A first in Turkey: We received OECI Accreditation!

On 9 April 2018, as Anadolu Medical Center, we are happy to have achieved a new first with the decision of the OECI General Assembly. Having fulfilled 97% of the requirements listed by the European Cancer Association for cancer centers, Anadolu Medical Centre became the first and only cancer center in Turkey and even in this geography to receive OECI accreditation. Now we are going to give the stage to Prof. Dr. Hüseyin Baloğlu, OECI Coordinator at Anadolu Medical Center to learn all the details of this good news. 

 

Why is OECI accreditation important? 

OECI is an independent non-governmental organization operating within the European Union that sets the standards of cancer centers through scientific data and actively monitors and accredits them in practice, standardizes, and registers the centers where all comprehensive cancer-related services are provided.

It has been operating since 1979 and accredits the eligible ones by evaluating the organizations applying to become cancer centers after an improvement process based on its standards. It inspects the applicant centres on site and carries out a detailed study by observing the standards required in the diagnosis, treatment and follow-up processes of cancer. And we are very happy that our official application, which we made in April 2016, resulted in accreditation. 

 

Since the date we applied for OECI accreditation, the cooperation and contributions of all our units have yielded results. With our OECI certificate, we have become the first and only clinical cancer center in Turkey with this accreditation.

Imagine an accreditation process with details monitoring and evidence of whether the current scientific standards are provided in all processes at all stages of cancer disease, from the way the patient is admitted to the diagnostic processes, from the way the first treatment is planned to the follow-up of the treatments, follow-up on the survival of patients and comparison with the results of other centers, and including a total of 800 details... A process that analyses the implementations in all these processes one by one together with their results... The number of centers in Europe that meet these standards is also very small. A total of 82 centers accepting cancer patients from 27 countries in Europe and nearby regions are members of OECI. Only 31 of these have completed their accreditation process as Clinical Cancer Centers that have successfully passed the OECI audit. Now Anadolu Medical Centre is one of them.

What is the validity of our OECI accreditation?

Once the process is complete, it is valid for 5 years, under follow-up, i.e. until 2023. In this process, the status reports for the centers are shared within a annual convention. In other words, there is a control mechanism during the process. They inspect whether the quality is maintained and after 5 years, they start from the beginning and re-inspect. Therefore, in order to monitor and determine whether the quality is maintained at the same standards, the audit process is repeated every 5 years, and accreditation is renewed for the centers that meet and maintain the standards as required.

Back to the beginning, how was it decided to apply for an international accreditation? What happened in this process? 

An administrative decision was taken in March 2016.  This decision was based on the principle that all services in the cancer field in our hospital should be provided at international standards.  A small group of three people was established to work for this purpose.  This group also completed their research in a short time.  The oldest organization determining accreditation or international service quality levels was in the USA.  We applied by submitting the required documents, but our application was not considered because the organization had never granted accreditation outside the USA.  Our biggest obstacle was the fact that this group was established only for service within the USA Having reached a conclusion by this route, we started to search for alternative standards. Europe was a good alternative and we reached OECI, which is operating this service in Europe. The fact that since 2006 they have been effectively pursuing the standardization of cancer centers and have built up considerable experience and confidence in this process is evident from the quality of the European cancer centers they have accredited. It was established within European Union in 1979. Its aim is to determine and implement standards that will ensure better service provision in cancer-related research and development activities, cancer prevention, diagnosis, and treatment. Since then, it is an independent and reputable organization that has carried out regular studies, group planning and multidisciplinary meetings and has come a long way until today.

In 2016, we decided to apply. They sent a preliminary evaluation form.  It was a questionnaire with more than 800 questions, including information about the organization, the work carried out, the number of employees and their qualifications.  After submitting the relevant documents, we submitted our formal application in April 2016.  Two pre-auditors from OECI came to pre-assess the application.  After this pre-assessment, we were found qualified to be a candidate and the first part of the process was completed. Then, on 10-11 November 2016, a team of four people examined all relevant departments on site for two days.  They determined the people, content, and time they would talk to.  Their check-lists were completed.  They presented us with a SWOT analysis and according to this analysis, our leading departments were the Breast Health Centre, Pathology, and Hematology departments.  They informed us that the service in these three departments is high level and at European standards.  Indeed, we have also seen our other shortcomings in these presentations. Two months later, we received a formal report. It seemed that we still had existing deficiencies for OECI accreditation. They requested an action plan to resolve these. The deficiencies were reviewed with our own working group. New organizations were set up and new working groups were identified. I ensured the coordination, but we carried out this work with the contributions of many of our professors, healthcare professionals, and other colleagues, mainly from our oncology-related departments. As a result of these works, we have determined a road map. We sent our plan to OECI and our deficiency elimination algorithm in compliance with the standards was accepted. This process continued until all our deficiencies were resolved. We sent a final report considering that we have completed all our objectives. In this declaration, we stated that we have completed all these studies together with our hospital's extended general assembly and the OECI working group and that we have provided all the information requested by OECI. I also made a presentation at the OECI General Assembly last year, where we shared our hospital and our progress in the accreditation process. Eventually, they made a decision on our application at the last OECI accreditation board meeting held on 9 April 2018. From this date, Anadolu Medical Centre has been certified as the first and only OECI-accredited cancer center in Turkey that fully meets the standards of the European Cancer Society. The traditional certificate ceremony will be held on 22 June, the last day of the OECI traditional symposium in Poznan, Poland.

Would you mention its importance for Turkey as well? 

This process starts at the first contact between the patients and our hospital. To standardize the applications methods. How soon can I make an appointment after applying? How long will it take to be examined, and how long will they wait? How long will it take to be diagnosed? When is treatment started after diagnosis? How is the follow-up done after treatment? Are the survival times compatible with the results of other cancer centers considering the stage of the disease? Are the employees qualified both quantitatively and qualitatively? Are the facilities provided adequate for all social and psychological situations encountered during the illness? These are important questions. For instance, in our treatment planning, each patient is discussed with a multidisciplinary approach (surgery, oncology, pathology, radiology, nuclear medicine, psychiatry) in our tumor boards specific to the disease group. Primary treatments of the patients are planned and approved by the board. This plan is added to the patient file. Other than the physician who is responsible for the patient, all members of the board know about the patient and approve the decisions or offer a new one. Monitoring the compliance of the treatment decisions with the international protocols is also an OECI standard. What is the response to the question of whether the results of the treatment continue? If the response is not the expected one or an unexpected situation has occurred in the course of the disease, that patient will be brought back to the tumor board, discussed and a decision will be made. It's a rule and a standard. Treatment, follow-up, surgery decision, chemotherapy, radiotherapy, these are all multidisciplinary decisions. OECI saw, examined and approved all of these in our hospital within the standards, as in the other 30 European centers they accredited, within a 16-month audit period. This is the most important difference that separates our organization from other registered centers. Anadolu Medical Centre is certified to provide cancer treatment according to the standards set by the European Cancer Society. Thus, we are not the only ones saying that we are the first and only center in Turkey to provide world-class cancer treatment. An independent international authority, the OECI, also confirms this statement.

Many of our physicians and colleagues contributed in obtaining OECI accreditation. Our Clinical Quality and Patient Safety Department, IT department, Technical support units. An exemplary solidarity process was demonstrated with great devotion and faith. This is the pride of the AMC family. I would like to thank everyone who made efforts.