Abstract
BackgroundPractice accreditation is a widely used method to assess and improve the quality of healthcare services. In the Netherlands, a practice accreditation program was implemented in primary medical care. We aimed to identify determinants of impact of a practice accreditation program, building on the experiences of primary care professionals who had participated in this program.MethodsAn interview study was done to document the experiences of 33 participating primary care professionals and used to identify determinants of outcomes. The Consolidated Framework for Implementation Research (CFIR) was used as framework for the qualitative analysis.ResultsAfter analyzing 23 interviews saturation was reached. The practice accreditation program is based on structured quality improvement, but only some of its elements were identified as determinants of impact. Factors that were perceived to facilitate implementation of the program were: designating one person responsible for the program, ensuring clear lines of communication within the whole practice team and having affinity with or stimulate enthusiasm for improving quality of care. Contextual factors such as participation in a care group and being connected to the GP educational institute were important for actual change. The accreditation program was perceived to have positive effects on team climate and commitment to quality of care in the practice team. The perception was that patient care was not directly influenced by the accreditation program. Receiving a certificate for completing the accreditation program seemed to have little added value to participants.ConclusionsPractice accreditation may have positive outcomes on quality of care, but not all planned elements may contribute to its outcomes. Both factors in the accreditation process and in the context were perceived as determinants of quality improvement. The challenge is to build on facilitating factors, while reducing the elements of accreditation that do not contribute to its impact.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-015-0294-x) contains supplementary material, which is available to authorized users.
Highlights
Practice accreditation is a widely used method to assess and improve the quality of healthcare services
The program was initiated by Nouwens et al BMC Family Practice (2015) 16:78 the Dutch College of General Practitioners (DCGP) and is delivered by an independent organization (Netherlands Institute for Accreditation in Healthcare, NPA)
Previous research with respect to the Dutch practice accreditation program showed that general practitioners (GPs) were willing to assess their practice in order to improve the quality of care
Summary
Practice accreditation is a widely used method to assess and improve the quality of healthcare services. Accreditation and certification are widely used methods to assess and improve healthcare services. In the Netherlands, primary care practice accreditation is a voluntary activity comprising a comprehensive audit, which covers clinical and organizational domains, followed by structured planning of improvements and formal review by an external assessor [3]. The program was initiated by Nouwens et al BMC Family Practice (2015) 16:78 the Dutch College of General Practitioners (DCGP) and is delivered by an independent organization (Netherlands Institute for Accreditation in Healthcare, NPA). Previous research with respect to the Dutch practice accreditation program showed that general practitioners (GPs) were willing to assess their practice in order to improve the quality of care. The practice accreditation program is used to obtain understanding of the practice organization in order to enhance the quality of care in the practice [7]
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