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Archives of Pathology & Laboratory... Mar 2014In the late 1990s, the Accreditation Council for Graduate Medical Education developed the Outcomes Project and the 6 general competencies with the intent to improve the...
CONTEXT
In the late 1990s, the Accreditation Council for Graduate Medical Education developed the Outcomes Project and the 6 general competencies with the intent to improve the outcome of graduate medical education in the United States. The competencies were used as the basis for developing learning goals and objectives and tools to evaluate residents' performance. By the mid-2000s the stakeholders in resident education and the general public felt that the Outcomes Project had fallen short of expectations.
OBJECTIVE
To develop a new evaluation method to track trainee progress throughout residency using benchmarks called milestones. A change in leadership at the Accreditation Council for Graduate Medical Education brought a new vision for the accreditation of training programs and a radically different approach to the evaluation of residents.
DATA SOURCES
The Pathology Milestones Working Group reviewed examples of developing milestones in other specialties, the literature, and the Accreditation Council for Graduate Medical Education program requirements for pathology to develop pathology milestones. The pathology milestones are a set of objective descriptors for measuring progress in the development of competency in patient care, procedural skill sets, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice.
CONCLUSIONS
The milestones provide a national standard for evaluation that will be used for the assessment of all residents in Accreditation Council for Graduate Medical Education-accredited pathology training programs.
Topics: Accreditation; Clinical Competence; Education, Medical, Graduate; Humans; Pathology; United States
PubMed: 24576024
DOI: 10.5858/arpa.2013-0260-SA -
Hospital accreditation processes in Saudi Arabia: a thematic analysis of hospital staff experiences.BMJ Open Quality Jan 2022Hospital accreditation by an international organisation can play an important role in health quality and safety. However, little is known about how managers and...
BACKGROUND
Hospital accreditation by an international organisation can play an important role in health quality and safety. However, little is known about how managers and front-line employees experience and perceive the effects of accreditation. Their views could inform quality improvement processes and procedures.
OBJECTIVE
To explore perceptions of employees at the managerial level on the Joint Commission International (JCI) accreditation process and its impact on quality of patient care in Saudi Arabian JCI-accredited hospitals.
METHODS
We undertook a qualitative study using semi-structured interviews to explore the perspectives of senior staff from three accredited public hospitals in Saudi Arabia. Interviews were transcribed prior to thematic analysis.
RESULTS
Twenty managers participated in the interviews. The following inter-related themes emerged concerning the JCI accreditation process and its impact on quality of patient care: drivers for the change; the plan for the change; the process of the change; maintaining changes post-accreditation and patients' issues. Participants were positive in their accounts of: drivers for the change; planning for the change needed to achieve accreditation and managing patients' issues. However, participants reported less favourably on: the process of the change; and maintaining changes post-accreditation.
CONCLUSION
The planning stage was perceived as the easiest component of JCI accreditation. Implementing and maintaining changes post-accreditation that demonstrably promote patient safety and quality of care was perceived as more difficult. When planning for accreditation, institutions need to incorporate strategies to ensure that improvements to care continue beyond the accreditation period.
Topics: Accreditation; Hospitals; Humans; Personnel, Hospital; Quality Improvement; Saudi Arabia
PubMed: 34980590
DOI: 10.1136/bmjoq-2021-001652 -
Clinical Chemistry and Laboratory... Jul 2012Accreditation of medical laboratories in Europe is primarily according to ISO15189. The percentage of accredited laboratories is still small. The time spent on an... (Review)
Review
Accreditation of medical laboratories in Europe is primarily according to ISO15189. The percentage of accredited laboratories is still small. The time spent on an assessment is quite different between countries. More important is the way the assessment process is carried out. Harmonisation in accrediting medical laboratories is the main task of the Health Care Committee within EA (European cooperation of Accreditation). The EFCC Working Group on Accreditation strongly contributes as the representative of laboratory professionals. An important item is the use of flexible scope. The intention is that all tests within a medical discipline are offered for accreditation. This is not yet normal practice. Other items concern accreditation of point-of-care testing (POCT) - reliability of the pre-analytical phase, when the phlebotomy is not done by the laboratory, and practical use of uncertainty and verification. Also the diversity in time spent for an assessment is discussed. The added value of accreditation is strongly dependent upon the assessors who have an important task. Their training and calibration needs continuous input. The medical laboratory professionals should participate in all aspects concerning the quality system, starting with the standard, working on the guidelines, the assessment itself, and input in the accreditation bodies.
