The impact of accreditation on healthcare quality improvement: a qualitative case study

Abstract

Journal of Health Organization and Management r n a l o f H e a l t h O r g a n i z a t i o n a n d M a n a g e m e1 The impact of accreditation on healthcare quality improvement: a qualitative case study Abstract PurposeResearch on accreditation has mostly focused on assessing its impact using large scale quantitative studies, yet little is known on how quality is improved in practice through an accreditation process. Using a case study of an acute teaching hospital in Portugal, the article aims at exploring the dynamics through which accreditation can lead to an improvement in the quality of healthcare services provided. Design/methodology/approachData for the case study was collected through 46 in-depth semi-structured interviews with 49 clinical and non-clinical members of staff. Data were analysed using a framework thematic analysis. FindingsInterviewees felt that hospital accreditation contributed to the improvement of healthcare quality in general, and more specifically to patient safety, as it fostered staff reflection, a higher standardization of practices, and a greater focus on quality improvement. However, findings also suggest that the positive impact of accreditation resulted from the approach the hospital adopted in its implementation as well as the fact that several of the procedures and practices required by accreditation were already in place at the hospital, albeit often in an informal way. Research limitations/implicationsThe study was conducted in only one hospital. The design of an accreditation implementation plan tailored to the hospital's context can significantly contribute to positive outcomes in terms of quality and patient safety improvements. Originality/valueThis study provides a better understanding of how accreditation can contribute to healthcare quality improvement. It offers important lessons on the factors and processes that potentiate quality improvements through accreditation.

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

“… 36 44–50 To be perceived as relevant, the standards should be adapted to the local context. 51 52 Development and revision of standards require a collaborative approach and the expertise of a range of stakeholders including the patients. 53–55 …”

“…46 116 However, a challenge is that the standard used for inspection is not necessarily sensitive to improvement over time, and it might not include requirements on how to use measurements to inform continuous evaluation and improvement over time. 46 48 85 Cross-sectional studies based on survey and performance data indicate that the inspection process can facilitate the development of measurement systems, which can be used to evaluate performance, 51 61 82 85 108 113 119 120and survey and interview data suggest that inspection can have a positive influence on clinicians' understanding of the necessity of measuring and evaluating improvement progress. 56 121 122 However, contradictory findings based on survey data indicate that inspection does not affect the way the inspected organisation uses and processes data to evaluate its performance.…”

Doing a Case Study on Health Care Quality Improvement at a Large Public Teaching Hospital: A Non-Clinician’s Account

“…Data analysis for the article Melo (2016) followed the framework thematic analysis (Spencer, Ritchie, Ormston, O' Connor, & Barnard, 2014). As Spencer et al (2014) The fact that Melo's (2018Melo's ( , 2016 articles had very specific objectives fostered the use of more systematic ways of coding as well as coding at a more minutious level than the one adopted in the PhD thesis (Melo, 2012) and on the article Melo & Beck (2015). In both, the PhD thesis and Melo & Beck's (2015) article, data analysis followed the method proposed by Scapens (2004) where themes and patterns were identified by reading the interview transcripts several times and highlighting the key ideas.…”

“…The critical role of the quality of interviews (Melo, 2016) and Human Resource Development Quarterly (Melo & Beck, 2015) as well as in papers presented at leading international conferences and workshops. A number of other papers are still being written using the data of the case study.…”

Influence of continuous quality improvement on patients’ satisfaction within hospitals in Nairobi, Kenya

“…Studies conducted on various aspects of TQM within Kenya, however, there is little evidence of research and literature on TQM principles and its influence on customer satisfaction in the Kenyan healthcare sector (Ngware et al, 2016;Awuor and Kinuthia, 2013;Barake, 2015;Wamuyu, 2015). Further, most of the previous studies (Kumar et al, 2009;Kristiano et al, 2012;Sadikoglu & Olcay 2014;Sara Melo, 2016) are largely theoretical and only few provide empirical evidence to support their conclusions.This study therefore will seek to fill this gap and inform future studies that focus on continuous quality improvement and patient satisfaction in the Kenya Healthcare sector.…”