Program Accreditation, Innovation, or Both? – The Interdependencies in Specialized Cancer Care

Abstract

Objective To understand (a) the determinants of hospitals’ decisions to seek program accreditation and pursue innovation activities in specialized cancer care, (b) whether accreditation and innovation activities help hospitals reach their strategic goals, and (c) how program accreditation and innovation activities influence one another. Data Sources Semi-structured, in-depth interviews with hospital physicians and quality managers (n=25). Study Design Comparative case study of hospitals that provide specialized cancer care in Germany (n=19). Data Collection/ Extraction methods Inductive grounded theory approach and coding of interview transcripts across multiple waves to develop a conceptual model of the relationship between program accreditation and innovation activities, including determinants of both measures at the environmental and organizational levels. Principal Findings The hospitals in our sample engaged in program accreditation and innovation activities in order to achieve quality and financial goals. However, the strategic focus varied across different hospital types. For smaller hospitals, such accreditation was a necessary condition to be able to compete in competitive market environments. Regardless of competition, smaller hospitals benefitted from a positive effect of accreditation on incremental process and product innovation. For larger hospitals, obtaining accreditation was a necessary condition to acquire additional funding, but the influence on innovation activities was limited because these were generally already being pursued with high intensity. Conclusions Seeking program accreditation and pursuing innovation activities are not contradictory strategies for hospitals. Ideally, both can be aligned in such a way that the quality and financial performance outcomes achieved are superior to those that would be possible were only one of these strategies to be pursued or to predominate. Hospital decision-makers must align both activities while taking account of costs and benefits. Policy makers can support access to high quality care by setting incentives for hospitals to acquire accreditation.