Topics: Accreditation; European Union; Humans; Laboratories; Quality Control
PubMed: 23024982
DOI: 10.1515/cclm-2011-0586 -
BMJ (Clinical Research Ed.) Mar 1995
Topics: Accreditation; Hospitals, Community; Pilot Projects; State Medicine; United Kingdom
PubMed: 7711570
DOI: 10.1136/bmj.310.6982.755 -
Human Resources For Health May 2021Increasing evidence suggests that sustainable delivery of interprofessional education (IPE) has the potential to lead to interprofessional collaborative practice (IPCP),...
BACKGROUND
Increasing evidence suggests that sustainable delivery of interprofessional education (IPE) has the potential to lead to interprofessional collaborative practice (IPCP), which in turn has the potential to lead to enhanced healthcare systems and improved patient-centered care health outcomes. To enhance IPE in Canada, the Accreditation of Interprofessional Health Education (AIPHE) project initiated collaborative efforts among accrediting organizations of six health professions to embed IPE language into their respective accreditation standards. To further understand the impact of the AIPHE project, this study evaluated the accountability of the IPE language currently embedded in Canadian health professions' accreditation standards documents and examined whether such language spanned the five accreditation standards domains identified in the AIPHE project.
METHODS
We conducted a comparative content analysis to identify and examine IPE language within the "accountable" statements in the current accreditation standards for 11 Canadian health professions that met our eligibility criteria.
RESULTS AND DISCUSSION
A total of 77 IPE-relevant accountable statements were identified across 13 accreditation standards documents for the 11 health professions. The chiropractic, pharmacy, and physiotherapy documents represented nearly 50% (38/77) of all accountable statements. The accountable statements for pharmacy, dentistry, dietetics, and nursing (registered) spanned across three-to-four accreditation standards domains. The remaining nine professions' statements referred mostly to "Students" and "Educational program." Furthermore, the majority of accreditation standards documents failed to provide a definition of IPE, and those that did, were inconsistent across health professions.
CONCLUSIONS
It was encouraging to see frequent reference to IPE within the accreditation standards of the health professions involved in this study. The qualitative findings, however, suggest that the emphasis of these accountable statements is mainly on the students and educational program, potentially compromising the sustainability and development, implementation, and evaluation of this frequently misunderstood pedagogical approach. The findings and exemplary IPE-relevant accountable statements identified in this paper should be of interest to all relevant stakeholders including those countries, where IPE accreditation is still emerging, as a means to accelerate and strengthen achieving desired educational and health outcomes.
Topics: Accreditation; Canada; Health Occupations; Humans; Interprofessional Education; Interprofessional Relations
PubMed: 33985513
DOI: 10.1186/s12960-021-00611-1 -
Indian Journal of Public Health 2021Accreditation has become a benchmark for health-care organizations that require huge investment and effort. The impact of accreditation in health-care delivery needs to...
BACKGROUND
Accreditation has become a benchmark for health-care organizations that require huge investment and effort. The impact of accreditation in health-care delivery needs to be assessed.
OBJECTIVES
The study aimed to assess the impact of accreditation on the quality of public healthcare delivery in primary and secondary healthcare settings in Kerala.
