Impact of Healthcare Accreditation Using a Systematic Review: Balanced Score Card Perspective

Abstract

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.

The impact of hospital accreditation on the quality of healthcare: a systematic literature review

“…As an extension of previous reviews [ 13 , 31 , 32 , 34 ], our analysis did not find a correlation between accreditation and higher patient satisfaction or experience. The earlier presumption that patient satisfaction is a reverberation of hospital quality of service [ 120 ] was not confirmed in our review.…”

“…On the one hand, positive impacts of hospital accreditation on organizational culture [ 12 , 32 , 34 ], clinical practice, organizational performance [ 23 ], clinical leadership, patient safety systems [ 28 ], quality of services [ 29 ], care delivery process [ 30 ], and efficiency [ 35 ] have been demonstrated. On the other hand, several reviews reported insufficient evidence pertaining to the impact of accreditation on measurable changes in quality of care [ 12 ], health outcomes [ 26 ], patient satisfaction [ 31 ], and economic outcomes [ 13 , 26 , 34 ]. For instance, Greenfield and Braithwaite [ 13 ] present diverging findings on the impact of accreditation as the effect was limited to promoting change and professional development, while on other impact categories such as quality measures, financial impact, and public disclosure results were inconclusive.…”

“…Previously published accreditation reviews included the impact of specialty [ 30 ] or disease-specific [ 34 ] accreditation programs which could dilute the overall impact of hospital accreditation, used stringent inclusion designs that could limit its contribution room [ 6 , 12 ], restricted search languages, or overlooked several important relevant studies [ 35 ]. This review has overcome such hindrances and aimed to identify and analyze the evidence on the impact of hospital accreditation.…”

“…The legitimacy concerns about accreditation are due to the scant of high-quality trials and conflicting reported results [23][24][25]. Contradictory findings have generated inconsistency in the conclusions of previously published reviews [6,12,13,23,[26][27][28][29][30][31][32][33][34][35]. On the one hand, positive impacts of hospital accreditation on organizational culture [12,32,34], clinical practice, organizational performance [23], clinical leadership, patient safety systems [28], quality of services [29], care delivery process [30], and efficiency [35] have been demonstrated.…”

Patient Safety Culture Associated With Patient Safety Competencies Among Registered Nurses

“…Likewise, in South Korea, patient safety has become a major focus in recent years, resulting in the initiation of a hospital accreditation program surveyed by the Korea Institute for Healthcare Accreditation (KOIHA) in 2010 to ensure patient safety and quality of care in Korean healthcare settings (KOIHA, n.d.). Many Korean hospitals have spent substantial funds and resources to prepare for the KOIHA survey, which appears to be effective in facilitating the improvement of patient safety (Kim, Jung, Kim, & Lee, ; Park, Jung, Park, Hwang, & Suk, ). Moreover, the KOIHA accreditation brought into focus the need for the education and training of nurses to enhance their patient safety competencies in their work (Hwang, ).…”