Raising the Bar in Healthcare Quality: The Abu Dhabi Model

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The following was originally published in the October 2019 special print edition of Medical Tourism Magazine, which was initially available at the 12th annual World Medical Tourism & Global Healthcare Congress in Abu Dhabi.

It is no secret that the healthcare sector has witnessed a transformative change over the past few decades. Globally, the sector is marking new breakthroughs in medical research, disease treatment and innovative healthcare technology. These technologies are helping reduce healthcare costs - which still remain a burdening issue for healthcare systems worldwide – as well as achieve financial sustainability whilst maintaining highest levels of quality and safety.

Despite the healthcare sector being over-saturated with healthcare providers who are fiercely competing in different ways to gain the trust and loyalty of patients, one specific thought remains a common denominator—bringing quality to healthcare. According to PwC’s Healthcare Advisory report, there are substantial quality gaps in the regional healthcare sector, and patients  yearn to feel more confident in the local provision across the Middle East. In previous years, a report by Professional Services Firm Ernst Young titled ‘What is the cure for a better patient experience in the GCC?’ showed that 38 percent of GCC patients have trust in their local healthcare system, whereas 51 percent of healthcare professionals think overall quality in healthcare needs to be more consistent.

Health of the Abu Dhabi community remains at the forefront of government’s priorities, and providing world-class healthcare is one its strategic goals. The Emirate of Abu Dhabi has embarked on a journey to raise the quality of healthcare to international best practice standards.

The Abu Dhabi healthcare sector has already taken steps to achieve this goal and address quality gap challenges, in its bid to transform into a world-class, trusted healthcare system that is sustainable and investment-conducive. In 2014, the Department of Health—Abu Dhabi (DoH) launched the Abu Dhabi Healthcare Quality Index- Muashir (the Arabic for “Index”). The framework started with Jawda – the Arabic word for ‘Quality’  a quality monitoring framework that is founded on four main quality metrics: patient safety, timeliness of delivery, effectiveness of care and patient centricity.  Each metric consists of a set of indicators that healthcare providers are evaluated at. Over the past years, the Abu Dhabi Quality Index has evolved and included eight more quality metrics in addition to Jawda metric. Those include healthcare regulation assurance, data quality assurance, correct claims, patient voice, safe workplace, patient happiness, staff happiness, and research and innovation. The Abu Dhabi Quality Index has been designed to raise the bar for healthcare quality and ensure highest-quality of service delivery are provided to nationals and residents in the Emirate of Abu Dhabi.

“When it comes to healthcare in particular, Quality is an unnegotiable requirement,” said Dr. Asma Al Mannaei, Director of Healthcare Quality Division at DoH. “Improving the quality of care has been the quest of different healthcare systems around the world to ensure patient safety, value of care and thus the sustainability of the system. Achieving wide improvements on the quality of care requires strategic planning and systematic approach for behavioral changes to implement a large-scale change of quality culture.”

In 2014, The Department of Health—Abu Dhabi has used a five-stage systematic performance approach to develop a quality improvement framework through Abu Dhabi Healthcare Quality index and Jawda (the Arabic word for quality) program that puts the patient at the center of the system. Abu Dhabi is offering A World-Class healthcare services in highly regulated system which provides a worry free healing experience and treatment.

A case in point: in just one year after the programme was put into effect, hospitals’ performance witnessed remarkable improvements. The timeliness of the delivery of care— one of the biggest concerns at the time— saw an increase cross multiple indicators such as timeliness for securing primary care appointments increased from 94 percent to 97 percent. The overall waiting time in Emergency Departments was significantly lower. The compliance to the target time in seeing a doctor in cases of accidents and emergencies increased from 96 percent to 97 percent, while the registration to leaving emergency departments within two hours increased by around three percent.

Patient satisfaction has also significantly improved in many areas. A survey was carried out in 2018, which indicated that the overall patient satisfaction with therapeutic services for inpatient in Abu Dhabi was marked high, with an average of 86-a rate higher than patient satisfaction levels in the GCC region, the United Kingdom, and Germany. The latest results indicated improvements in reducing unplanned readmission by 12 percent, reducing Pressure Ulcer by nine percent, and 25 percent reduction in patient falls incidents.

“We believe that investing in quality is what drives an exceptional patient experience," Dr. Al Mannaei said. "As such, we continued to work closely with healthcare facilities to ensure they understand the framework’s implementation and reporting processes as well as the repercussions that could result from failing to meet the minimum quality standards.”

This year, the indicators under Jawda metrics were further refreshed and an additional set of indicators were introduced, covering a wider range of healthcare specialized services such as Orthopedics and Bariatric. With Abu Dhabi Quality Index - Muashir proving to be a successful model for enhancing quality and patient experience, DoH began ranking healthcare facilities based on their compliance and alignment of practice with the different Muashir’s dimensions. The Muashir ranking list includes all hospitals that are meeting the minimum requirements of quality and patient safety in the Emirate of Abu Dhabi. It allows to differentiate between the good provider from the outstanding provider.

“There are future plans to make the Muashir rankings accessible to the public by way of promoting transparency and further instilling accountability and raising quality,” Dr. Al Mannaei said.

In addition to transforming patient experience, the Muashir - Abu Dhabi Quality model has enabled data collection and the centralisation of information through a unified reporting system. This data is continuously analyzed and used to drive insights into common practices, which enables the healthcare system in Abu Dhabi to pinpoint areas of improvement and work closely with providers to address them. The data gathered are also being strategically fed into a database which would be used for machine learning, as Abu Dhabi healthcare begins to shift towards full digitalisation of healthcare data and the adoption of AI technology to enhance services delivery.

The Abu Dhabi healthcare system witnessed unprecedented levels of excellence and the high quality of healthcare services offered have contributed to reinforcing Abu Dhabi’s position on the global map as a leading medical tourism destination. When DoH launched the medical tourism network, the Jawda results of healthcare facilities were used as determinant of hospitals’ eligibility to become a part of the network. The medical network now has 40 healthcare facilities all of which adhere to the requirements of DOH’s Muashir standards to guarantee international patients access to the best-in-class health facilities in Abu Dhabi.

Currently, Abu Dhabi is on the frontline of medical tourism in the GCC region. The healthcare industry in Abu Dhabi boasts a solid infrastructure and an attractive business climate in addition to an advanced regulatory framework set in stone. This, coupled with the ongoing efforts to continuously advance the healthcare sector, gives Abu Dhabi a competitive market advantage and offers a conducive investment environment for healthcare investors.