METHODS
This cross-sectional study was conducted from July 2017 to July 2018 among 621 in-patients in medical wards at accredited (312) and nonaccredited (309) primary (community health center) and secondary (general, women and children, and taluk level hospitals) public health-care facilities. Ten constructs such as physical facility, admission services, patient centeredness, accessibility of medical care, financial matters, professionalism, staff services, medical quality, diagnostic services, and patient satisfaction were used in the study. Nonaccredited and accredited hospitals were compared using Median and Kruskal-Wallis test using SPSS version 22, with a set significance level of P ≤0 .05.
RESULTS
The median score of constructs of accredited primary health-care facilities in the Structure, Process, and Outcome domains are higher than the nonaccredited hospitals. There are significant differences between the scores of these three domains in accredited and nonaccredited primary health-care institutions but absent in secondary care institutions.
CONCLUSION
If accreditation has to bring the embedded quality, structural, and procedural aspects of health-care facilities must be improved. Structural upgradation of a health-care facility alone cannot guarantee patient satisfaction. Accreditation process must be perceived as a tool for holistic and continuous transformation of a health-care facility overarching infrastructural and interpersonal domains.
Topics: Accreditation; Ambulatory Care Facilities; Child; Cross-Sectional Studies; Female; Humans; India; Public Health
PubMed: 34135177
DOI: 10.4103/ijph.IJPH_827_20 -
Journal of Public Health Management and... 2019To improve quality and consistency of health departments, a voluntary accreditation process was developed by the Public Health Accreditation Board. Understanding...
BACKGROUND
To improve quality and consistency of health departments, a voluntary accreditation process was developed by the Public Health Accreditation Board. Understanding accreditation's role as a mediator in workforce training needs, satisfaction, and awareness is important for continued improvement for governmental public health.
OBJECTIVE
To compare differences in training needs, satisfaction/intent to leave, and awareness of public health concepts for state and local health department staff with regard to their agency's accreditation status.
DESIGN
This cross-sectional study considered the association between agency accreditation status and individual perceptions of training needs, satisfaction, intent to leave, and awareness of public health concepts, using 2017 Public Health Workforce Interests and Needs Survey (PH WINS) data. Respondents were categorized on the basis of whether their agencies (at the time of survey) were (1) uninvolved in accreditation, (2) formally involved in accreditation, or (3) accredited.
RESULTS
Multivariate logistic regression models found several significant differences, including the following: individuals from involved state agencies were less likely to report having had their training needs assessed; staff from accredited and involved agencies identified more gaps in selected skills; and employees of accredited agencies were more aware of quality improvement. While state employees in accredited and formally involved agencies reported less job satisfaction, there were no significant differences in intent to leave or burnout. Differences were identified concerning awareness of various public health concepts, especially among respondents in state agencies.
CONCLUSIONS
While some findings were consistent with past research (eg, link between accreditation and quality improvement), others were not (eg, job satisfaction). Several self-reported skill gaps were unanticipated, given accreditation's emphasis on training. Potentially, as staff are exposed to accreditation topics, they gain more appreciation of skills development needs. Findings suggest opportunities to strengthen workforce development components when revising accreditation measures.
Topics: Accreditation; Adult; Aged; Correlation of Data; Cross-Sectional Studies; Female; Health Workforce; Humans; Job Satisfaction; Male; Middle Aged; Multivariate Analysis; Needs Assessment; Public Health; Staff Development; Surveys and Questionnaires
PubMed: 30720624
DOI: 10.1097/PHH.0000000000000920 -
Frontiers in Public Health 2022Foundational Capabilities (FC) are the public health (PH) infrastructure areas that are essential for local health departments (LHDs) to support a "minimum package" of...
