Objective: In order to encourage more hospitals to participate in the accreditation, there needs to be "substantial evidence of the effectiveness of accreditation". The aim of this study was to identify and analyze healthcare employees' perceptions of hospital accreditation and the impact of hospital accreditation on the quality of healthcare in Korea. Methods: Eight electronic databases were searched between June and July 2016. Of the initially identified 392 abstracts, 14 empirical studies on healthcare accreditation in Korea were selected based on the inclusion criteria. These were retrieved and analyzed. Results: The 14 studies assessed healthcare employees' perception of hospital accreditation as well as the impact of hospital accreditation on the quality of healthcare. The results were classified into four categories according to perception (Need, Purpose, Intent, and Relevance of standards), and into five categories according to the impact of accreditation (Patient safety and healthcare quality, Satisfaction with hospital employees, Leadership, Organizational culture, and Managerial performance). Findings showed that healthcare employees' had good understanding of the purpose, need, and intention of the healthcare accreditation system, but indicated that limitations exist with the accreditation standards. Moreover, evidence showed that healthcare accreditation in Korea has made a positive impact on "patient safety and healthcare quality", "leadership" and "organizational culture". Conclusions: Healthcare accreditation has had a positive overall impact on hospitals and has improved the quality of healthcare as well as patient safety. However, more rigorous research and more diverse research methods are required to determine its long-term effect.

Original Articles 의료기관인증의 효과에 대한 체계적 문헌고찰: Balanced Score Card 관점으로 2 Purpose: The purpose of this study was to analyze the impact of healthcare accreditation and to provide empirical evidence to validate positive effectiveness. Methods: Six electronic databases (KERIS, KoreaMed, NDSL, Ovid-medline, Embase, Cochrane library) were accessed in May 2016. Keywords used were 'accreditation' and 'Joint Commission on Accreditation of Healthcare Organization (JCAHO)'. Of the initially identified 3,008 articles, 60 studies on healthcare accreditation were selected based on inclusion criteria that are hospital accreditation, accreditation by disease and clinical center accreditation. These were retrieved and analyzed. Result: The 60 study results were on the impact of healthcare accreditation. Results were classified into four perspectives of Balanced Score Card (Financial, Customer, Internal Process, Learning & Growth). In internal process perspective, results revealed that healthcare accreditation has made a positive impact on "care process and procedure". In learning & growth perspective, healthcare accreditation has made a positive influence on "leadership", "organizational cultures" and "change mechanisms". However, it revealed that healthcare accreditation does not directly affect financial performance. It is also difficult to reach a definitive conclusion that healthcare accreditation programs affect patient satisfaction of customer and clinical outcome of the internal process. Conclusion: Healthcare accreditation programs provide positive impact on change of care process and building communication-oriented hospital culture. However, more rigorous and diverse research is needed on financial effects and clinical outcomes of healthcare accreditation.