Quality improvement programs and the professional nursing practice environment: an integrative review

Background Hospital accreditation is an established quality improvement intervention. Despite a growing body of research, the evidence of effect remains contested. This umbrella review synthesises reviews that examine the impacts of hospital accreditation with regard to health care quality, highlighting research trends and knowledge gaps. Methods Terms specific to the Population: ‘hospital’, and the Intervention: ‘accreditation’ were used to search seven databases: CINAHL (via EBSCOhost), Embase, Medline (via EBSCOhost), PubMed, Scopus, the Cochrane Database of Systematic Reviews and the JBI EBP Database (via Ovid). 2545 references were exported to Endnote. After completing a systematic screening process and chain-referencing, 33 reviews were included. Following quality assessment and data extraction, key findings were thematically grouped into the seven health care quality dimensions. Results Hospital accreditation has a range of associations with health system and organisational outcomes. Effectiveness, efficiency, patient-centredness and safety were the most researched quality dimensions. Access, equity, and timeliness were examined in only three reviews. Barriers to robust original studies were reported to have impeded conclusive evidence. The body of research was largely atheoretical, incapable of precisely explaining how or why hospital accreditation may actually influence quality improvement. Conclusion The impact of hospital accreditation remains poorly understood. Future research should control for all possible variables. Research and accreditation program development should integrate concepts of implementation and behavioural science to investigate the mechanisms through which hospital accreditation may enable quality improvement.

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Hospital accreditation: an umbrella review

Lewis

Hinchcliff

2022

International Journal for Quality in Health Care

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Quality improvement programs and the professional nursing practice environment: an integrative review

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Hospital accreditation: an umbrella review

Hospital accreditation: an umbrella review

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