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SHORT COMMUNICATION
Year : 2015  |  Volume : 2  |  Issue : 1  |  Page : 27-29

Facilitating accreditation of health care establishments: A holistic tool for ensuring benefits to employers, employee and patients


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India

Date of Web Publication29-Nov-2014

Correspondence Address:
Saurabh RamBihariLal Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2148-7731.145824

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  Abstract 

The World Health Organization (WHO) has revealed that a persistent rise has been seen in most of the infectious diseases, non-communicable diseases (NCD), and nutritional disorders, especially in developing countries. Owing to the impending globalization, developments in the health care delivery system, and rising level of awareness among the people, maintaining a sustained level of quality of care which is accessible and available to all is of prime importance. Accreditation is described as a systematic process by which a recognized body, assesses and recognizes that a health care organization meets predetermined standards. Multiple benefits have been documented secondary to the accreditation of a hospital or a health care establishment. To conclude, accreditation is an international phenomenon and thus should be designed, regulated, and monitored properly to ensure expansion of the health sector and delivery of quality assured health care services to all.

Keywords: Accreditation, healthcare, hospital, medical tourism, quality


How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Facilitating accreditation of health care establishments: A holistic tool for ensuring benefits to employers, employee and patients . Sifa Med J 2015;2:27-9

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Facilitating accreditation of health care establishments: A holistic tool for ensuring benefits to employers, employee and patients . Sifa Med J [serial online] 2015 [cited 2019 Aug 24];2:27-9. Available from: http://www.imjsu.org/text.asp?2015/2/1/27/145824


  Introduction Top


The World Health Organization (WHO) has revealed that a persistent rise has been seen in most of the infectious diseases, non-communicable diseases (NCD), and nutritional disorders, especially in developing countries. [1],[2] Owing to the impending globalization, developments in the health care delivery system, and rising level of awareness among the people, maintaining a sustained level of quality of care which is accessible and available to all is of prime importance. [1] Over the years, assessment of health care services by an external agency, in order to deliver quality-assured care, has become a crucial area of health sector reform globally. [3]


  Accreditation and its Objectives Top


Accreditation is described as a systematic process by which a recognized body, assesses and recognizes that a health care organization meets predetermined standards. [3] It is a voluntary process which involves interaction with external inspectors to attain desired quality improvements. [4] The accreditation process is undertaken to achieve a set of objectives, namely ensuring improvement in the quality of care available in hospitals and medical laboratories; stimulating the integration and management of health services; reducing the health care costs by focusing on increased efficiency and effectiveness of services; sensitizing health care organizations/managers/health professionals regarding quality improvement strategies and "best practices" in health care; strengthening the public's confidence in the quality of health care and minimizing the risks associated with injury and infections for patients and staff; and establishing a comparative database of health care organizations able to meet selected structure, process and outcome standards. [3],[5]

Elements of an accreditation procedure

Although multiple external agencies are involved in providing accreditation to health care institutions, they usually have common elements in a typical accreditation procedure such as setting and publication of standards by a recognized body; application by the health care institution for registration; payment of the due fees; pre-survey activities; survey by the multidisciplinary team of accreditation body; re-survey, if the institution is found deficient in some areas of delivery of care; issuing accreditation report/award of accreditation; and resurvey after a fixed period. [3],[6]

Assessed domains

An accreditation decision about a health care institute is achieved following an on-site assessment by a team of experts regularly. [6] This assessment is done with the help of multiple approaches such as conducting interviews of the top level administrators of the organization/clinicians and support staff/patients and their family members; observing patient care and services; undertaking comprehensive inspection of the infrastructure; supervising written documents such as policies and procedures, training documents, financial documents and quality assurance plans; evaluating specific outcome measures (viz. immunization rates, hospital acquired infection rates, patient satisfaction, etc.); and assessing patients' medical records. [7],[8]

Advantages of accreditation to the hospital, employees and patients

Multiple benefits have been documented secondary to the accreditation of a hospital or a health care establishment like a medical college. These benefits have been classified into benefits to the hospital (viz. improvement in the delivery of medical care, enhancement in the image of the hospital, facilitates continuous improvement in delivery of medical care); [6],[8] benefits for the employees (viz. aids in education, training and development of professional staff, provides leadership for quality improvement within medical profession and nursing, increases satisfaction of employees with working conditions, augments employee safety and security, and promotes team work); [9],[10],[11] and benefits for the patients (viz. provides access to organizations providing quality medical care so that people can make informed decisions, patient's rights are respected and protected, augments family-centred care, and improves patient safety). [12],[13],[14] These advantages can be achieved secondary to careful planning, organizational commitment, and strong government support. [3]

Future challenges

Although multiple advantages have been observed of accreditation, a wide range of challenges such as increase in competitive rivalry amongst the health care organizations (viz. increasing acquisition of high cost and advanced technology to ensure the implementation of accreditation standards); [3] technological boom and haphazard mushrooming of equipment industries; [15] boost for the medical tourism industry; [16] issues pertaining to accreditation of miscellaneous health care organizations; disease-specific care institutes; organizations providing alternative form of health care; [10],[17] rising trend for insurance agencies to empanel the hospitals which are accredited; [6] escalation of the cost for health care during the process of accreditation; [18] no provisions for people who cannot afford services in accredited hospitals; [19] and augmentation in the incidence of medical trade [6],[18] have been observed.

