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BMC Health Services Research Jul 2020The aim of this study was to present challenges of implementing the accreditation model in university and military hospitals in Iran.
BACKGROUND
The aim of this study was to present challenges of implementing the accreditation model in university and military hospitals in Iran.
METHODS
In this qualitative study, purposive sampling was used to select hospital managers and implementers of the model working in 3 hospitals affiliated to Kerman University of Medical Sciences and in 3 military hospitals in Kerman, Iran. A total of 39 participants were interviewed, and semi-structured questionnaires and thematic analysis were used for data collection and analysis, respectively.
RESULTS
In this study, 5 major codes and 17 subcodes were identified: (1) perspectives on accreditation model with 5 subcodes: a difficult and time-consuming model, less attention to the patient, accreditation as a way of money acquisition, not being cost-effective, and accreditation means incorrect documentation; (2) absence of appropriate executive policy, with 3 subcodes: lack of financial funds and personnel, disregarding local conditions in implementation and evaluation, and absence of the principle of unity of command; (3) training problems of the accreditation model, with 2 subcodes: absence of proper training and incoordination of training and evaluation; (4) human resources problems, with 3 subcodes: no profit for nonphysician personnel, heavy workload of the personnel, and physicians' nonparticipation; (5) evaluation problems, with 4 subcodes: no precise and comprehensive evaluation, inconformity of authorities' perspectives on evaluation, considerable change in evaluation criteria, and excessive reliance on certificates.
CONCLUSIONS
This study provided useful data on the challenges of implementing hospitals' accreditation, which can be used by health policymakers to revise and modify accreditation procedures in Iran and other countries with similar conditions. The accreditation model is comprehensive and has been implemented to improve the quality of services and patients' safety. The basic philosophy of hospital accreditation did not fully comply with the underlying conditions of the hospitals. The hospital staff considered accreditation as the ultimate goal rather than a means for achieving quality of service. The Ministry of Health and Medical Education performed accreditation hastily for all Iranian hospitals, while the hospitals were not prepared and equipped to implement the accreditation model.
Topics: Accreditation; Hospitals, Military; Hospitals, University; Humans; Iran; Patient Safety; Qualitative Research; Surveys and Questionnaires
PubMed: 32727444
DOI: 10.1186/s12913-020-05536-4 -
International Journal of Occupational... Jul 2016Hospital accreditation can be an incentive to improve occupational health and safety (OHS) performance.
INTRODUCTION
Hospital accreditation can be an incentive to improve occupational health and safety (OHS) performance.
OBJECTIVE
This study assesses the relationship between status of accreditation among private Lebanese hospitals and compliance with OHS accreditation standards.
METHODS
A survey was administered to 68 private Lebanese hospitals to assess accreditation status and specific indicators related to each of the 9 OHS codes in the Lebanese accreditation manual. Chi-square, Fisher's exact test, and independent sample t-tests compared the OHS standards between accredited and non-accredited hospitals.
RESULTS
Fifty-six percent of participating private hospitals were accredited. Accredited hospitals reported statistically better OHS performance than non-accredited hospitals based on the standards outlined in the accreditation manual. However, there was inconsistent performance on numerous OHS indicators among participating hospitals.
CONCLUSION
The gaps in OHS performance suggest the need for strengthened OHS guidelines in the national accreditation process to safeguard workers' health. Strategies to fortify OHS performance include tying service reimbursement to OHS compliance and linking OHS standards with national labor legislation.
Topics: Accreditation; Guideline Adherence; Hospitals, Private; Humans; Lebanon; Occupational Health
PubMed: 27398975
DOI: 10.1080/10773525.2016.1200211 -
Human Resources For Health Sep 2021The World Health Organization's Global Strategy on Human Resources for Health (HRH) emphasizes the importance of dynamic and effective health worker regulation for...
BACKGROUND
The World Health Organization's Global Strategy on Human Resources for Health (HRH) emphasizes the importance of dynamic and effective health worker regulation for achieving the health-related Sustainable Development Goals, with the establishment of education standards and quality assurance of education programs being critical. Governments in West Africa have struggled to address the problems within their higher education systems for health professionals, and it is now generally acknowledged that private institutions can play a crucial role in revitalizing the region's outdated universities. However, the rapid expansion of private schools raises concerns about the quality of education and adequacy of regulatory mechanisms. The USAID-funded Mali HRH Strengthening Activity, led by IntraHealth International, assisted Mali's Ministry of Health and Social Development to deliver targeted HRH interventions to improve the quality of education in private universities, better manage available health workers, and initiate a decentralized strategy for health worker recruitment and motivation.
