Cost Of Accreditation Research Articles

The multifaceted impact of ISO/IEC 17025 accreditation: a sector-specific analysis in civil engineering testing and calibration laboratories

PurposeThis study aims to dissect the multifaceted impact of ISO/IEC 17025 accreditation, specifically within civil engineering testing and calibration laboratories. To achieve this, it intends to explore several key objectives: identifying the prominent benefits of accreditation to laboratory performance, understanding the advantages conferred through participation in proficiency testing schemes, assessing the role of accreditation in enhancing laboratory competitiveness, examining the primary challenges encountered during the accreditation process, investigating any discernible adverse effects of accreditation on laboratory performance and evaluating whether the financial cost of accreditation justifies the resultant profitability.Design/methodology/approachThis study employs a qualitative approach through semi-structured interviews with 23 industry professionals—including technical managers, quality managers, external auditors and clients. Thematic analysis, guided by Braun and Clarke’s six-stage paradigm, was utilized to interpret the data, ensuring a comprehensive understanding of the accreditation’s impact.FindingsFindings reveal that accreditation significantly enhances operational processes, fosters quality awareness and facilitates continuous improvement, contributing to greater client satisfaction. In addition, standardized operations and rigorous quality controls further result in enhanced performance metrics, such as staff capability and measurement accuracy. However, the study also uncovers the challenges of accreditation, including high resource costs and bureaucratic hurdles that can inhibit innovation and slow routine operations. Importantly, the research underscores that the impact of accreditation on profitability is not universal, but contingent upon various factors like sector-specific regulations and market demand. The study also highlights sector-specific variations in the role of accreditation as a marketing tool and differing perceptions of its value among clients. It further emphasizes the psychological stress of high-stakes evaluations during audits.Originality/valueThis study represents the first in-depth investigation into the impact of ISO/IEC 17025 accreditation on civil engineering testing and calibration laboratories, directly contributing to the enhancement of their quality and operational standards. Providing actionable insights for laboratories, it underscores the importance of weighing accreditation costs and benefits and the necessity for a tailored approach to the unique market and regulatory landscapes they operate in.

The accreditation paradigm: a comparative analysis of accreditations for management programmes

PurposeThe present paper concerns the domestic and international accreditations of business schools to find the commonalities in various accreditation standards. The study also addresses cost involvement and comparisons between various accreditations.Design/methodology/approachThe research examined the requirements, methods and preparations for many national and international accrediting authorities. The accreditation criteria, history and guidelines were collected from secondary data sources. The content analysis was used to draw conclusions about the similarities and differences between the data sources and identify any differences and similarities between various accreditations.FindingsThe study found commonalities across accreditation standards and cost analyses, helping institutions achieve suitable accreditations. To unify the administrative procedure at the institutional level and reduce duplicates for schools seeking multiple accreditations, similarities in all accreditation requirements are analysed. The comparison helps organisations determine which accreditation standard best suits their needs and goals. Schools with limited budgets might compare accreditation costs to determine which are worth pursuing.Research limitations/implicationsThis study is limited to comparing a few accreditation bodies related to management education. In future research, the study may be extended to other areas. The use of the approach developed in this study for evaluating accreditation agencies of different streams, such as engineering, science and medicine, will be the study's future implications.Practical implicationsThe research indicates that schools can streamline accreditation by identifying commonalities, aligning procedures, comparing standards and conducting cost assessments. These insights aid efficient accreditation and inform accrediting bodies' framework enhancements. Standards facilitate global performance comparisons.Originality/valueThis is likely the first study to compare Indian and international accreditations using the accreditation frameworks and cost analyses using comparative analysis. The study recommends strategies for achieving academic benchmarks through continuous improvement activities and success in international competition.

Exploring Motivations and Barriers To Accreditation Adoption Among Physician Assistant and Nurse Practitioner Emergency Medicine and Orthopedic Surgery Residency and Fellowship Programs.

