Category Archives: MCI.1

JCI Standard MCI.1 – Communication with the Community

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It is natural to think of the Public Relations (PR) department of a hospital when a hospital needs to deal with a community it serves to facilitate access to care and access to information about its patient care services. Thus, it is not surprising to pass the buck to a representative of the PR department of a hospital sitting in a Management Of Communication And Information (MCI) Committee to deal with, and in order to comply with the Joint Commission International (JCI) Standard MCI.1 which states “The organization communicates with its community to facilitate access to care and access to information about its patient care services.”

I think if you are a leader championing the JCI MCI standards, this leader must not merely delegate this MCI standard to the PR department representative to deal with, but must also nurture as teacher, mentor, colleague, and friend to guide and be responsible to coach in the implementation and compliance of this standard, thus to care for and encourage the growth or development of MCI standards for the hospital. In this scenario, it is important for this leader to be knowledgeable in PR by at least researching the subject matter and linking his or her literature reviews with this standard.

From my interactions with representatives of PR department of hospitals, they normally deal with the management of both internal and external communications. They told me they are responsible for promotions of the hospital and implementation of the hospital’s marketing programmes that are related to overall mission and vision of the hospital, also manage and improve the flow of information within the hospital and between the hospital and the community it serves. Public relations professionals also serve as liaisons to the community and work closely with other health partners in the locality in preventive health. The responsibilities of a PR person in a hospital setting includes writing and distributing news release, feature articles to the press, compiling press list, witting of newsletters, handling and maintaining a media information service, arranging press, radio and television interviews for management, preparing marketing plans for various programmes and create strategies in promotional and marketing efforts. In summary, the PR department is responsible for community relations, hospital publications, media relations special events and support for fundraising.

Since the measurable elements for this standard requires a hospital to (i) implement  a communication strategy, (ii) provide information on its services, hours of operation, and the process to obtain care through mass media interventions, such as those delivered by leaflets, booklets, posters, billboards, newspapers, radio and television, and (iii) provide information on the quality of its services, “the quality of services as is always determined by certain attributes that they have or should have. The most important attributes health services should have, are accessibility and availability,usage facility, public’s acceptance and all these always in relation to their cost.” (Athina and Andriani, 2012, p. 205) which is provided to the public and to referral sources with defined communities  and populations of interest,  I personally think that the PR department in a hospital is best suited to manage and measure this standard based on what I have already said in the preceding paragraph.

With all what I wrote above and what I intend to say in the next paragraph, let me remind you that all of us serving in the socioeconomic system of healthcare, including doctors and patients carry on our lives as person-systems within a hierarchy of multiple and overlapping systems of family, community and wider society. The internal needs of patients as person-systems, i.e. the patient is unwell, the patient’s family, workmates, employers and hospitals will tend to accept the sick role of this patient. After a defined length of time, the patient seeks the professional endorsement of a doctor for a clinical transaction, which is a subsystem of the hierarchy of systems comprising health care.  At the end of the day, the person-systems of doctor and patient constituting of the patient, members of family, community systems and professional (e.g. the doctor) or economic systems, all support a speedy and complete return to health for the patient.

Members of the MCI Committee must be aware that the approach it chooses in understanding and measuring as well as complying with this standard, is driven by the care delivery for the population served by the hospital in advising patients on how to leverage the system to ensure coordination of care across the continuum, integrated across the continuum among defined communities and populations of interest with healthcare specialists in the hospital.

So what is this “defined communities and populations of interest”,  if you are a member of  a  MCI Committee, you need to focus on?

Marie and Sandra (2011, pp. 46-47) define population of interest as “a population at risk or those with a common risk factor leading to the threat of a particular health issue. It also may be defined as a population of interest known as a healthy population who may in fact improve their health by making certain choices that will further promote health and/or protect against disease or injury. For example, an adolescent population that engages in alternative sports and chooses to wear protective gear avoids serious injury.”

I have been asked how and what does the PR department do in order to understand patterns and trends within this population of interest. First, I think it is the best interest of the PR department to be comfortable enough with information technology to collect and organise data, initiate and develop appropriate databases for their practice to better assess and serve the population of interest. I also think the PR department must design cross-sectional studies at finding out the prevalence of a phenomenon, problem, attitude or issue by taking a snap-shot or cross-section of the population. Pre-test/post-test studies could also be undertaken to measure the efficacy of a program on the same population to determine if a change has occurred.

I have also been asked how and what does the PR department do when identifying defined communities. My advice is that the PR department must be involved in gathering census data that provide the PR department with evidence about the overall health status of the population living in a particular community. The PR department could use the Internet which provides a wealth of data such as geography and history of a community as well as census track boundaries and data.