CASE PRESENTATION
In 2018, the HRH activity leveraged the West African Health Organization (WAHO)'s accreditation system to support 10 private nursing schools to introduce WAHO's regionally accepted, competency-based curriculum in reproductive, maternal, newborn, and child health. The project undertook a 10-step process to work alongside private nursing and midwifery schools to assess their current status against WAHO regional standards, implement action plans to address identified gaps, and support the institutions toward accreditation. As a result, eight schools in Mali are now accredited compared to only three at project inception.
CONCLUSIONS
This case study underscores the importance of private school accreditation in Mali to improve the quality of health worker training through a standardized local curriculum. By supporting existing regulatory bodies that oversee accreditation, local capacity for initial accreditation of private nursing schools has been increased. Engaging universities in a partnership that shows the benefits of accreditation while maintaining a focus on the need to protect communities is critical to success. If the global community is to meet the WHO's predicted health worker shortfall, then private education providers will need to be part of the solution. Robust and engaging health worker education accreditation systems are an essential part of that future.
Topics: Accreditation; Child; Curriculum; Female; Humans; Infant, Newborn; Mali; Midwifery; Pregnancy; Schools, Nursing
PubMed: 34583729
DOI: 10.1186/s12960-021-00654-4 -
The Journal of the American Osteopathic... Apr 2018The transition period for the single accreditation system for graduate medical education under the Accreditation Council for Graduate Medical Education (ACGME) began on...
CONTEXT
The transition period for the single accreditation system for graduate medical education under the Accreditation Council for Graduate Medical Education (ACGME) began on July 1, 2015, and will end June 30, 2020. As of February 5, 2018, 82.6% of residency programs accredited by the American Osteopathic Association (AOA) have applied for or achieved ACGME accreditation and 160 programs have applied for or achieved osteopathic recognition.
OBJECTIVE
To assess baseline attitudes of osteopathic and allopathic faculty and residents in AOA-accredited and dually accredited residency programs regarding the value of osteopathic-focused educational curricula and mentors.
METHODS
A survey was emailed to 60 program directors of AOA-accredited programs and dually accredited residency programs, some of which had obtained ACGME osteopathic recognition. The survey was to be completed by residents and faculty. Items were formulated to obtain baseline measurements regarding the level of awareness of osteopathic principles and practice (OPP), attitudes regarding osteopathic culture, and the weighted importance of aspects of the osteopathic curriculum. Principal components analysis with Varimax rotation was used. Comparison analysis was accomplished by either independent t tests for subscale scores or Mann-Whitney U tests for item-level scores.
RESULTS
A total of 327 people responded to the survey (115 faculty members, 211 residents, and 1 no response). Of the 60 program directors contacted, 53 replied with at least 1 program representative. One hundred twenty-nine of all 211 residents (61.7%), including 107 of 134 osteopathic family medicine residents (79.9%), agreed that they intended to use OMT when in practice. The curricular component item with the lowest total survey score, indicating the highest-ranked level of importance, was the ability to work with osteopathic faculty (mean [SD], 1.98 [0.98]). Of the items measuring osteopathic awareness, statements with the strongest level of agreement from all respondents were "I have seen OMT performed on a patient or a peer" and "I am familiar with the basic tenets of OPP."
CONCLUSION
Residents in AOA-accredited programs value osteopathic mentors and OMT, and they generally intend to use OMT when in practice. Respondents from programs with osteopathic recognition had more favorable attitudes toward osteopathic culture and curriculum than did respondents from programs without osteopathic recognition.
Topics: Accreditation; Attitude of Health Personnel; Faculty, Medical; Female; Humans; Internship and Residency; Male; Manipulation, Osteopathic; Osteopathic Medicine; Osteopathic Physicians; Surveys and Questionnaires; United States
PubMed: 29582060
DOI: 10.7556/jaoa.2018.050 -
Bulletin of the World Health... Jun 2022While the regulatory framework for medical education in Egypt has rapidly evolved, the progress of developing a system for continuing professional development has been...