Althoughthere has beenarapidincrease in thenumber of physician assistant(PA) and nurse practitioner postgraduate residency/fellowship specialty training programs in the United States, voluntary accreditation of these programs is a relativelynew phenomenon. There is little research examiningwhich factors may be predictorsof accreditation adoption among PA and nurse practitioner (NP) postgraduate programs. Therefore, the primary aim of this study was to investigatewhich motivating factors influencepostgraduate programs choiceon whether to pursue accreditation. Methodology A descriptive cross-sectional survey consisting of 10 questions was distributed to 56 postgraduate emergency medicine and orthopedic surgery PA, NP, and joint PA/NP residency/fellowship programs via email between November2022and February2023. Descriptive statistics were performed. Results Nineteen postgraduate programs responded to the survey. Two programs submitted incomplete surveys where less than 50% of the total items were completed. The partially completed surveys were omitted from the data analysis. The final response rate was 30% (17/56). Among the responded programs, 47% (8/17) offer dual PA and NP training, and 53% (9/17) are PA only. Although 88% (15/17) of postgraduate programs have discussed accreditation funding with their sponsoring institution only 76% are planning to do so or are in the process of pursuing accreditation. The two most commonreasons for pursuing accreditation are program validation and assessment of educational quality 59% (10/17) and competition for applicants 24% (4/17). However, Magnet hospital designation, requirement of the sponsoring institution, or demand from employers were notdeterminingfactors of whether to pursue accreditation or not. Reasons for not pursuing accreditation includedhigh costs of accreditation 18% (3/17), lack of perceived value of accreditation 6% (1/17), and lack of protected time to pursue accreditation 6% (1/17). Conclusion Although literature is still lacking on the effectiveness and impact of PA and NP postgraduate program accreditation, the findings of this rare study indicate that postgraduate programs are motivated to pursue accreditation. It is important for accreditors to communicate the utility of program-level accreditation and other value-added benefits to programs and their sponsoring institutions. Further work is necessary to better understand the value of external validation, specific drivers for validation, and barriers that influence accreditation adoption among these postgraduate programs.

The financialization of medical laboratories in France: what are the risks for the profession and public health?

Medical laboratories in France have always adapted to technical and medical progress, as well as to the regulations imposed by the supervisory authorities. However, over the last ten years, this evolution has been so important that biologists are witnessing a revolution in their mode of practice. The supervisory authorities wanted to increase and harmonize the quality of laboratory results. But the new legislation, sometimes misused, as well as the fear and the cost of accreditation, are at the origin of the excessive acceleration of the financialization of medical biology laboratories. We will see how the hegemony of financial groups can be detrimental to the quality of service provided to patients and to the independence of the medical biologist.

The Innovation and the Transformation of Indonesian Schools Accreditation Management System

All schools at the primary and secondary education levels in Indonesia must be accredited. An independent body called the National Accreditation Board for Schools/Madrasah (BAN-S/M) as an external quality assurance agency, accredits schools throughout Indonesia. Since 2005, the percentage of schools accredited in levels A and B has always increased from year to year based on the accreditation results. However, the improvement of school quality based on accreditation did not strongly correlate with the national exam and PISA results. This article discusses the facts of the experience of implementing accreditation for 15 years which became the basis for accreditation reform in Indonesia. BAN-S/M started the reformation in 2020 with three fundamental changes. First, the change in the accreditation instrument from compliance-based to performance-based. Second, the recruitment of new assessors based on cognitive competence and personality. Third, the changes of the accreditation business process through the dashboard monitoring system that will select schools with automatic accreditation extensions without visitation and schools that assessors must visit. implementation of Innovation and accreditation management reform can reduce accreditation costs by more than 60% and is expected to increase the accuracy of school quality assessment results. The findings strengthen the current transformation to the new, more efficient, rational accreditiation management system for schools/madrasah.

The Scientific Preparation for Athletics Competition: It’s Personal and Social Impacts to The Masters Athletes in Asia

