Medical Quality Standards & Practices in the UAE

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In many cases, medical workers cannot improve their deficient services because they are not aware of their performance issues. As such, it is necessary first to create benchmarks against which a medical facility’s performance can be tested. Rojas (2017) provides an example of such a baseline by analyzing the quality of life of hemodialysis patients in the Middle East. The author uses two different questionnaires that contained a large number of independent variables and determines the dependent variable, their quality of life. However, the variety of issues and the conflicting natures of some tools complicate the process, creating a need for standardization.

There exist numerous benchmarks that evaluate a hospital’s overall operations and determine whether it is satisfactory according to a specific set of criteria. Mahate and Hamidi (2015) study the application of the Data Development Analysis technique using either the Banker, Charnes, and Cooper or the Charnes, Cooper, and Rhode model to government and private UAE hospitals. These approaches employ a large variety of independent variables and produce the dependent ones, namely the number of treated inpatients, outpatients, the average length of stay, and technical efficiency. The study finds that all of the nation’s hospitals perform similarly, but the average efficiency level is dissatisfactory.

New initiatives can be particularly problematic, as there is no past data for internal comparison and the detection of issues. Algora et al. (2018) highlight shortcomings that can arise in the creation of new systems and propose external benchmarks as standards against which comparisons may be made. An audit by an independent organization helped the authors determine the areas that needed improvement. As a result, they have been able to propose solutions and implement them, eventually becoming able to satisfy stringent requirements. Similar independent auditing bodies would be highly conducive to the growth of the healthcare system in the UAE, and their creation should be encouraged.

Benchmarks help improve service quality by showcasing the problem and helping researchers identify the interventions that contribute the most to helping resolve them. Vijayalakshmi and Rohini (2019) provide an example of air quality antenna usage in children’s asthma management. Air parameters such as carbon monoxide, methane, dust, humidity, and temperature are the independent variables, and the frequency of asthma incidents in children is the dependent one. The system can be used in various hospitals, creating a set of parameters that can then be compared to the incidence of asthma in these environments to determine the optimal conditions.

There are generally considerable differences between government-owned and private hospitals, which stem from their respective orientations. Electronic health records are a particularly relevant approach nowadays, as they have the potential to improve the transparency of the system and improve its efficiency. Ayat, Sharifi, and Jahanbakhsh (2017) claim that the adoption of the system in Iran, which is somewhat similar to the UAE, is low when rated using the Electronic Medical Record Adoption Model. The benchmark can be used in the Emirates to judge the level of progress in the implementation of electronic health records. As a result, the medical industry can understand the current issues and analyze their possible causes.

The next article concerns hand hygiene, an essential aspect of hospital operation and a topic of attention for bodies such as the World Health Organization. Ahamed, Shaik, Nancy, and Shibu (2016) evaluate compliance with the rules established by the group in a hospital located in the Ajman emirate. The independent variables were training and awareness, and the dependent ones were compliances with various aspects of WHO’s recommendations. The authors conclude that the FOCUS-PDCA improvement tool is an effective method for resolving the problem that is appropriate for the UAE. Considering the initially low hygiene level found in the study, other facilities in the nation should pay attention to the result.

There is a shortage of medical workers in the nation, and it is necessary to train more people to address the issue adequately. However, optimization efforts can help facilities serve patients more effectively with fewer staff members. Baskaran, Bargiela, and Qu (2015) propose the use of a greedy scheduling algorithm, which can be trained and tested using a variety of problematic benchmarks. The schedule is the independent variable, and the facility’s ability to serve patients is the dependent one. Due to its nature, the method is applicable in any medical environment, making it inherently suitable for UAE hospitals.

Healthcare workers should remember that they have to consider the population as a whole as well as patients who are inactive contact with the system. It is not feasible to actively monitor the health of every citizen of the nation, and so, they should determine the best methods of ensuring that people maintain excellent health. Bader, Koprulu, Hassan, Ali, and Elnour (2015) analyze the factors that lead people to use hypertension medication as prescribed or ignore it. They separate the independent variables into four categories: sociodemographic, therapy-related, patient-related, and healthcare-related. All of them contribute to the dependent variable, the decision to adhere to the prescription. The ultimate result is that a concerning portion of the population does not take their medication.

The cost of care is a significant predictor of the popularity of medical systems with the population. Ideally, it should be as low as possible, and so, benchmarks are necessary to find any deficiencies and address them. Kanavos et al. (2018) highlight the government-funded nature of most of the UAE’s healthcare industry, which leads to low access prices when compared to the other Middle East and North Africa countries. However, there are no active health insurance programs, and there is considerable out-of-pocket spending. Overall, the research concludes that the UAE’s healthcare policy is excellent when compared to the rest of the region.