While the regulatory framework for medical education in Egypt has rapidly evolved, the progress of developing a system for continuing professional development has been slow. In 2018 the government approved legislation establishing a regulatory authority for continuing professional development and added expectations for continuing professional development as a condition of relicensure for physicians in Egypt. The new authority has deployed a provider-accreditation model that sets criteria for educational quality, learning outcomes, independence from industry, and tracking of learners. Only accredited providers can submit continuing professional development accredited activities. Despite regulatory and administrative support there have been several barriers to the implementation of the system including limited availability of funding, lack of suitable training venues and equipment for hands-on training, and resistance from the profession. As of March 2022, 112 continuing professional development providers have achieved accreditation, and deployed 154 accredited continuing professional development activities. The majority of accredited providers were medical associations (64%) and higher education institutions (18%), followed by medical foundations and nongovernmental organizations (13%) and health-care facilities (5%). One electronic learning platform has been accredited. Any entity with commercial interests cannot be accredited as a continuing professional development provider. Funding of continuing professional development activities can be derived from provider budgets, programme registration fees or appropriate sponsors. Funding from industry is limited to unrestricted educational grants. The foundations for an effective continuing professional development system have been established in Egypt with the aim of achieving international recognition.
Topics: Accreditation; Education, Medical, Continuing; Egypt; Humans; Industry; Learning
PubMed: 35694624
DOI: 10.2471/BLT.22.287963 -
Quality & Safety in Health Care Apr 2005To examine the association between accreditation scores and the disclosure of accreditation reports.
OBJECTIVE
To examine the association between accreditation scores and the disclosure of accreditation reports.
DESIGN
A cross sectional study.
SETTING
Hospitals participating in an accreditation programme in Japan.
PARTICIPANTS
547 of the 817 hospitals accredited by the Japan Council for Quality Health Care (JCQHC) by January 2003.
MAIN OUTCOME MEASURES
Data on participation in public disclosure of accreditation reports through the JCQHC website were obtained from the JCQHC database. Comments on the disclosure were obtained using a questionnaire based survey.
RESULTS
A total of 508 (93%) of the participating hospitals disclosed their accreditation reports on the JCQHC website. Public hospitals were significantly more committed to public disclosure than private hospitals, and larger hospitals were significantly more likely to participate in public disclosure than smaller hospitals. Accreditation scores were positively related to the public disclosure of hospital accreditation reports. Scores for patient focused care and efforts to meet community needs were significantly higher in actively disclosing hospitals than in non-disclosing hospitals. Among the large hospitals, scores for safety management were significantly higher in hospitals advocating disclosure than in non-disclosing hospitals.
CONCLUSIONS
There was a positive correlation between accreditation scores and public disclosure. Our results suggest that the public disclosure of accreditation reports should be encouraged to improve public accountability and the quality of care. Future studies should investigate the interaction between public disclosure, processes and outcomes.
Topics: Accreditation; Benchmarking; Consumer Behavior; Cross-Sectional Studies; Health Care Surveys; Hospitals; Hospitals, Private; Hospitals, Public; Humans; Information Dissemination; Japan; Quality Assurance, Health Care; Quality Indicators, Health Care; Social Responsibility; Surveys and Questionnaires
PubMed: 15805452
DOI: 10.1136/qshc.2004.010629 -
Journal of Public Health Management and... 2017A national system of voluntary public health accreditation for state, local, and tribal health departments (local health departments [LHDs]) is part of a movement that...
CONTEXT
A national system of voluntary public health accreditation for state, local, and tribal health departments (local health departments [LHDs]) is part of a movement that aims to improve public health performance with ultimate impact on population health outcomes. Indiana is a good setting for the study of LHD accreditation adoption because several LHDs reported de-adopting accreditation in a recent statewide survey and because 71% of Indiana counties serve populations of 50 000 or less.
DESIGN
A systematic method of analyzing qualitative data based on the Performance Improvement Model framework to expand our understanding of de-adoption of public health accreditation.
SETTING/PARTICIPANTS
In 2015, we conducted a key informant interview study of the 3 LHDs that decided to delay their engagement in the accreditation based on findings from an Indiana survey on LHD accreditation adoption. The study is an exploration of LHD accreditation de-adoption and of the contributions made to its understanding by the Performance Improvement Model.
RESULT
The study found that top management team members are those who champion accreditation adoption, and that organizational structure and culture facilitate the staff's embracing of the change. The Performance Improvement Model was found to enhance the elucidation of the inner domain elements of Consolidated Framework for Implementation Research in the context of de-adoption of public health accreditation.
CONCLUSION
Governing entities' policies and priorities appear to mediate whether the LHDs are able to continue accreditation pursuit. Lacking any of these driving forces appears to be associated with decisions to de-adoption of accreditation. Further work is necessary to discern specific elements mediating decisions to pursue accreditation. This study demonstrates the added knowledge of Performance Improvement Model (PIM) to the CFIR framework. A large scale study is called to further clarify and discern supports of specific to the needs of individual LHDs for their performance improvement effort.