The research highlights the value and impact of a Philippines' state university accreditation and its quest for quality and excellence in education. The study assessed internal efficiency improvement in the university's vision, mission goals, objectives, faculty, curriculum and instruction, support to students, research, extension and community involvement, library, physical plant and facilities, and laboratories and administration. Accreditation reshaped the university's internal efficiency operation in ten areas. As a result, the university has undergone several transformations through AACCUP's accreditation of programs. Innumerable changes in its structure, policies, and operations have given way to an ambiance of novelty and innovation. The study also included the financial cost of accreditation. Though there are financial constraints towards this endeavor, the prestige and benefits it brings to the university far outweigh sacrifices and costs. Likewise, the faculty and student respondents revealed that accreditation was advantageous and contributory in upgrading university status. The accreditation task is daunting, but the reward is gratifying for the students and staff. The successful breakthroughs of the higher education institution, to a considerable extent, are attributed and a result of continuous accreditation. References AACCUP Accreditor’s Guide AACCUP Revised Instrument (2014), AACCUP Inc. and CA Mega Print Kis, V. (2005, August). Quality assurance in tertiary education: Current practices in OECD countries and a literature review on potential effects. OECD Thematic Review of Tertiary Education. Retrieved from http://www.oecd.org/education/skills-beyond-school/38006910.pdf DBM-CHED Joint Circular No 1 s.2016 - FY 2016 Levelling Instrument for SUCs and Guidelines For the Implementation There of Effective practices in accreditation: A guide for faculty (2015). Eaton, J.S. (2003, May). The Value of Accreditation: Four Pivotal Roles. Washington, DC Council for Higher Education Accreditation Eaton, J.S. (2010). Accreditation and the Federal Future of Higher Education. Academe, 96 (5), 35-37. Retrieved from http://www.jstor.org/stable/257998818 Harvey, L. (2004). The power of accreditation: Views of academics. Journal of Higher Education Policy Management, 26(2). Hamdatu, M.M. (2013, April). Application of quality assurance & accreditation in the institutes of higher education in the Arab world (descriptive & analytical survey). American Journal of Contemporary Research, 3(4). Hou, A.Y. (2012, May 26). Mutual recognition of quality assurance decisions on higher education institutes in three regions: A lesson for Asia. Higher Education, 64. Rahnuma, N. (2020). Evolution of quality culture in an HEI: Critical insights from university staff in Bangladesh. Educational Assessment, Evaluation and Accountability, 32. Retrieved from https://link.springer.com/article/10.1007/s11092-019-09313-8 Varonis, E.M. (2014). Most courses are not born digital: An overview of the Quality Matters peer review process for online course design. Campus-Wide Information Systems, 31(4). Vlasceanu, L., Grunberg, L., and Parlea, D. (2007). Quality assurance and accreditation: A glossary of basic terms and definitions. Bucharest: UNESCO. Yuhertiana, I., Rochmoeljati, Dwiridotjahjono, J., Putra, P., Wibawani, S. (2020, January 1). The impact of Indonesia new higher education accreditation criteria implementation. Journal of Critical Reviews, 7(3).

Patients experience more support, information and involvement after first-time hospital accreditation: a before and after study in the Faroe Islands.

The impact of hospital accreditation on the experiences of patients remains a weak point in quality improvement research. This is surprising given the time and cost of accreditation and the fact that patient experiences influence outcomes. We investigated the impact of first-time hospital accreditation on patients' experience of support from health-care professionals, information and involvement in decisions. We aimed to examine the association between first-time hospital accreditation and patient experiences. We conducted a longitudinal study in the three Faroese hospitals that, unlike hospitals on the Danish mainland and elsewhere internationally, had no prior exposure to systematic quality improvement. The hospitals were accredited in 2017 according to a modified second version of the Danish Healthcare Quality program. Study participants were 18 years or older and hospitalized for at least 24 h in 2016 before or 2018 after accreditation. We administered the National Danish Survey of Patient Experiences for acute and scheduled hospitalization. Patients rated their experiences of support, information and involvement in decision-making on a 5-point Likert scale. We calculated individual and grouped mean item scores, the percentages of scores ≥4, the mean score difference, the relative risk (RR) for high/very high scores (≥4) using Poisson regression and the risk difference. Patient experience ratings were compared using mixed effects linear regression. In total, 400 patients before and 400 after accreditation completed the survey. After accreditation patients reported increased support from health professionals; adjusted mean score difference (adj. mean diff.)= 1.99 (95% confidence interval (CI): 1.89, 2.10), feeling better informed before and during the hospitalization; adj. mean diff.= 1.14 (95% CI: 1.07; 1.20) and more involved in decision-making; adj. mean diff.= 1.79 (95% CI: 1.76; 1.82). Additionally, the RR for a high/very high score (≥4) was significantly greater on 15 of the 16 questionnaire items. The greatest RR for a high/very high score (≥4) after accreditation, was found for the item 'Have you had a dialogue with the staff about the advantages and disadvantages of the examination/treatment options available?'; RR= 5.73 (95% CI: 4.51, 7.27). Hospitalized patients experienced significantly more support from health professionals, information and involvement in decision-making after accreditation. Future research on accreditation should include the patients' perspective.

