Abstract
BackgroundAccreditation is a widespread tool for quality management in health care. However, there is lack of research on the impact of accreditation, particularly in general practice. This study explores how general practitioners and their staff experienced the impact of a mandatory accreditation program in Denmark.MethodsQualitative interviews with general practitioners and staff from 11 clinics. The respondents were interviewed twice: during preparation and after the survey visit. The interviews were analyzed using thematic analysis, and all specific changes and other types of impact were extracted from the transcribed interview data from each clinic.ResultsThe impact of accreditation varied markedly among the clinics as did the participants’ overall assessments of accreditation. Concerning specific changes in behavior and physical infrastructure, some clinics had only implemented a few minor changes in response to accreditation, some had made a relatively moderate number of changes, and a few clinics had made relatively many changes including a few pronounced ones. Further, some participants experienced that accreditation had enhanced knowledge sharing or upgraded competencies, and increased job satisfaction. However, the workload related to accreditation was emphasized as a problem by a majority of the professionals and for a few, accreditation had influenced job satisfaction negatively.ConclusionAccreditation may affect general practice clinics in very different ways. In spite of several examples of positive impact, the results suggest that it is difficult to design a mandatory accreditation program for general practice in which most professionals experience that the benefits of accreditation equal the resources used in the process.
Highlights
Accreditation is a widespread tool for quality management in health care
The experiences of the impact of accreditation in the 11 clinics could be divided into four different areas of impact: 1) Behavior and physical infrastructure, i.e. the specific changes implemented in the clinics in response to accreditation; 2) Knowledge and competencies; 3) Resources; 4) Job satisfaction
The clinics interpreted the standards in different ways and their decisions were influenced by their overall approach to accreditation, i.e. a positive occasion for change vs. a bureaucratic task that had to be completed with as little effort as possible as well as by their different expectations about what would be sufficient to achieve accreditation
Summary
There is lack of research on the impact of accreditation, in general practice. Accreditation is a process in which an accreditation agency conducts a systematic assessment of an organization based on a set of quality standards. This usually involves a formal survey visit at the organisation after which the accreditation agency makes a decision on the granting of accreditation status to the organisation. There is a pronounced lack of empirical research on the implementation and impact of accreditation [3] and the sparse
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