Topics: Accreditation; Humans; Indiana; Local Government; Public Health; Public Health Administration; Qualitative Research; Quality Improvement; Surveys and Questionnaires
PubMed: 28492448
DOI: 10.1097/PHH.0000000000000567 -
American Journal of Medical Quality :...The number of master's degree programs in healthcare quality and safety (HQS) has increased significantly over the past decade. Academic accreditation provides assurance...
The number of master's degree programs in healthcare quality and safety (HQS) has increased significantly over the past decade. Academic accreditation provides assurance that educational programs are of a high quality and meet the needs of students, employers, and the general public. Under the guidance of the Commission on Accreditation of Healthcare Management Education, faculty from 9 universities collaborated in the development of criteria and related content domains to be used in the accreditation of graduate programs in HQS. Thirteen content domains were identified. Four of the content domains, safety and error science, improvement science and quality principles, evidence-based practice, and measurement and process improvement are thought to be foundational domains for graduate education in HQS. This article describes the development of the content domains and accompanying standards for accreditation of graduate programs in HQS.
Topics: Accreditation; Curriculum; Education, Graduate; Humans; Quality of Health Care; Universities
PubMed: 34714779
DOI: 10.1097/JMQ.0000000000000021 -
Globalization and Health Sep 2014The growth of accreditation programs in low- and middle-income countries (LMICs) provides important examples of innovations in leadership, governance and mission which...
The growth of accreditation programs in low- and middle-income countries (LMICs) provides important examples of innovations in leadership, governance and mission which could be adopted in developed countries. While these accreditation programs in LMICs follow the basic structure and process of accreditation systems in the developed world, with written standards and an evaluation by independent surveyors, they differ in important ways. Their focus is primarily on improving overall care country-wide while supporting the weakest facilities. In the developed world accreditation efforts tend to focus on identifying the best institutions as those are typically the only ones who can meet stringent and difficult evaluative criteria. The Joint Learning Network for Universal Health Coverage (JLN), is an initiative launched in 2010 that enables policymakers aiming for UHC to learn from each other's successes and failures. The JLN is primarily comprised of countries in the midst of implementing complex health financing reforms that involve an independent purchasing agency that buys care from a mix of public and private providers [Lancet 380: 933-943, 2012]. One of the concerns for participating countries has been how to preserve or improve quality during rapid expansion in coverage. Accreditation is one important mechanism available to countries to preserve or improve quality that is in common use in many LMICs today. This paper describes the results of a meeting of the JLN countries held in Bangkok in April of 2013, at which the current state of accreditation programs was discussed. During that meeting, a number of innovative approaches to accreditation in LMICs were identified, many of which, if adopted more broadly, might enhance health care quality and patient safety in the developed world.
Topics: Accreditation; Developing Countries; Hospitals; Humans; Quality Improvement
PubMed: 25185526
DOI: 10.1186/s12992-014-0065-9 -
Israel Journal of Health Policy Research Apr 2019Pervasive disparities exist in the treatment of pain and anxiety in pediatric patients presenting to hospitals with emergency conditions. This finding has been...
Pervasive disparities exist in the treatment of pain and anxiety in pediatric patients presenting to hospitals with emergency conditions. This finding has been demonstrated worldwide, and is especially exacerbated in general emergency departments, which treat both adults and children. Policies to promote appropriate analgesia in the context of pediatric emergency care have been developed by several professional societies and governmental agencies in the United States; however, progress has been uneven, and data regarding these questions is lacking.In their excellent article, Capua and her co-authors address this precise problem through a unique methodology, by surveying nurse directors of both pediatric accredited and non-accredited emergency departments. Survey questions focused on availability of pharmacological and non-pharmacological modalities, and on the prevalence with which providers administered both oral and parenteral medications. The results demonstrated widespread availability of evidence based analgesic and anxiolytic treatment, ranging from medical clowns and specific holding positions, to use of intravenous opiates and conscious sedation. No significant differences were found associated with accreditation.These results are surprising and seem to call into question the value of pediatric accreditation. However, an alternative hypothesis would be that accreditation has succeeded, and the results reflect a large spillover effect, in which providers trained in accredited institutions bring these advanced practices to their local departments. Regionalization has been promoted for emergency care of many acute conditions such as trauma, stroke, and myocardial infarction. These results suggest that for pediatric emergencies, at least in regard to analgesia, the answer likely lies in dissemination of knowledge, rather than super specialization. In other words, bring the expertise to the children, not the children to the experts. Further research in this area could focus on optimal ways to achieve such knowledge translation.
Topics: Accreditation; Female; Humans; Male; Pain Management; Pediatrics; Quality of Health Care; Surveys and Questionnaires
PubMed: 30961654
DOI: 10.1186/s13584-019-0305-9