Antibiotics are well-known for their potentially powerful effects and tendency to harm the patient when applied inappropriately. Nasr, Paravattil, and Wilby (2017) try to analyze the application of stewardship strategies in the Middle East and their effects on prescriptions. The authors highlight several issues after a review of contemporary local literature and provided a benchmark for comparison. They use the application of an active antimicrobial stewardship program as the independent variable and the appropriateness of the antibiotics prescribed as the dependent one. In the end, they recommend strategies such as the development and updating of local policies as well as interdisciplinary collaboration.

Medical workers are responsible for much of the advancement required by the healthcare system, but the role of the government cannot be understated. It can push facilities to improve themselves to match international standards and provide the funding necessary to do so. Hammou, Mohammadi, Al Raisi, and Al Harbi (2019) highlight the successes of the governments of Oman, Morocco, and Iran in combating eye disease. They did so by setting various benchmarks and having workers achieve them over time. The study highlights the government’s power in popularizing measurements and making sure that every institution adheres to them.

Benchmarks and evidence of success are critical for the adoption of new and innovative methods for the treatment of specific conditions. Gondal et al. (2016) propose the usage of laparoscopic sleeve gastrectomy as a treatment for obesity in the UAE and display the procedure’s benefits on a patient sample. The study uses the application of the procedure as the independent variable and weight loss as well as diabetes mellitus, hypertension, gastritis, knee joint paint, and backache improvements as dependent ones. The procedure has displayed significant positive results, and, as such, it merits adoption, providing an example of the benefits of benchmarks for improving medical care.

In addition to understanding the effects of treatment and implementing the best possible solution, the healthcare industry has to be aware of the conditions of patients. If average health improves over time, the system is likely operating well, but if there are stagnant or receding areas, a focus on improvement is necessary. Kumar et al. (2015) analyze colorectal patients in Oman to determine their overall characteristics and determine their relationship with those mentioned in local and global literature. The same methodology can be applied in the UAE for various patient populations. The authors conclude that Oman’s patient data is consistent with worldwide averages, but if this is not the case in the UAE, action will be necessary.

Some medical services, such as blood banks, rely on the assistance of volunteers to supply the material necessary for the treatments they provide. As such, they have to attract these donors with a variety of benefits, excellent service quality being among the most important ones. Jain, Doshit, and Joshi (2015) propose a benchmark and best practices identification approach based on the SERVQUAL instrument. A variety of service quality indicators are the independent variables, and visitor satisfaction is the dependent variable. The authors determine the blood banks that perform the best in specific aspects and propose that they should be used as benchmarks.

Information usage is an essential aspect of care, and so, the introduction of electronic systems is generally beneficial for hospitals. However, Al-Hashimi and Aqleh (2018) highlight the experiences of medical workers in working with these frameworks and their ability to identify issues. The study uses the system, information, and service quality as independent variables that affect the dependent variables, user satisfaction, system use, and perceived net benefits. The authors conclude that while system development is necessary, users have to become more proficient at using them, which they can achieve by depending on electronics more.

The UAE government has been promoting the emergence of the private healthcare sector as a viable, innovative alternative to national services. However, it is still small, and it is best if the businesses follow the guidelines established by other successful private systems elsewhere. Al Khoury, Bekhazi, and Al Khoury (2017) propose the introduction of Western analysts that can benchmark a private facility’s performance and offer recommendations based on their experience. The addition of people who are familiar with the latest practices can help the Emirates achieve a worldwide standard of excellence faster.

There are instruments for performance benchmarking that has earned international acclaim for their accuracy and ease of use. Cebeci (2018) discusses the use of the Balanced Scorecard, a method that is applied among various organizations throughout the world in Turkish hospitals. He succeeds at that goal by visiting local hospitals, collecting information, and creating a decision support system framework. The researcher finishes the article with a description of the ten-stage process formulated during the research and recommendations for others. Turkey is a Middle Eastern country, and so, its experiences may be partially applicable to the UAE.

The United Arab Emirates is a wealthy country that has access to advanced tools such as helicopter emergency medical services. They enable quicker and safer delivery of patients to care, but Al-Thani et al. (2017) claim that they are currently more dangerous to patients than traditional ground-based services. The mode chosen is the independent variable, and various complication rates, as well as prolonged ICU and hospital stay, are dependent. Despite the high potential of the new method, it requires considerable refinement before it can outperform the benchmark set by the approaches currently considered standard.

It is critical to benchmark the incidence of various conditions and the outcomes of their treatment at individual facilities. Al Mosallam, Qureshi, Alshehri, Alshehri, and Ullah (2018) discuss the outcomes of patients with multiple sclerosis in a medical center located in Saudi Arabia. They underwent inpatient rehabilitation, one of the many methods used for the condition worldwide. The sample’s demographic factors were the independent variables, and the various aspects of their outcomes and hospital stay were dependent. The authors conclude that the treatment is useful, but other centers have to conduct similar testing to analyze their performance.

