A focused ethnography in the context of a European cancer research hospital accreditation program

Elisa Mazzini,Giorgio Mazzi,Lucia Genovese,Luca Ghirotto,Loredana Cerullo,Francesco Soncini,Giovanni Apolone,Massimo Costantini

doi:10.1186/s12913-021-06466-5

Abstract

BackgroundA quality accreditation program (AP) is designed to guarantee predefined quality standards of healthcare organizations. Evidence of the impact of quality standards remains scarce and somewhat challenging to document. This study aimed to investigate the accreditation of a cancer research hospital (Italy), promoted by the Organization of European Cancer Institutes (OECI), by focusing on the individual, group, and organizational experiences resulting from the OECI AP.MethodsA focused ethnography study was carried out to analyze the relevance of participation in the accreditation process. Twenty-nine key informants were involved in four focus group meetings, and twelve semistructured interviews were conducted with professionals and managers. Inductive qualitative content analysis was applied to examine all transcripts.ResultsFour main categories emerged: a) OECI AP as an opportunity to foster diversity within professional roles; b) OECI AP as a possibility for change; c) perceived barriers; and d) OECI AP-solicited expectations.ConclusionsThe accreditation process is an opportunity for improving the quality and variety of care services for cancer patients through promoting an interdisciplinary approach to care provision. Perceiving accreditation as an opportunity is a prerequisite for overcoming the barriers that professionals involved in the process may report. Critical to a positive change is sharing the values and the framework, which are at the basis of accreditation programs. Improving the information-sharing process among managers and professionals may limit the risk of unmet expectations and prevent demotivation by future accreditation programs. Finally, we found that positive changes are more likely to happen when an accreditation process is considered an activity whose results depend on managers’ and professionals’ joint work.

Highlights

A quality accreditation program (AP) is designed to guarantee predefined quality standards of healthcare organizations
We identified four groups of Healthcare Professionals (HP): one group of researchers and methodologists, one of HPs involved in multidisciplinary clinical pathways, one of the patients’ association members and information and communication technology (ICT) managers, and one of HPs secondarily involved in the accreditation process
The final sample consisted of 41 HPs, and 29 participated in four Focus Group (FG) meetings

Summary

Introduction

A quality accreditation program (AP) is designed to guarantee predefined quality standards of healthcare organizations. Evidence of the impact of quality standards remains scarce and somewhat challenging to document. While the AP as a quality initiative has increasingly been considered the preferred method to promote healthcare advances [3], evidence about APs and their induced changes is scarce, as they are difficult to document [4, 5]. Both the accreditation process [6] and the impact of implementing accreditation standards [1] need further research [6]. Policymakers may find it helpful to understand from the stakeholders’ point of view the change that the AP may promote along with the ability of an organization and its HPs to follow, resist to or even remove that change [8,9,10,11]

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