Predictors of the effectiveness of accreditation on hospital performance: A nationwide stepped-wedge study

Bogh, Søren Bie; Falstie-Jensen, Anne Mette; Hollnagel, Erik; Holst, René; Braithwaite, Jeffrey; Raben, Ditte Caroline

doi:10.1093/intqhc/mzx052

Cited by 22 publications

(19 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A cross-sectional study using data from 4400 hospitals did not find differences in outcomes to be associated with type of accreditation programme. 90 Performance data from two cohort studies suggest that hospital size and type did not predict effects of accreditation 91 ; however, lower performing hospitals improved at a greater rate than moderate and higher performing hospitals. 92 Two case studies indicate that degree of improvement can depend on improvement capability of the inspected organisation, 43 and that accreditation can be easier to implement in smaller facilities.…”

Section: Resultsmentioning

confidence: 99%

Mediators of change in healthcare organisations subject to external assessment: a systematic review with narrative synthesis

Hovlid

Braut

Hannisdal³

et al. 2020

BMJ Open

View full text Add to dashboard Cite

ObjectivesExternal inspections are widely used to improve the quality of care. The effects of inspections remain unclear and little is known about how they may work. We conducted a narrative synthesis of research literature to identify mediators of change in healthcare organisations subject to external inspections.MethodsWe performed a literature search (1980–January 2020) to identify empirical studies addressing change in healthcare organisations subject to external inspection. Guided by the Consolidated Framework for Implementation Research, we performed a narrative synthesis to identify mediators of change.ResultsWe included 95 studies. Accreditation was the most frequent type of inspection (n=68), followed by statutory inspections (n=19), and external peer review (n=9). Our findings suggest that the regulatory context in which the inspections take place affect how they are acted on by those being inspected. The way inspections are conducted seem to be critical for how the inspection findings are perceived and followed up. Inspections can engage and involve staff, facilitate leader engagement, improve communication and enable the creation of new networks for reflection on clinical practice. Inspections can contribute to creating an awareness of the inspected organisation’s current practice and performance gaps, and a commitment to change. Moreover, they can contribute to facilitating the planning and implementation of change, as well as self-evaluation and the use of data to evaluate performance.ConclusionsExternal inspections can affect different mediators of organisational change. The way and to what extent they do depend on a range of factors related to the outer setting, the way inspections are conducted and how they are perceived and acted on by the inspected organisation. To improve the quality of care, the organisational change processes need to involve and impact the way care is delivered to the patients.

show abstract

Section: Resultsmentioning

confidence: 99%

Mediators of change in healthcare organisations subject to external assessment: a systematic review with narrative synthesis

Hovlid

Braut

Hannisdal³

et al. 2020

BMJ Open

View full text Add to dashboard Cite

show abstract

“…Unfortunately, it is difficult to make a meaningful direct comparison with previous studies since to the best of our knowledge, there are no studies like our study which is (i) targeting AMI and stroke, (ii) comparing before and after accreditation, and (iii) using mortality as an outcome variable at the same time. This difficulty is even greater considering that the effect of accreditation can vary from disease to disease [ 27 ]. Nevertheless, a careful comparison of previous studies with our findings was performed as follows.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, Devkaran S. et al’s studies which have used interrupted time series analysis to see if there were significant differences in the clinical quality measures before and after accreditation for all diseases reported that the structure and process quality indicators improved after accreditation compared to before, but the patient mortality reduction was not significant [ 31 , 32 ]. Given that the effect of accreditation on the mortality reduction can be disease-specific [ 27 ], it is natural that these studies targeting all diseases did not clearly demonstrate the effect of accreditation on patient mortality reduction. In addition to these, the results of other studies using mortality as an outcome indicator reported results in which accreditation had little or no effect on mortality reduction [ 16 , 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Accreditation and In-Hospital Mortality in Patients with Major Cardiovascular Diseases in South Korean Hospitals: Pre-Post Accreditation Comparison

Chun¹,

Lee

2020

Medicina

View full text Add to dashboard Cite

The direct impact of hospital accreditation on patients’ clinical outcomes is unclear. The purpose of this study was to evaluate whether mortality within 30 days of hospitalization for acute myocardial infarction (AMI), ischemic stroke (IS), and hemorrhagic stroke (HS) differed before and after hospital accreditation. This study targeted patients who had been hospitalized for the three diseases at the general hospitals newly accredited by the government in 2014. Thirty-day mortality rates of three years before and after accreditation were compared. Mortality within 30 days of hospitalization for the three diseases was lower after accreditation than before (7.34% vs. 6.15% for AMI; 4.64% vs. 3.80% for IS; and 18.52% vs. 15.81% for HS). In addition, hospitals that meet the criteria of the patient care process domain have a statistically lower mortality rate than hospitals that do not. In the newly accredited Korean general hospital, it was confirmed that in-hospital mortality rates of major cardiovascular diseases were lower than before the accreditation.

show abstract

“… Brubakk et al (2015) claim that accreditation has little effect on patient outcomes, organizational culture, and reliability. Many other researchers argue that there was no convincing evidence on improving output quality and patient safety due to accreditation and certification ( Grepperud, 2015 ; Bogh, et al , 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Medical negligence in healthcare organizations and its impact on patient safety and public health: a bibliometric study

et al. 2021

View full text Add to dashboard Cite

Background: Medical negligence is an increasing public health concern among healthcare providers worldwide as it affects patient safety. It poses a significant risk of patient injury, disease, disability, or death. The WHO has recognized deficiencies in patient safety as a global healthcare issue to be addressed. This study aimed to analyze various components of medical negligence research literature. Methods: Bibliographic data visualizations tools like Biblioshiny (RStudio) and VOSviewer were used besides MS Excel to examine the types of documents, annual scientific production, top contributing authors and their impact, authorship patterns and collaboration, top contributing countries and organizations, most significant sources of publication, most cited documents, and most frequently used keywords. Bibliometric methods were used to analyze the bibliographic records of research output on medical negligence downloaded from the Web of Science Core Collection. Results: The annual productivity of medical negligence research was increasing gradually. The most productive period for medical negligence research was 2011-2020. Bird contributed the highest number of publications to medical negligence literature while Brennan emerged as the highly cited author. Single-authored publications on medical negligence were not highly cited. The United States was the highest contributing country and the University of South Florida was the highest contributing organization while Harvard University was a highly cited organization. Nine out of the top ten contributing organizations were academic institutions and most of them belonged to the United States. The most important sources of publication on this topic were The Lancet and British Medical Journal. Localio et al. was the most important research article on medical negligence research. Conclusion: Due to increasing attention on this topic, there was a sharp increase in the research output on medical negligence. This is of significance as the WHO set in motion a patient safety program almost two decades ago.

show abstract

Predictors of the effectiveness of accreditation on hospital performance: A nationwide stepped-wedge study

Abstract: Hospital characteristics were not found to be predictors for the effects of accreditation, whereas conditions and types of care to some extent predicted the effectiveness.

Cited by 22 publications

References 20 publications

Mediators of change in healthcare organisations subject to external assessment: a systematic review with narrative synthesis

Mediators of change in healthcare organisations subject to external assessment: a systematic review with narrative synthesis

Association between Accreditation and In-Hospital Mortality in Patients with Major Cardiovascular Diseases in South Korean Hospitals: Pre-Post Accreditation Comparison

Medical negligence in healthcare organizations and its impact on patient safety and public health: a bibliometric study

Contact Info

Product

Resources

About