Inspectors are the backbone of JACIE; without them, there is no certification process. Becoming an inspector is a wonderful way to contribute to maintaining global quality standards. As the number of JACIE applications has increased, we are constantly looking for new inspectors to join our ranks. At the moment, we are particularly keen to hear of German, French and Spanish speaking Clinicians and Quality Managers.
Each month, you will have the opportunity to meet with one of our JACIE Inspector who will share his/her experience.
Read our interview with John Snowden.
Introduce yourself and your role(s) and position(s) within EBMT and outside of EBMT
For over two decades, I have been an NHS Consultant Haematologist and Director of the BMT & Cellular Therapy Programme in Sheffield Teaching Hospitals and more recently Professor of Haematology at the University of Sheffield, UK.
I have a long association with the EBMT and JACIE, including JACIE Medical Director (2012-16) and Chair of the JACIE Committee (2015-20). I have also served as a member of the EBMT Board and Scientific Council, initially as Autoimmune Diseases Working Party Chair (2016-20) and as Secretary to EBMT from 2020-24.
In my early career, I worked in BMT in the 1990’s – when clinical practice had much fewer ‘checks and balances’ or quality control - so have personally witnessed the benefits of JACIE and associated survival benchmarking exercises! Like many, I believe strongly that we must be accountable to our patients and their families, colleagues that refer us patients, and the health service payers that publicly fund our programmes. Over the last 25 years, JACIE certification has become a means to satisfying these goals.
Why did you decide to become a JACIE inspector?
I decided to become a JACIE inspector shortly after taking up my role of Director of BMT in 2002, when I started building up the BMT programme in Sheffield. JACIE was going to the way forward, both for providing a template and structure for teamworking and facilities for a BMT programme and for maintaining quality in a high-risk speciality. After attending the training course in the Hospital Clinic Barcelona, I undertook my first inspection in 2004 in Leeds, and thereafter many others followed. With increasing experience with JACIE, I became a team leader and progressively more involved with development of the FACT-JACIE standards and strategic work.
What has been the most memorable inspection that you have ever done?
I would quote two examples. I was lucky to be chosen to lead the first ‘non-European’ JACIE inspection at King Faisal Hospital in Riyadh, Saudi Arabia in 2009, and then the first in Africa, at the East Pretoria Hospital in South Africa in 2013. These inspections opened up JACIE to being a truly global organisation, working across continental borders, and with mutual support and collaboration with FACT.
What ‘keys to successful JACIE certification’ can you share with us?
As a BMT Programme Director, I completely know how tough working through all the JACIE standards with Quality Manager and other team members in preparation for an inspection. Having an ‘external’ inspection can be hard work and sometimes nerve-racking for teams.
One important aspect of JACIE is that the inspectors are experienced clinical and scientific ‘peers’ and healthcare professional, who are volunteers from our ‘community’. Therefore, they fully understand the realities and challenges of our speciality! Inspectors must be professional but can also be friendly and insightful. This is part of the success of JACIE, as, if teams can be comfortable and trusting in the JACIE process and their inspectors, they can be open and honest and identify, and ultimately correct weaknesses for the benefit of their service and their patients.
How has your career/work benefited from being a JACIE inspector?
My career and day-to-day work have both benefitted significantly through being a JACIE inspector.
Being a JACIE inspector has meant I have had the immense privilege to be invited in to inspect other programmes, including evaluating the different ways of addressing the standards and other challenges. On a personal level, there have been many learning points from every inspection that I’ve done! As a Team Leader in many JACIE inspections, I also learned leadership skills by organising the team and bringing their inspection report together in a timely manner according to deadline (sometimes harder than I imagined!).
Outside of inspections, my experience extended to central ratification of inspection reports in the JACIE Accreditation Committee from 2006. Later, I became JACIE Medical Director (2012-2016) and Chair of the JACIE Committee (2015-20) working with JACIE officers and EBMT Board to oversee day-to-day operations, strategic direction and various updates of the FACT-JACIE standards in an era where our speciality has evolved to incorporate CAR-T and other Immune Effector Cells (IECs) into the standards.
As EBMT Secretary (2020-24), I was the main representative of JACIE on the EBMT Board. With the late Riccardo Saccardi, JACIE Medical Director, and Eoin McGrath (previous JACIE executive officer), I led the EBMT benchmarking initiative. Most recently, I was integral to the formation of a new EBMT JACIE Working Party, now chaired by Lynn Manson (a very experienced inspector) which will give JACIE a substantive voice in the EBMT Board and Scientific Council alongside the capable directorship of Tuula Rintala and her international JACIE team.
Nowadays, I am happy to join the occasional JACIE inspection and clinically oversee the annual benchmarking exercise and let many talented others lead!
Do you have any tips or advice for anyone who aspires to become a JACIE Inspector?
You must be well organised and have a supportive hospital employer to provide time off your routine work for inspections (perhaps one every 1-2 years), which, in turn, will benefit your own programme and team with the shared knowledge and expertise when they are preparing for inspection. These days it reduces the inspection fees for your programme too.
Whilst there is a great need to review fine detail of procedures and processes prior to the inspections, walking around facilities asking ‘open’ and ‘closed’ questions reveals much about programmes and how they operate. Inspectors should always meet the deadlines of the Team Lead, ideally covering many of the standards before the inspection team leaves the building, or at least before they return to the often-hectic routine of their busy ‘day jobs’.
One overall tip to aspiring inspectors is that it’s not boring! Moreover, it has meaningful impacts on the lives of our patients and it’s important to keep the bigger picture in mind. The excellent large EBMT registry-based studies led by Alois Gratwohl (one of the original founders of JACIE in 1998) support significant improvements in patient survival through centres working to pre-defined standards, implementing quality systems, and undergoing external inspection to achieve JACIE accreditation - these measures were as great in impact as many other significant ‘scientific’ and ‘therapeutic’ advances and breakthroughs in our specialty!
In our ever evolving but often complex and high-risk HCT speciality, JACIE is as strong as ever. JACIE is here to stay in this amazing era of personalised precision medicine as it is delivered via our teams and health services to our patients. I would heartily encourage everyone with relevant medical, nursing, scientific or quality management experience to contribute to the HCT ‘community’ as a JACIE inspector!
References
JACIE Accreditation of HCT Programs Saccardi R, Rintala T, McGrath E, & Snowden JA. pp41-48. The EBMT Handbook: Hematopoietic Stem Cell Transplantation and Cellular Therapies; 8th edition. Editors Sureda, Corbacioglu, Greco, Kröger, Carreras; Springer 2024. Open access The EBMT Handbook
Snowden JA, McGrath E, Orchard K, Kröger N, Sureda A, Gratwohl A. Visions for a JACIE Quality Management System 4.0. Bone Marrow Transplant. 2021; 56(12):2876-2881.