Exploring hospital certification processes from the certification body’s perspective - a qualitative study

Johannesen, Dag Tomas Sagen; Wiig, Siri

doi:10.1186/s12913-020-05093-w

Cited by 5 publications

(4 citation statements)

References 42 publications

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“…All observation notes were taken openly and guided by an auditor typology framework [38]. The auditor styles observed were presented in a separate article [39].…”

Section: Sources Recruitment and Data Collectionmentioning

confidence: 99%

Certification as support for resilience? Behind the curtains of a certification body — a qualitative study

Johannesen

Lindøe

Wiig

2020

BMC Health Serv Res

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Background: Certification in healthcare often involves independent private sector bodies performing legally required or voluntary external assurance activities. These certification practices are embedded in international standards founded in traditional beliefs about rational and predictable processes for quality and safety improvement. Certification can affect organizational and cultural changes, support collaboration and encourage improvement that may be conducive to resilient performance. This study explores whether ISO 9001 quality management system certification can support resilience in healthcare, by looking at characteristics in the objectives, methods, and practice of certification from a certification body's perspective. Methods: One of Norway's four certification bodies in healthcare was studied, using an explorative embedded single-case design. The study relies on document analysis of the international standards and associated guidances for the performance of certification bodies and thematic analyses of data from 60 h of observations of auditors in three certification processes and nine qualitative interviews with managers and personnel from the certification body. Results from the analyses were compared to identify discrepancies between the written and perceived certification approach and practice. Results: Standards and guidances for certification embed an elasticity between formal and consistent assessments of nonconformities in organizations and emphasize holistic approaches that brings added value. Auditors were then left with the latitude to navigate their auditing strategy during interaction with the auditees. Members of the certification body perceived and practiced a holistic and flexible auditing approach using opportunities to share knowledge, empower and make guidance for improvement. Conclusions: ISO certification expects structures and systems to ensure consistent and objective certification processes. At the same time, it embodies a latitude to adopt flexible and context-specific certification approaches, as demonstrated by a certification body in this study, to give added value to the certified organizations. Such an ISO 9001 certification approach may support resilient performance in healthcare by nurturing the potential to respond and learn. These results are important for further development of methods that certification bodies use in the auditing encounter.

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“…All observation notes were taken openly and guided by an auditor typology framework [38]. The auditor styles observed were presented in a separate article [39].…”

Section: Sources Recruitment and Data Collectionmentioning

confidence: 99%

Certification as support for resilience? Behind the curtains of a certification body — a qualitative study

Johannesen

Lindøe

Wiig

2020

BMC Health Serv Res

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“…, 2015; Johannesen and Wiig, 2017; Johannesen et al. , 2020; Johannesen, 2020). In late 2022, the Joint Commission announced a reduction in the number of standards with 168 accreditation requirements, as well as the revision of 14 standards (Joint Commission, 2022).…”

Section: Discussionmentioning

confidence: 99%

Comparison of external evaluation policies and regulations for quality improvement and safety of health services in Norway and the United States

Øyri,

Bates,

Wiig

2023

IJHG

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Purpose The authors compare perspectives on external evaluation of health service provision between Norway and the USA. External inspection and accreditation are examples of internationally wide-spread external evaluation methods used to assess the quality of care given to patients. Different countries have different national policy strategies and arrangements set up to do these evaluations. Although there is growing attention to the impact and effects on quality and safety from external evaluation, there is still a gap in knowledge to how structures and processes influence these outcomes. Accordingly, the purpose of this article is to describe the structures and processes in external evaluation designed to promote quality improvement in Norway and the USA with attention to comparison of enablers and barriers in external evaluation systems.Design/methodology/approach Data collection consisted of documentary evidence retrieved from governmental policies, and reviews of the Joint Commission (the US), international guidelines, recommendations and reports from the International Society for Quality in Health Care, and the World Health Organization, and policies and regulations related to Norwegian governmental bodies such as the Ministry of Health and Care Services, the Norwegian Directorate of Health, and the Norwegian Board of Health Supervision . Data were analyzed inspired by a deductive, direct content analytical framework.Findings The authors found that both accreditation and inspection are strategies put in place to ensure that healthcare providers have adequate quality systems as well as contributing to the wider risk and safety enhancing management and implementation processes in the organizations subjected to evaluation. The US and the Norwegian external regulatory landscapes are complex and include several policymaking and governing institutions. The Norwegian regulatory framework for inspection has replaced an individual blame logic with a model which “blames” the system for inadequate quality and patient harm. This contrasts with the US accreditation system, which focuses on accreditation visits. Although findings indicate an ongoing turning point in accreditation, findings also demonstrate that involving patients and next of kin directly in adverse event inspections is a bigger part of a change in external inspection culture and methods than in processes of accreditation.Research limitations/implications The message of this paper is important for policymakers, and bodies of inspection and accreditation because knowledge retrieved from the comparative document study may contribute to better understanding of the implications from the different system designs and in turn contribute to improving external evaluations.Originality/value Although there is a growing attention to the impact and effects on quality and safety from external evaluation, the implications of different regulatory strategies and arrangements for evaluation on quality and safety remain unclear.

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“…Due to the superior comparability, SR has the potential to improve communication with other involved healthcare providers, thus facilitating patient management and reducing inquiries and, more importantly, misunderstandings 22 . Furthermore, SR may be a valuable quality control tool to assist in the accreditation process that forms the basis for patient referrals, treatment, and billing in many countries 23 .…”

Section: Discussionmentioning

confidence: 99%

Structured Reporting of Head and Neck Sonography Achieves Substantial Interrater Reliability

Weimer,

Künzel,

Ernst

et al. 2023

Ultrasound Int Open

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Purpose Ultrasound examinations are often criticized for having higher examiner dependency compared to other imaging techniques. Compared to free-text reporting, structured reporting (SR) of head and neck sonography (HNS) achieves superior time efficiency as well as report quality. However, there are no findings concerning the influence of SR on the interrater reliability (IRR) of HNS. Materials and Methods Typical pathologies (n=4) in HNS were documented by video/images by two certified head and neck ultrasound instructors. Consequently, structured reports of these videos/images were created by n=9 senior physicians at departments of otolaryngology or maxillofacial surgery with DEGUM instructors on staff. Reports (n=36) were evaluated regarding overall completeness and IRR. Additionally, user satisfaction was assessed by a visual analog scale (VAS). Results SR yielded very high report completeness (91.8%) in all four cases with a substantial IRR (Fleiss‘ κ 0.73). Interrater agreement was high at 87.2% with very good user satisfaction (VAS 8.6). Conclusion SR has the potential to ensure high-quality examination reports with substantial comparability and very high user satisfaction. Furthermore, big data collection and analysis are facilitated by SR. Therefore, process quality, workflow, and scientific output are potentially enhanced by SR.

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Exploring hospital certification processes from the certification body’s perspective - a qualitative study

Cited by 5 publications

References 42 publications

Certification as support for resilience? Behind the curtains of a certification body — a qualitative study

Certification as support for resilience? Behind the curtains of a certification body — a qualitative study

Comparison of external evaluation policies and regulations for quality improvement and safety of health services in Norway and the United States

Structured Reporting of Head and Neck Sonography Achieves Substantial Interrater Reliability

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