Abstract

To evaluate whether accredited health organizations perform better management practices than non-accredited ones. The study was developed in two stages: a literature review, and a study of multiple cases in 12 healthcare organizations in the state of São Paulo, Brazil. It surveyed articles comparing hospital accreditation with the EFQM (European Foundation for Quality Management) model of excellence in management. According to the pertinent literature, the accreditation model and the EFQM model are convergent and supplementary in some aspects. With 99% confidence, one can say that there is evidence that accredited organizations scored better in the evaluation based on the EFQM model in comparison to non-accredited organizations. This result was also confirmed in the comparison of results between the categories Facilitators and Results in the EFQM model. There is convergence between the accreditation model and the EFQM excellence model, suggesting that accreditation helps the healthcare sector to implement the best management practices already used by other business sectors. Avaliar se as organizações de saúde acreditadas possuem melhores práticas de gestão do que as não acreditadas. A pesquisa foi dividida em duas etapas: revisão da literatura e estudo de casos múltiplos com 12 organizações de saúde, localizadas no estado de São Paulo ‒ Brasil. Foram pesquisados artigos que comparavam a acreditação hospitalar com o modelo de excelência em gestão da EFQM (European Foundation for Quality Management), sendo que a literatura pertinente considera que o modelo de acreditação e o modelo da EFQM são convergentes e, ao mesmo tempo, complementares em determinados aspectos. Com 99% de confiança, pode-se afirmar que há evidência de que as organizações com acreditação obtiveram uma pontuação maior na avaliação baseada no modelo EFQM comparativamente às organizações não acreditadas. Este resultado também se confirmou na comparação dos resultados das categorias Facilitadores e Resultados do modelo EFQM. Há uma convergência entre o modelo de acreditação e o modelo de excelência da EFQM, sugerindo que a acreditação contribui para o setor de saúde implementar as melhores práticas de gestão já difundidas em outros setores de negócio.

Highlights

  • The need to implement quality control and management standards in healthcare services has significantly increased in the last decades, and has become an important aspect of organizations working in this segment

  • Healthcare organizations can use a wide range of quality programs, such as: structured method to improve processes (PDCA, 8D, 5S, 3R); accreditation (ONA, JCI, Council on Healthcare Services Accreditation (CCHSA), National Integrated Accreditation for Healthcare Organizations (NIAHO)); organizational excellence models (PNGS, the Malcolm Baldrige National Quality Award, the European Foundation for Quality Management [EFQM]); and the International Organization for Standardization (ISO) rules (ISO 9001:2008; ISO 14000; ISO 26000), among others

  • Less than 5% of hospitals have some kind of accreditation, and most of these are accredited by the ONA national program, despite other international accreditations in Brazilian www.ee.usp.br/reeusp health organizations such as: JCI; the Canadian Council on Healthcare Services Accreditation (CCHSA); and National Integrated Accreditation for Healthcare Organizations (NIAHO)

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Summary

Introduction

The need to implement quality control and management standards in healthcare services has significantly increased in the last decades, and has become an important aspect of organizations working in this segment. Organizations have faced increasing demands in terms of compliance with existing laws, proper cost management, and the satisfaction of the services’ users. An external quality mechanism can be defined as a regional or national process voluntarily created by services providing organizations to improve the organization and delivery of health care considering standards developed by teams moderated by a non-partisan authority involving users, providers, purchasers, and government[1]. The bill does not define the evaluation process to be adopted, but assumes the existence of a quality system involving the adoption of standards for operational procedures, technical quality, and management and humanized service[3]

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