Does quality matter in determining child care prices? Evidence from private child care provision in Turkey

Child care prices are expected to reflect the quality of provision. However, in contexts where there are high information asymmetries between the users of the services and providers, we may expect this link between quality and prices to be weaker. Turkey is selected for the study as it has a highly regulated child care sector where the costs of accreditation and initial setup are high. However, there is very little on-going supervision and no information provided to users on the quality or ranking of these services. This paper investigates the role of quality in determining private child care prices using a unique provider-level data set collected in five provinces of Turkey. Regression results show that prices are mainly driven by infrastructure quality while human resources and curriculum and materials quality scores that are more likely to have a strong bearing on child development do not have a significant impact on prices.

The American Board of Medical Specialties: Certification and the Need for Antitrust Enforcement

Certification functions as medicine’s gatekeeper. Certifying organizations ensure that their physicians meet the appropriate professional standards. Traditionally, numerous organizations have provided certification services, which often involve costly testing and exams. Competition among these organizations drove innovation and lowered healthcare costs. The domination of the American Board of Medical Specialists (ABMS) over certification is dramatically raising certification costs and indirectly accreditation costs throughout medicine, decreasing access to physicians, increasing already exploding medical budgets, and reducing healthcare innovation. Leveraging its dominant market position in certification, ABMS and its member boards are now extracting even more revenue from physicians by requiring not simply periodic recertification exams to maintain board membership but continuous participation in maintenance of certification (MOC) programs. ABMS’ growing power is spreading beyond certification. Its influence has appeared to lead to hospitals only granting privileges to, and even insurance companies only reimbursing, ABMS-certified physicians. State boards of medicine, under ABMS’ sway, are adopting policies only favoring ABMS-certified physicians. Cementing the ABMS-monopoly will only drive up healthcare costs, as physicians pass on the cost of their certification testing to patients and the government. The number of physicians will also decline, exacerbating access problems particularly in rural America.

Institutional accreditation by nursing education and training quality assurance: Perspectives of heads of private nursing institutions in South Africa

Background and objective: Nursing education throughout the world is striving for international competitiveness and accountability for effectiveness, quality, and trust to the students, patients, and the community, thus making the issue of institutional accreditation increasingly important. The aim of this paper was to explore the perceptions of heads of private nursing institutions on the benefits of school accreditation by nursing education and training quality assurance (ETQA) in KwaZulu-Natal region, South Africa.Methods: The study adopted a qualitative approach. Data were collected from seven heads of private nursing institutions. In-depth interviews were used to explore the perceived benefits of the accreditation of nursing institutions by Nursing ETQA. Thematic content analysis was used in this study to analyse the collected data. The study adhered to all ethical principles.Results: The findings from this study revealed that heads of private nursing institutions perceived the accreditation by nursing ETQA as a tool used to promote quality outcomes in nursing education. Results from this study further revealed that accreditation is a mechanism of ensuring high standards of performance, and it increases trust, confidence, and reinforcement of uniformity across the nursing education sector. In this study, several challenges were reported to hinder the accreditation process including as a disjoint and an inconsistent process of accreditation, unclear criteria for accreditation, the high cost of accreditation, accreditation being detrimental to teaching the outcome, lack of uniformity in the recommendations; and a lengthy process of accreditation.Conclusions: Accreditation is an important tool to ensure that programs and degrees meet the highest standards of education. In nursing education, the accreditation process is associated with several challenges, and there is a need for collaborative and well-coordinated accreditation of nursing schools nationally and globally.

ISO/IEC 17025: custos de acreditação em uma universidade pública brasileira

A norma ISO/IEC 17025 é um padrão de qualidade internacional que especifica os requisitos gerais para a competência de laboratórios de ensaio e calibração. Esta norma traz diversos benefícios a laboratórios ligados a instituições de ensino superior, o que tem feito estes, no Brasil, buscarem a acreditação. Todavia, entre as dificuldades encontradas neste tipo de projeto, está o custo envolvido, tema pouco explorado pela literatura. Considerando-se que a Universidade Federal de Santa Maria (UFSM) apoia seus laboratórios na implantação desta norma, objetivou-se neste artigo identificar e quantificar os custos de acreditação nos laboratórios da UFSM, acreditados ou que trabalham em um projeto para acreditação. Assim, realizou-se um levantamento/survey nestes laboratórios com objetivo exploratório e analisaram-se os dados obtidos quantitativa e qualitativamente. Observou-se que custos relacionados com horas de trabalho estão ligados à qualificação dos colaboradores, e que altas despesas em equipamentos e infraestrutura ocorrem em laboratórios com recursos financeiros externos.