CONTEXT
Foundational Capabilities (FC) are the public health (PH) infrastructure areas that are essential for local health departments (LHDs) to support a "minimum package" of programs and services that promote population health. Despite being a critical component of LHD programs, FC are chronically underfunded, and studies specific to the relationship between LHD FC expenditures and their performance-the LHDs' ability to provide essential PH programs and services to their community-have not been previously reported. Public Health Accreditation Board (PHAB) accreditation is a nationally recognized accreditation program for PH agencies. PHAB accreditation assesses LHDs' performance against sets of standards that are based on the 10 essential PH services. Alignment between FC and the PHAB standards presents a means for assessing LHD FC expenditures relative to their performance in PHAB accreditation standards.
OBJECTIVES
We examined the association between LHD total FC expenditures, as well as FC funding allocation patterns, and performance score on selected PHAB accreditation standards.
METHODS
We used Bayesian regression methods to estimate the coefficients for the aggregate performance score, and performance scores on individual PHAB standards.
RESULTS
Analyses showed that a dollar increase in total FC expenditures is associated with a 0.2% increase in the aggregate performance score in selected PHAB standards as well as the performance score on most of the standards examined. LHDs that allocated FC budgets more evenly across FC programs were found to be more likely to have higher scores.
CONCLUSIONS
Investment in FC could improve LHD performance scores in PHAB accreditation standards and support LHDs' capability for improving community health outcomes. Allocating available FC resources across the various FC programs could support better LHD performance, as indicated by accreditation scores. This study contributes to advancing the understanding of public health finances in relation to performance and could help guide effective LHD resource allocation.
Topics: Accreditation; Bayes Theorem; Health Expenditures; Local Government; Public Health; Quality Improvement
PubMed: 35692346
DOI: 10.3389/fpubh.2022.861587 -
Chiropractic & Manual Therapies 2019The aim of this study was to report on key informant opinions of Councils on Chiropractic Education (CCE) regarding recent research findings reporting on improving...
BACKGROUND
The aim of this study was to report on key informant opinions of Councils on Chiropractic Education (CCE) regarding recent research findings reporting on improving accreditation standards and processes for chiropractic programs (CPs).
METHODS
This qualitative study employed in-depth semi-structured interviews with key experienced personnel from the five CCEs in June and July of 2018. The interviews consisted of open-ended questions on a range of issues surrounding accreditation, graduate competency standards and processes. All interviews were audio-recorded, and transcribed verbatim. The transcripts were analysed to develop codes and themes using thematic analysis techniques assisted by NVivo coding software. The study followed the COREQ guidelines for qualitative studies.
RESULTS
Six themes were isolated from the interview transcripts; they were: professional differences; keep it in the family; to focus on outcomes or be prescriptive?; more resources please; inter-profession integration; and CPs making ends meet. Most respondents saw a need for CCEs standards and processes to improve interdisciplinarity while at the same time preserving the 'uniqueness' of chiropractic. Additionally, informants viewed CCEs as carrying out their functions with limited resources while simultaneously dealing with vocal disparate interest groups. Diverse views were observed on how CCEs should go about their business of assessing chiropractic programs for accreditation and re-accreditation.
CONCLUSIONS
An overarching confounder for positive changes in CCE accreditation standards and processes is the inability to clearly define basic and fundamental terms such as 'chiropractic' and its resultant scope of practice. This is said to be because of vocal, diverse and disparate interest groups within the chiropractic profession. Silence or nebulous definitions negotiated in order to allow a diversity of chiropractic practice to co-exist, appears to have complicated and hindered the activities of CCEs. Recommendations are made including an adoption of an evidence-based approach to accreditation standards and processes and the use of expertise from other health professions. Further, the focus of attention should be moved away from professional interests and toward that of protection of the public and the patient.
Topics: Accreditation; Chiropractic; Education, Medical; Expert Testimony; Female; Humans; Male; Narration; Qualitative Research
PubMed: 31528336
DOI: 10.1186/s12998-019-0275-6 -
Journal of the American College of... Sep 2014
Topics: Accreditation; Cardiology; Fellowships and Scholarships
PubMed: 25212650
DOI: 10.1016/j.jacc.2014.07.951