Proposed solutions

In response to the identified challenges, it is imperative on the part of policy makers to work out some regulatory mechanism so that all unethical practices can be averted. These mechanisms should encompass regulation of accreditation bodies; [3] streamlining the entire process of accreditation; [6],[20] facilitating accreditation of equipment agencies to discourage mushrooming of substandard technology; [15] implementing steps to ensure not a significant hike in the cost of health care services-by promoting public-private partnership schemes or by ensuring subsidy for the people from the poor class; [3],[15] and by supervising the medical trade so that the image of health care sector is not tarnished. [16],[18] In addition, research work should also be promoted to assess the validity, impact and value of accreditation processes in health care. [3],[6]


  Conclusion Top


To conclude, accreditation is an international phenomenon and thus should be designed, regulated and monitored properly to ensure expansion of the health sector and delivery of quality assured health care services to all.



 
  References Top

1.
World Health Organization. World health Statistics 2013. . Geneva: WHO press.  Back to cited text no. 1
    
2.
Shrivastava SR, Shrivastava PS, Ramasamy J. Implementation of public health practices in tribal populations of India - challenges & remedies. Healthc Low-resource Settings 2013;1:e3.  Back to cited text no. 2
    
3.
World Health Organization. Quality and accreditation in health care services: A global review. Geneva: WHO press; 2003.  Back to cited text no. 3
    
4.
McLees AW, Thomas CW, Nawaz S, Young AC, Rider N, Davis M. Advances in public health accreditation readiness and quality improvement: Evaluation findings from the national public health improvement initiative. J Public Health Manag Pract 2014;20:29-35.  Back to cited text no. 4
    
5.
Guerin S, Le Pogam MA, Robillard B, Le Vaillant M, Lucet B, Gardel C, et al. Can we simplify the hospital accreditation process? Predicting accreditation decisions from a reduced dataset of focus priority standards and quality indicators: Results of predictive modelling. BMJ Open 2013;3:e003289.  Back to cited text no. 5
    
6.
Dastur FD. Hospital accreditation: A certificate of proficiency for healthcare institutions. J Assoc Physicians India 2012;60:12-3.  Back to cited text no. 6
    
7.
Bukonda N, Tavrow P, Abdallah H, Hoffner K, Tembo J. Implementing a national hospital accreditation program: The Zambian experience. Int J Qual Health Care 2002;14:7-16.  Back to cited text no. 7
    
8.
Wung CH. The reform of the hospital accreditation system in Taiwan. World Hosp Health Serv 2008;44:14-5.  Back to cited text no. 8
[PUBMED]    
9.
Rabarison K, Ingram RC, Holsinger JW Jr. Application of situational leadership to the national voluntary public health accreditation process. Front Public Health 2013;1:26.  Back to cited text no. 9
[PUBMED]    
10.
Sekimoto M, Imanaka Y, Kobayashi H, Okubo T, Kizu J, Kobuse H, et al.; Japan Council for Quality Health Care, Expert Group on Healthcare-Associated Infection Control and Prevention. Impact of hospital accreditation on infection control programs in teaching hospitals in Japan. Am J Infect Control 2008;36:212-9.   Back to cited text no. 10
    
11.
Manzo BF, Brito MJ, Correa Ados R. Implications of hospital accreditation on the everyday lives of healthcare professionals. Rev Esc Enferm USP 2012;46:388-94.  Back to cited text no. 11
    
12.
Sack C, Scherag A, Lutkes P, Gunther W, Jockel KH, Holtmann G. Is there an association between hospital accreditation and patient satisfaction with hospital care? A survey of 37,000 patients treated by 73 hospitals. Int J Qual Health Care 2011;23:278-83.  Back to cited text no. 12
    
13.
Dror Y. Promoting quality and patient safety via the new integrated hospital accreditation programme. World Hosp Health Serv 2010;46:41-3.  Back to cited text no. 13
[PUBMED]    
14.
El-Jardali F, Jamal D, Dimassi H, Ammar W, Tchaghchaghian V. The impact of hospital accreditation on quality of care: Perception of Lebanese nurses. Int J Qual Health Care 2008;20:363-71.   Back to cited text no. 14
    
15.
Thielen L, Leff M, Corso L, Monteiro E, Fisher JS, Pearsol J. A study of incentives to support and promote public health accreditation. J Public Health Manag Pract 2014;20:98-103.  Back to cited text no. 15
    
16.
Woodhead A. Scoping medical tourism and international hospital accreditation growth. Int J Health Care Qual Assur 2013;26:688-702.  Back to cited text no. 16
[PUBMED]    
17.
Brodribb W, Kruske S, Miller YD. Baby-friendly hospital accreditation, in-hospital care practices, and breastfeeding. Pediatrics 2013;131:685-92.   Back to cited text no. 17
    
18.
Ammar W, Khalife J, El-Jardali F, Romanos J, Harb H, Hamadeh G, et al. Hospital accreditation, reimbursement and case mix: Links and insights for contractual systems. BMC Health Serv Res 2013;13:505.   Back to cited text no. 18
    
19.
Stiefel RH. Analysis: New hospital accreditation agency falls short. Biomed Instrum Technol 2010;44:328-30.   Back to cited text no. 19
[PUBMED]    
20.
Manzo BF, Brito MJ, Alves M. Influence of communication in the hospital accreditation process. Rev Bras Enferm 2013;66:46-51.  Back to cited text no. 20
    



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