Comparative Analysis of Job Stress, Job Satisfaction and the Effects of Medical Services among Hospital Employees According to the Hospital Accreditation System

The purpose of this study was to examine the impact of the hospital accreditation system on the stress and job satisfaction of hospital employees and the effects of their medical services. The subjects in this study were 300 employees of four selected hospitals who were doctors, nurses, medical technicians and the administrative staff. Out of the selected hospitals, four hospitals were accredited, and four werent. The employees of the accredited hospitals expressed higher job satisfaction, and the effects of their medical services were better. Hospital accreditation exerted statistically significant positive influences on the two variables, and there were no significant differences in job stress. Thus, the members of the accredited hospitals were more satisfied, and higher satisfaction had a bigger impact on the effects of medical services. Basically, the hospital accreditation system is not mandatory, but this study found that the system produced good effects. Accordingly, it seems required to consider how to encourage medical institutions to take part in the accreditation system in order to vitalize it. For instance, a differentiated medical fee schedule should be applied if a hospital is accredited, or the cost of accreditation should be subsidized.

Professional Bodies and Quality Assurance of Higher Education Programmes in South Africa: Towards an Appropriate Framework

Collaboration between universities and professional bodies is neither new nor unique to South Africa. It occurs in many higher education systems and revolves around the role that professional bodies play in the quality assurance and accreditation of the relevant higher education programmes. In South Africa, this relationship has become increasingly problematic over the recent past due to a number of factors. This article begins by exploring those factors before highlighting the legal framework governing the role of professional bodies in University programmes. A critique of the said role is then undertaken against the backdrop of views and opinions from academics involved in professional programmes in some South African universities, including the thorny issue of who should meet the costs of accreditation. The article concludes with suggestions on the principles that should underpin a revised framework, under the custodianship of the Council on Higher Education, to govern the relationship between universities and professional bodies.

Counting the costs of accreditation in acute care: an activity-based costing approach

ObjectivesTo assess the costs of hospital accreditation in Australia.DesignMixed methods design incorporating: stakeholder analysis; survey design and implementation; activity-based costs analysis; and expert panel review.SettingAcute care hospitals accredited by the...

The impact of AACSB accreditation on the autonomy and costs of limited resource institutions whose missions are primarily teaching

Purpose – The purpose of this paper is to evaluate the impact of AACSB accreditation on the autonomy and costs of limited resource institutions whose missions are primarily teaching. Design/methodology/approach – To evaluate the research questions, a content analysis of all publications in the EBSCO Business Source Premier Database for the period January 1, 1990 through December 15, 2012 was conducted. Findings – The findings indicate that in the process of becoming AACSB accredited, faculty members of the subject institutions shift their focus more toward research and less toward teaching activities, and that the institutions become less autonomous and more like their benchmark AACSB institutions. In addition, the costs of AACSB accreditation are likely to be significant for the subject institutions. Research limitations/implications – The findings of the study point to the need for additional theoretical and empirical research related to the research questions. First, there is a need to formulate a conceptual framework for clearly identifying and measuring the implicit and explicit costs, including all of the opportunity costs, associated with accreditation. In addition, there is a compelling need to develop a conceptual framework and measurement system that will allow business schools to better assess their quality and productivity. For limited resource institutions whose missions are primarily teaching this system should comport with the schools’ teaching missions. Practical implications – The findings suggest that the subject institutions seeking AACSB accreditation should carefully consider a number of questions before pursing accreditation. First, is the institution's mission congruent with AACSB standards or will its mission have to be changed? If AACSB accreditation is deemed to be appropriate, how will the associated changes in resource needs and resource allocation serve to further the institution's mission? And, what are the incremental costs of accreditation, and does the institution have the resource base to sustain accreditation? Originality/value – The study is the first to conduct a detailed content analysis to evaluate some of the costs and benefits of AACSB accreditation for limited resource institutions whose missions are primarily teaching.

Healthcare accreditation systems: further perspectives on performance measures

The purpose of this paper is to identify and suggest a number of performance measures to facilitate the evaluation of accreditation programs in healthcare. The paper is based on an exploratory research which has used qualitative methods, including snowball sampling technique, email interview and thematic content analysis. Respondents (experts and professionals) were selected from a diverse spectrum ranging from healthcare organizations, universities and accreditation-associated institutions. The analysis of the data provided key measures to be considered in the evaluation of accreditation programs' impact at macro and micro levels as well as their nature and operations. The measures can be used to, for example, assess the degree of stakeholders' reliance on accreditation results, measure the cost of accreditation for participating organizations and serve as a formal mechanism for accredited organizations to appeal accreditation decisions. This paper has brought together a number of generic, yet influential and workable, measures which could be utilized for assessing the overall performance of an accreditation program in healthcare. The application of these measures depends on the features of given accreditation program and the context in which the program operates. Therefore, the next step/steps in the assessment of an accreditation program might be choosing the measures suiting that program.

