The effect of certification and accreditation on quality management in 4 clinical services in 73 European hospitals
Shaw, Charles D. (University of New South Wales)
Groene, Oliver (London School of Hygiene and Tropical Medicine)
Botje, Daan (Netherlands Institute for Health Services Research (NIVEL))
Suñol Sala, Rosa (Universitat Autònoma de Barcelona. Institut Universitari Avedis Donabedian)
Kutryba, Basia (Polish Society for Quality Promotion in Healthcare)
Klazinga, Niek (University of Amsterdam. Department of Public Health, Academic Medical Center)
Bruneau, Charles (Haut Autorité de Santé)
Hammer, A (Institute for Medical Sociology. Health Services Research and Rehabilitation Science. Faculty of Human Science and Faculty of Medicine. University of Cologne)
Wang, Aolin (University of Edinburgh)
Arah, Onyebuchi A.. (University of Edinburgh)
Wagner, Cordula (Department of Public and Occupational Health. EMGO Institute for Health and Care Research. VU University Medical Center)
Kringos, D.S. (University of Amsterdam. Academic Medical Centre-AMC)
Lombarts, K. (University of Amsterdam. Academic Medical Centre-AMC)
Plochg, T. (University of Amsterdam. Academic Medical Centre-AMC)
Lopez, M. A. (Universitat Autònoma de Barcelona. Institut Universitari Avedis Donabedian)
Secanell, M. (Universitat Autònoma de Barcelona. Institut Universitari Avedis Donabedian)
Vallejo, P. (Universitat Autònoma de Barcelona. Institut Universitari Avedis Donabedian)
Bartels, Paul (Central Denmark Region. The Department of Clinical Medicine. Aalborg University)
Kristensen, S. (Central Denmark Region. Center for Healthcare Improvements. Aalborg University)
Michel, P. (Comité de la Coordination de l'Evaluation Clinique et de la Qualité en Aquitaine)
Saillour-Glenisson, F. (Comité de la Coordination de l'Evaluation Clinique et de la Qualité en Aquitaine)
Vlcek, F. (Czech Accreditation Committee)
Car, M. (Dr Foster Intelligence-DFI)
Jones, S. (Dr Foster Intelligence-DFI)
Klaus, E. (Dr Foster Intelligence-DFI)
Garel, Pascal (European Hospital and Healthcare Federation-HOPE)
Hanslik, K. (European Hospital and Healthcare Federation-HOPE)
Saluvan, M. (Hacettepe University)
Depaigne-Loth, A. (Haute Autorité de la Santé-HAS)
Shaw, C. (Independent Consultant)
Ommen, O. (Institute for Medical Sociology. Health Services Research and Rehabilitation Science. University of Cologne-IMVR)
Pfaff, H. (Institute for Medical Sociology. Health Services Research and Rehabilitation Science. University of Cologne-IMVR)
Kutaj-Wasikowska, H. (Polish Society for Quality Promotion in Health Care-TPJ)
Escoval, Ana (Portuguese Association for Hospital Development-APDH)
Franca, M. (Portuguese Society for Quality in Health Care-SPQS)
Almeman, F. (Turkish Society for Quality Management in Healthcare-SKID)
Kus, H. (Turkish Society for Quality Management in Healthcare-SKID)
Ozturk, K. (Turkish Society for Quality Management in Healthcare-SKID)
Mannion, Russell (University of Birmingham)
Chow, A. (Palo Alto Medical Foundation Research Institute)
Dersarkissian, Maral (Palo Alto Medical Foundation Research Institute)
Thompson, C. (Palo Alto Medical Foundation Research Institute)
Thompson, A. (University of Edinburgh)

Date:	2014
Abstract:	Objective: To investigate the relationship between ISO 9001 certification, healthcare accreditation and quality management in European hospitals. Design: A mixed method multi-level cross-sectional design in seven countries. External teams assessed clinical services on the use of quality management systems, illustrated by four clinical pathways. Setting and Participants: Seventy-three acute care hospitals with a total of 291 services managing acute myocardial infarction (AMI), hip fracture, stroke and obstetric deliveries, in Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey. Main Outcome Measure: Four composite measures of quality and safety [specialized expertise and responsibility (SER), evidence-based organization of pathways (EBOP), patient safety strategies (PSS) and clinical review (CR)] applied to four pathways. Results: Accreditation in isolation showed benefits in AMI and stroke more than in deliveries and hip fracture; the greatest significant association was with CR in stroke. Certification in isolation showed little benefit in AMI but had more positive association with the other conditions; greatest significant association was in PSS with stroke. The combination of accreditation and certification showed least benefit in EBOP, but significant benefits in SER (AMI), in PSS (AMI, hip fracture and stroke) and in CR (AMI and stroke). Conclusions: Accreditation and certification are positively associated with clinical leadership, systems for patient safety and clinical review, but not with clinical practice. Both systems promote structures and processes, which support patient safety and clinical organization but have limited effect on the delivery of evidence-based patient care. Further analysis of DUQuE data will explore the association of certification and accreditation with clinical outcomes.
Grants:	European Commission 241822 European Commission 24188
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	International journal for quality in health care, Vol. 26 (2014) , p. 100-107, ISSN 1464-3677

DOI: 10.1093/intqhc/mzu023
PMID: 24257160
PMID: 24615598

8 p, 157.7 KB

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