Strengthening organizational performance through accreditation research-a framework for twelve interrelated studies: the ACCREDIT project study protocol

Abstract

BackgroundService accreditation is a structured process of recognising and promoting performance and adherence to standards. Typically, accreditation agencies either receive standards from an authorized body or develop new and upgrade existing standards through research and expert views. They then apply standards, criteria and performance indicators, testing their effects, and monitoring compliance with them. The accreditation process has been widely adopted. The international investments in accreditation are considerable. However, reliable evidence of its efficiency or effectiveness in achieving organizational improvements is sparse and the value of accreditation in cost-benefit terms has yet to be demonstrated. Although some evidence suggests that accreditation promotes the improvement and standardization of care, there have been calls to strengthen its research base.In response, the ACCREDIT (Accreditation Collaborative for the Conduct of Research, Evaluation and Designated Investigations through Teamwork) project has been established to evaluate the effectiveness of Australian accreditation in achieving its goals. ACCREDIT is a partnership of key researchers, policymakers and agencies.FindingsWe present the framework for our studies in accreditation. Four specific aims of the ACCREDIT project, which will direct our findings, are to: (i) evaluate current accreditation processes; (ii) analyse the costs and benefits of accreditation; (iii) improve future accreditation via evidence; and (iv) develop and apply new standards of consumer involvement in accreditation. These will be addressed through 12 interrelated studies designed to examine specific issues identified as a high priority. Novel techniques, a mix of qualitative and quantitative methods, and randomized designs relevant for health-care research have been developed. These methods allow us to circumvent the fragmented and incommensurate findings that can be generated in small-scale, project-based studies. The overall approach for our research is a multi-level, multi-study design.DiscussionThe ACCREDIT project will examine the utility, reliability, relevance and cost effectiveness of differing forms of accreditation, focused on general practice, aged care and acute care settings in Australia. Empirically, there are potential research gains to be made by understanding accreditation and extending existing knowledge; theoretically, this design will facilitate a systems view of accreditation of benefit to the partnership, international research communities, and future accreditation designers."Accreditation of health-care organisations is a multimillion dollar industry which shapes care in many countries. Recent reviews of research show little evidence that accreditation increases safety or improves quality. It's time we knew about the cost and value of accreditation and about its future direction." [Professor John Øvretveit, Karolinska Institute, Sweden, 7 October 2009]

Evaluating Perceptions of the Healthcare Providers Concerning Accreditation in Healthcare Organizations in the R. Macedonia

“…In this study, perceptions of the respondents that drivers of organizational changes-in almost equal percentage are management and the expert team, shows that not in all institutions management is perceived as overtaking the role to implement changes and the team does not perceive them as leaders toward positive changes. However, in practice, positive changes are certainly driven by the management (Braithwaite et al, 2011). The level to which employees can participate in the planning and implementing of such processes is in the power of the management (Pahkin et al, 2014), having in mind that changes to be successful employees need to be involved as much as possible (Braithwaite et al, 2011).…”

Conforming to accreditation in Iranian hospitals

“…Firstly, in order to obtain the accreditation, organisations are assessed against externally designed standards. The standards are intended to cover all aspects of healthcare provision by investigating the organisation in terms of management and clinical performance (Braithwaite et al, 2011;Greenfield and Braithwaite, 2008;Pomey et al, 2010;Shaw, 2004b). Many of these standards are often defined in the language of control; for example as output standards, input standards and process standards that are used to measure the performance of the organisation (Montagu, 2003;Neely et al, 2001;Brown, 1996).…”

“…Whether they actually do, is debatable and a number of studies have indicated the problematic nature of achieving these goals (Scrivens, 1997a;de Walcque et al, 2008). The standards are applied against current organisational activities typically by way of self-assessment (such as filling out questionnaires), desk appraisal of internal documents and on-site visits, usually by peers (Montagu, 2003;Braithwaite et al, 2011).…”

Establishing a tracking system in human resources department to improve the completeness of personnel files at a district hospital in Rwanda

“…This information is vital for both employee and the hospital and aids in the assurance that the hospital is staffed appropriately. [30,[38][39][40][41][42] Apart from being essential items in hospital management, proper personnel files are also essential for hospital accreditation. [43][44][45] Rwanda's Ministry of Health, which aims to strengthen health systems by ensuring provision of high quality services, adopted a hospital accreditation system in 2006 as one of the main strategies to improve quality of care.…”