Impact of Accreditation on the Quality of Healthcare Services: a Systematic Review of the Literature

BACKGROUND AND OBJECTIVE:Accreditation is usually a voluntary program in which trained external peer reviewers evaluate a healthcare organization's compliance and compare it with pre-established performance standards. The aim of this study was to evaluate the impact of accreditation programs on the quality of healthcare servicesMETHODS:We did a systematic review of the literature to evaluate the impact of accreditation programs on the quality of healthcare services. Several databases were systematically searched, including Medline, Embase, Healthstar, and Cinhal.RESULTS:Twenty-six studies evaluating the impact of accreditation were identified. The majority of the studies showed general accreditation for acute myocardial infarction (AMI), trauma, ambulatory surgical care, infection control and pain management; and subspecialty accreditation programs to significantly improve the process of care provided by healthcare services by improving the structure and organization of healthcare facilities. Several studies showed that general accreditation programs significantly improve clinical outcomes and the quality of care of these clinical conditions and showed a significant positive impact of subspecialty accreditation programs in improving clinical outcomes in different subspecialties, including sleep medicine, chest pain management and trauma management.CONCLUSIONS:There is consistent evidence that shows that accreditation programs improve the process of care provided by healthcare services. There is considerable evidence to show that accreditation programs improve clinical outcomes of a wide spectrum of clinical conditions. Accreditation programs should be supported as a tool to improve the quality of healthcare services.

The Cost of Accreditation: Hillsdale Ends Its Teacher Certification Program

The Cost of Accreditation: Hillsdale Ends Its Teacher Certification Program

ACCREDITATION AND ACCOUNTABILITY: IS THE CART BEFORE THE HORSE?

As the authors of “Accountability: The Fast Lane on the Highway to Change”1 point out, public health accreditation appears to be similar to a train with a strong head of steam. The train's destination of improving population health by improving public health management is laudable. The arguments behind holding local public health departments accountable with accreditation are that it will improve population health, that marginal benefits outweigh marginal costs, and that undesirable unintended consequences can be mitigated. The causal mechanism is that accountability will result in better performance of the essential health services, which will result in improved population health.2,3 Because the accreditation standards focus on the essential services functions rather than on content, such as Healthy People 2010, the accreditation effect presumably occurs in 2 ways: (1) accreditation makes resource acquisition for population health improvement easier because it legitimizes local health departments,1 and (2) accreditation leads to better management, which improves population health. Adel Hanna of Framingham (left) and Herman Cohen of Boston (right) join a group of protestors outside of the statehouse in Boston, Massachusetts, on October 3, 1989. The noon rally was a protest against the proposed repeal of the state's Universal Health Plan. Photograph by Julia Malakie. Printed with permission of AP Photo. Although anecdotal evidence of improvement suggests that accreditation can work, is it sufficient as an evidence-based approach? As the anecdote of food safety in Mississippi County, Missouri, suggests, public health is improved by implementing programs in specific content areas such as food safety. In contrast to the anecdotal evidence, the accreditation standards have an emphasis on functions rather than content; it is reasonable to argue that this emphasis may be harmful to achieving accreditation goals. While the difficulty with specifying accreditation standards in terms of content is understandable,4 has the pendulum swung too far toward functions? There are at least 6 reasons why the current approach to accreditation may be more harmful than helpful: (1) functionality is emphasized over content; (2) accreditation does not have a strong evidence base; (3) accreditation costs outweigh its benefits; (4) accreditation may have unintended consequences; (5) accreditation weakly acknowledges the contribution of related health professionals; and (6) accreditation may not fit local health department economics. (The e-note at http://www.ajph.org/cgi/eletters/99/9/1545 more fully develops these arguments.) Because of the potential harmful effects of accreditation, it may be wise to approach it in a more deliberate fashion that addresses potential difficulties. We hope this letter will help spark a broader debate about accreditation that will result in an improved accreditation process, one that has a greater promise for improving population health.

The impact of accreditation on small colleges

AbstractSmall colleges' accreditation costs may be proportionately higher than those of larger institutions; however, accreditation benefits can be substantially greater as well.