Abstract
BackgroundThis study aimed to examine managers’ attitudes towards and use of a mandatory accreditation program in Denmark, the Danish Healthcare Quality Program (Den Danske Kvalitetsmodel [DDKM]) after it was terminated in 2015.MethodsWe designed a nationwide cross-sectional online survey of all senior and middle managers in the 31 somatic and psychiatric public hospitals in Denmark. We elicited managers’ attitudes towards and use of DDKM as a management using 5-point Likert scales. Regression analysis examined differences in responses by age, years in current position, and management level.ResultsThe response rate was 49% with 533 of 1095 managers participating. Overall, managers’ perceptions of accreditation were favorable, highlighting key findings about some of the strengths of accreditation. DDKM was found most useful for standardizing processes, improving patient safety, and clarifying responsibility in the organization. Managers were most negative about DDKM’s ability to improve their hospitals’ financial performance, reshape the work environment, and support the function of clinical teams. Results were generally consistent across age and management level; however, managers with greater years of experience in their position had more favorable attitudes, and there was some variation in attitudes towards and use of DDKM between regions.ConclusionFuture attention should be paid to attitudes towards accreditation. Positive attitudes and the effective use of accreditation as a management tool can support the implementation of accreditation, the development of standards, overcoming disagreements and boundaries and improving future quality programs.
Highlights
This study aimed to examine managers’ attitudes towards and use of a mandatory accreditation program in Denmark, the Danish Healthcare Quality Program (Den Danske Kvalitetsmodel [DDKM]) after it was terminated in 2015
Previous research on managers outside of the Danish context has found mixed results, with some studies identifying their negative views of accreditation, [14] and others positive views [16]
Accreditation was found most useful in standardizing processes, improving patient safety and clarifying responsibilities in the organization, yet it did not improve the work environment, support the function of teams or improve the financial performance of their hospital
Summary
This study aimed to examine managers’ attitudes towards and use of a mandatory accreditation program in Denmark, the Danish Healthcare Quality Program (Den Danske Kvalitetsmodel [DDKM]) after it was terminated in 2015. Previous research found that some staff value accreditation for creating organizational foundations for future quality improvement initiatives, [12] and for enhancing quality and organizational performance, while others perceived it as not worthwhile for patient care, and as bureaucratic and time-consuming [7, 11]. Such attitudes vary by the type of staff member (e.g., doctors, nurses, managers), accreditation programs, and the context in which it is implemented [11]. Previous research on managers outside of the Danish context has found mixed results, with some studies identifying their negative views of accreditation (e.g., little benefit compared with time and cost), [14] and others positive views (e.g., promoting quality, good practices and uniting staff, [15] legitimizing their right to intervene in patient care) [16]
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