Experiences of accreditation impact in general practice – a qualitative study among general practitioners and their staff

Abstract

BackgroundAccreditation is a widespread tool for quality management in health care. However, there is lack of research on the impact of accreditation, particularly in general practice. This study explores how general practitioners and their staff experienced the impact of a mandatory accreditation program in Denmark.MethodsQualitative interviews with general practitioners and staff from 11 clinics. The respondents were interviewed twice: during preparation and after the survey visit. The interviews were analyzed using thematic analysis, and all specific changes and other types of impact were extracted from the transcribed interview data from each clinic.ResultsThe impact of accreditation varied markedly among the clinics as did the participants’ overall assessments of accreditation. Concerning specific changes in behavior and physical infrastructure, some clinics had only implemented a few minor changes in response to accreditation, some had made a relatively moderate number of changes, and a few clinics had made relatively many changes including a few pronounced ones. Further, some participants experienced that accreditation had enhanced knowledge sharing or upgraded competencies, and increased job satisfaction. However, the workload related to accreditation was emphasized as a problem by a majority of the professionals and for a few, accreditation had influenced job satisfaction negatively.ConclusionAccreditation may affect general practice clinics in very different ways. In spite of several examples of positive impact, the results suggest that it is difficult to design a mandatory accreditation program for general practice in which most professionals experience that the benefits of accreditation equal the resources used in the process.

What Impact Does Accreditation Have on Workplaces? A Qualitative Study to Explore the Perceptions of Healthcare Professionals About the Process of Accreditation

“…With respect to the research questions, it was found that preparing for accreditation went hand-in-hand with increased psychosocial risks, such as increased job demands and work pace, conflicting information, and perceived strain. Such findings support evidence from previous observations regarding the negative impacts of accreditation, which include increased workload (Touati and Pomey, 2009;El-Jardali et al, 2014), increased stress levels (Kousgaard et al, 2019), and use of resources (Brubakk et al, 2015).…”

“…The nature of accreditation is to assess the performance of healthcare facilities through an external inspection process, using a defined set of standards. When comparing accredited and non-accredited ones, accreditation has been found to support the promotion of patients' health and safety (Shaw et al, 2010), improve the quality of healthcare services (Greenfield and Braithwaite, 2008;O'Beirne et al, 2013;Shaw et al, 2014;Bogh et al, 2016), encourage organizational change (Kousgaard et al, 2019), and allow professional development (Greenfield and Braithwaite, 2008). Furthermore, previous research has shown that accreditation can have positive effects on the quality of healthcare management and leadership (El-Jardali et al, 2014).…”

“…In addition, over 70 countries have employed such accreditation programs in their healthcare organizations, including developing countries such as the United Arab Emirates (Greenfield and Braithwaite, 2008;Devkaran and O'Farrell, 2015;Greenfield et al, 2019). While healthcare accreditation might be appealing to managers and stakeholders, many have argued that accreditation is a demanding activity, which increases workload and stress levels among workers (Touati and Pomey, 2009;Elkins et al, 2010;El-Jardali et al, 2014;Kousgaard et al, 2019).…”

From intention to action: A systematic literature review of provider behaviour change‐focused interventions in physical health and behavioural health settings

“…The target intervention population for 18 studies were doctors, and predominantly primary care providers/general practitioners. 26,28,34,35,37,39,46,47,49,50,55,56,[58][59][60][65][66][67] To be included and eligible to participate in an intervention, primary care providers often needed to treat a specific subset of patients in their practice. For example, Presseau et al focused on general practitioners who provided care to patients with type 2 diabetes across 44 general practices through a national cohort study.…”

Perceptions on the Implementation of Accreditation Requirements and Standards in the Primary Healthcare Centres, Ras Al Khaimah, UAE

“…Accreditation may affect general practice in very different ways. Despite several examples of positive impact, the results suggest that it is difficult to design a mandatory accreditation programme for general practice in which most professionals experience that the benefits of accreditation equal the resources used in the process (Kousgaard et al, 2019). The accredited healthcare setting implement quality care and patients’ safety practice better than non-accredited facilities.…”