HIV and AIDS are prominent issues in the Middle East, in part due to the local culture and awareness. Alotaibi, Alabbas, Almoshadq, Pacha, and Alghamdi (2016) research the awareness of Saudi students about the condition and find deficiencies in their knowledge. It is the task of the healthcare system to teach the population about the practices that will help them avoid disease. Furthermore, Saudi Arabia is similar in some regards to the UAE, and so an investigation into its schools is necessary. It can help test the medical system’s information spreading capabilities.

The quality of service in hospitals is vital to the overall perception of healthcare by consumers. Priyono and Yulita (2017) use the Kano Model and quality function deployment to benchmark the service quality of a front office and propose improvement strategies. The authors use 14 customer service requirements and rate them based on their relative importance. They note that the results are different than they would have been with the application of either method on its own. The method requires further testing, but it provides a useful benchmarking tool for UAE hospitals.

The healthcare system has to always be ready for the emergence of new, formerly unexplored issues, particularly with regard to infection. Caswell and Hijazi (2019) discuss the Middle Eastern Coronavirus epidemic in the Arabian Peninsula and the development of a new screening system in response. They highlight the issues that led to the outbreak growing as it did as well as the responses by the medical workers that eventually allowed them to stabilize the situation. Other countries can learn from this information when designing their health efforts and preparing for potential emergencies.

Technical improvements and overall advancement are at the center of healthcare system growth. However, the introduction of new technology can be associated with issues such as potential infections. Al-Abdely et al. (2017) discuss the tools used in Saudi Arabian intensive care units and find that the rates of device-associated illness are higher than those reported by local health authorities. The result is a cause for alarm and requires interventions that would address it. It is necessary to perform such investigations regularly to locate issues and address them before they can lead to significant harm.

Local information is essential, but many conditions are not affected by geographical location as much as other factors. Hence, Silva et al. (2017) propose the use of an American cardiovascular data registry as a benchmark for improvement in other areas of the world. As healthcare in the U.S. is among the most advanced in the world, its results provide an excellent foundation towards which many other countries should work. The authors note the improvement in local care quality after the benchmark started seeing use in quality improvement programs.

The use of successful examples to guide facilities that underperform is an essential part of benchmarking. As such, medical workers should continuously compare different hospitals to see which operate better and why. Ketabi, Teymouri, and Ketabi (2018) provide the example of a program that evaluated emergency departments in Iran based on a set of input and output parameters. The authors use a data envelopment analysis technique to determine whether some of the facilities reviewed are inefficient. They determine that a significant portion is not operating at a level proportional to the spending and staff they have. The same analysis can be applied in the UAE to isolate issues such as excessive staff or machinery for patient throughput.

It should be noted that patient satisfaction does not necessarily depend on the quality of care provided. The reason is that it can be challenging for a patient to evaluate the effect of a treatment on their body or compare the location to another hospital, as people tend not to visit many different facilities. Al Qadire and Alkhalaileh (2017) confirm this and note that patients expect different qualities from government and private hospitals. They highlight pain management, nursing, information, communication, and cost as essential determinants of satisfaction for the latter, and the former can only improve by enhancing their care standards.

By their nature, emergency departments should be ready to serve new patients, who may be in critical condition, as soon as possible upon their arrival. AlMulhim and Saddik (2015) highlight the patient waiting time as an essential benchmark and associate it with five caregiver traits. These characteristics are their work field, education level, work schedule, experience, and access to the health information system. It can be challenging to change some of these factors for a given worker, but schedules, education levels, and accessibility can be improved with effort. As such, UAE emergency department administrators should consider them and conduct thorough analyses.

The Emirates government aims to expand the private healthcare system, which is generally associated with higher costs than governmental services. Saudi Arabia has already gone through this process, and its experience may be used as a benchmark upon which local growth can be tested. Almutairi and Al Shamsi (2018) discuss its use of the Australian model to keep care accessible while increasing the privatization of the sector. They highlight the need for governance to avoid cost increases without any improvement in the outcomes. The UAE government should observe the example of Saudi Arabia and adopt beneficial measures while avoiding harmful ones in its efforts.

Paradigms that have proven successful for improvement in other fields may be applied in healthcare to provide additional benchmarks and enhance performance. Shakoor, Jadayil, Jabera, and Jaber (2017) highlight the concept of lean thinking, which aims to reduce waste and increase productivity as a result. They apply it to an emergency department to determine whether there was any room for improvement. They determine that the department is using extra beds, which can be transferred to other wards that need them. With approaches such as this one, care providers can increase their ability to help patients without incurring high costs or requiring more staff.

The latest technological advancements allow an organization to gather and analyze data from a massive number of institutions that use electronic health records. Accurate real-time information about the performance of the nation’s healthcare system as a whole would be highly beneficial as a benchmark. AlNuaimi, Masud, and Mohammed (2015) propose the use of such a system to predict patient deterioration and apply treatment early for improved outcomes. In doing so, they reduce the need to use redundant tests to confirm the presence of the issue and decrease the observation time, improving throughput. With more data, the experiment can yield better, more accurate results, and so, it warrants further discussion.

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Medical Quality Standards & Practices in the UAE

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