova, AAAASF Executive Director, added: “In July, AAAASF conducted a triennial resurvey of Hasan Surgery, which demonstrated that the centre not only achieved the highest level of patient safety standards during its first survey, but also maintained its compliance with them.”

Core requirements for AAAASF accreditation:

• Floor plans of a day care centre must indicate that it has space for designated consultation, examination, surgery and recovery areas. These plans require to be approved by the accrediting body.

• Doctors working at the centre must have qualifications as per the local laws of the land and privileges to operate at a local hospital in case a patient has to be transferred in case of an emergency

• The qualification of the staff nurse, the doctors, anaesthetists and the ancillary staff has to be up-to-date.

• Staff must have training in Advanced Cardiac Life Support Course (ACLS). (In the case of the day care centre where the Emirati woman underwent surgery ,the staff was trained in ACLS) .

* The accredited centre has to send a full report regarding one complicated surgery every month to the board with detailed notes on what was done.

• If a patient dies during surgery, the board will investigate it.

• The AAAASF has strict guidelines on infection control, pest control and hand hygiene which is reviewed constantly.

• The operation theatre is commissioned every six months (the walls, the equipment and the air vents checked for any bacterial infestation).

• There are other Key Performance Indicators (KPI) that the centre is to follow in terms of the number of surgeries, the positive outcomes.

• The centre must also hold academic events on the education on patient safety and quality.