Armed with knowledge on defined communities  and populations of interest, the PR department  must surely be able to show evidence that there is (i) a communication strategy to reach the defined communities  and populations of interest , (ii) information on its services, hours of operation, and the process to obtain care, and (iii) information on the quality of its services, which is provided to the public and to referral sources with defined communities  and populations of interest, in order to fully comply with Standard MCI.1.

All this is possible when the hospital and the PR department jointly develop and revise strategic and operational plans to address community needs for a healthier community within larger geographic or political areas as reflected in the hospital’s mission and required by the JCI Standard GLD.3.1 which states that “Organization leaders plan with community leaders and leaders of other organizations to meet the community’s health care needs.”, thus recognising that they have responsibility for and can achieve an impact on the community.

References:

  1. Athina, L & Andriani, D, 2012, Quality assurance in healthcare service delivery, nursing, and personalized medicine: technologies and processes, Medical Information Science Reference, Hershey, PA, USA
  2. Joint Commission International, 2010, Joint Commission International Accreditation Standards For Hospitals, 4th edn, JCI, USA
  3. Kingsley, N & Sam, S 2009, Problems With Patients: Managing Complicated Transactions, Cambridge University Press, Cambridge, UK
  4. Louise, LI & Carolyn, LB 2008, Public Health Nursing: Leadership, Policy & Practice, Delmar Cengage Learning, New York, USA  
  5. Marie, TL & Sandra, BL (eds.) 2011, Public health nursing : practicing population-based care, Jones and Bartlett Publishers, Sudbury, MA, USA
  6. Stephan, J & Frank,  MG 2011,  Information and Communication Technologies in Healthcare, CRC Press, Boca Raton, FL, USA

JCI Standard MCI.1 – brochure example

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In my previous post JCI Standard MCI.1, I talked about the “Communication with the Community” and how the HIM/MR Department communicates with its community to facilitate access to care and access to information provided by the HIM/MR Department of a hospital.

I like to share with you (with expressed permission) this brochure (file will open in a new tab of your current window of your browser) from St Vincent’s Hospital Sydney Ltd, a facility of St Vincents & Mater Health Sydney, Darlinghurst, NSW, Australia. I have always admired the Aussies for a high standard in documentation!

I think it is a good brochure on communication with the community about the privacy of a patient’s health information.

JCI Standard MCI.1

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I am going to watch a movie on ASTRO Fox Movies Premium after this, and cannot help but post this off as I have finished it already.

Pals, I need to stop blogging here pretty soon, as I got other blogs to maintain as well, amongst which – one in particular, so posts here will be delayed or less frequent, unless I am fully energised and wish to rush a post here.

So here goes!

In the JCI Accreditation Standards for Hospitals – Introductory Post dated May 23, 2012 I had posted about the Management of Communication and Information (MCI) function and its direct and indirect relationship to the management of medical records.

In this post I shall talk about the first standard under this MCI function, namely “Communication with the Community, MCI.1” which states “The organization communicates with its community to facilitate access to care and access to information”.*

As part of a hospital, the Malaysian Medical Records Department (MRD) communicates directly to individuals but it is not normally authorised to communicate through public media and through agencies within the community or third parties.

There are 21 standards for this function, including 4 sub-standards and one sub=sub-standard for standard MCI.19, and 2 sub-standards for standard MCI.20.

Each standard has specific requirements. The Measurable Elements (MEs) are these specific requirements for each standard. The MEs simply list what is required to be in full compliance with the standard. The MEs will be reviewed and assigned a score during the accreditation survey process.

For MCI.1, the MEs measure the compliance of the MRD of the hospital to the requirements of this standard.  The MEs measure if:

  • the MRD has identified its communities and populations of interest.
    • I think these defined key groups will include all forms of patient contact with the hospital such as emergency care patients, outpatients discharged patients, and non-patient groups like the next of kin, members of the general public, students, the Polis, and sometimes even members of the Press and Media.
  • there is a communication strategy plan incorporating an on-going communication plan with its defined key groups of their communities and patient populations
  • there is information provided to the public and to referral sources on MRD services, hours of operation, and the process to obtain care
  • the MRD provides information on the quality of services to the public and to referral sources

If the MRD fully meets these requirements (full compliance), then I think the MRD as part of the organisation, has succeeded in communicating with its community to facilitate access to care and access to information.

Please note that this standard also applies to other departments of the hospital that also communicate with the community to facilitate access to care and access to information, for example the Public Relations Department.