The impact of accreditation of primary healthcare centers: successes, challenges and policy implications as perceived by healthcare providers and directors in Lebanon.

Fadi El-Jardali,Reem Mdeihly,Lucie Sagherian,Nour Ataya,Randa Hemadeh,Maha Jaafar,Ranime El-Skaff,Diana Jamal

doi:10.1186/1472-6963-14-86

Fadi El-Jardali, Reem Mdeihly + Show 6 more

Open Access

https://doi.org/10.1186/1472-6963-14-86

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Abstract

BackgroundIn 2009, the Lebanese Ministry of Public Health (MOPH) launched the Primary Healthcare (PHC) accreditation program to improve quality across the continuum of care. The MOPH, with the support of Accreditation Canada, conducted the accreditation survey in 25 PHC centers in 2012. This paper aims to gain a better understanding of the impact of accreditation on quality of care as perceived by PHC staff members and directors; how accreditation affected staff and patient satisfaction; key enablers, challenges and strategies to improve implementation of accreditation in PHC.MethodsThe study was conducted in 25 PHC centers using a cross-sectional mixed methods approach; all staff members were surveyed using a self-administered questionnaire whereas semi-structured interviews were conducted with directors.ResultsThe scales measuring Management and Leadership had the highest mean score followed by Accreditation Impact, Human Resource Utilization, and Customer Satisfaction. Regression analysis showed that Strategic Quality Planning, Customer Satisfaction and Staff Involvement were associated with a perception of higher Quality Results. Directors emphasized the benefits of accreditation with regards to documentation, reinforcement of quality standards, strengthened relationships between PHC centers and multiple stakeholders and improved staff and patient satisfaction. Challenges encountered included limited financial resources, poor infrastructure, and staff shortages.ConclusionsTo better respond to population health needs, accreditation is an important first step towards improving the quality of PHC delivery arrangement system. While there is a need to expand the implementation of accreditation to cover all PHC centers in Lebanon, considerations should be given to strengthening their financial arrangements as well.

Highlights

In 2009, the Lebanese Ministry of Public Health (MOPH) launched the Primary Healthcare (PHC) accreditation program to improve quality across the continuum of care
Quantitative results Twenty-three PHC centers out of the 25 centers participated in the quantitative component of the study
Of the 403 questionnaires that were distributed to the 23 PHC centers, 307 were returned complete (Table 1)

Summary

Introduction

In 2009, the Lebanese Ministry of Public Health (MOPH) launched the Primary Healthcare (PHC) accreditation program to improve quality across the continuum of care. Despite its routine use in the work course of most hospitals worldwide, accreditation has only recently has been introduced into the PHC setting in highincome countries (HICs) [7]. This recent emphasis on accreditation in PHC organizations came with the shift in healthcare policy from hospitals towards preventive and primary healthcare delivery services [8]. Accreditation of PHC practices was reported to increase emphasis on the role of PHC within the healthcare system and to ensure quality control and improvement [9]. The literature review showed that PHC accreditation results in improved teamwork, improved access to care, increased awareness of patient safety, improved practice systems and care processes and improved quality of care [10]

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