Health Care Accreditation Standards Research Articles

The Effect of Applying Health Care Accreditation Standards on Achieving Service Quality at University Hospitals

The Effect of Applying Health Care Accreditation Standards on Achieving Service Quality at University Hospitals

Primary healthcare accreditation standards: a systematic review

PurposeAccreditation is an essential component in primary healthcare (PHC) systems. The purpose of this paper is to investigate the most suitable PHC accreditation models and standards, worldwide, and to prepare a comprehensive and unbiased summary from research on these models.Design/methodology/approachA systematic search was undertaken using Web of Science, Scopus, Science Direct, Springer, PubMed and ProQuest databases in August 2016 and updated in January 2018. English language studies addressing PHC accreditation standards and models, published between 1995 and January 2018, were included, resulting in 9051 citations. After excluding duplicates and irrelevant studies, 19 were included in the final review. Two independent reviewers critically appraised the studies. Consequently, accreditation standards in the models were extracted and compared.FindingsResults indicate that USA, Australia, Canada, UK and New Zealand (non-eastern Mediterranean regions (EMR)) and Jordan, Saudi Arabia, Lebanon and Egypt (EMR) had well-developed and high-quality PHC accreditation models. The Jordanian, Egyptian and Saudi models had the highest diversity in their PHC standards domains. Community-oriented care, safe care, high-quality care, care continuity and human resource management had the highest priority among PHC accreditation programs.Originality/valueThe authors provide PHC accreditation benchmarks and determine high priority practical domains in accreditation standards. The findings should help health system managers and policymakers design new PHC accreditation programs and promote PHC service quality.

Fall prevention strategy in an emergency department

PurposeThe purpose of this paper is to document the need for implementing a fall prevention strategy in an emergency department (ED). The paper also spells out the research process that led to approving an assessment tool for use in hospital outpatient services.Design/methodology/approachThe fall risk assessment tool was based on the Morse Fall Scale. Gender mix and age above 65 and 80 years were assessed on six risk assessment variables using χ2 analyses. A logistic regression analysis and model were used to test predictor strength and relationships among variables.FindingsIn total, 5,371 (56.5 percent) geriatric outpatients were deemed to be at fall risk during the study. Women have a higher falls incidence in young and old age categories. Being on medications for patients above 80 years exposed both genders to equal fall risks. Regression analysis explained 73-98 percent of the variance in the six-variable tool.Originality/valueCanadian quality and safe healthcare accreditation standards require that hospital staff develop and adhere to fall prevention policies. Anticipated physiological falls can be prevented by healthcare interventions, particularly with older people known to bear higher risk factors. An aging population is increasing healthcare volumes and medical challenges. Precautionary measures for patients with a vulnerable cognitive and physical status are essential for quality care.

The process of development of accreditation standards for medical organizations in Kazakhstan

Quality in healthcare is known to be one of the significant areas. Healthcare accreditation standards are dedicated to improve clinical practice and organizational performance. Therefore, standard development, review and approval processes play crucial role in healthcare accreditation. Different accreditation systems exist to monitor the quality of medical services provided. Kazakhstan has its own National accreditation system. The Ministry of Health of the Republic of Kazakhstan (MoH) is the only authorized body for national accreditation, as well as it assigns the Republican center for Healthcare Development (RCHD) as responsible organization for healthcare development. Accreditation Center of RCHD is one of the key organs that develops and reviews standards needed for accreditation, while MoH has key role in standard approval process. This paper is going to describe the implication of the Policy on development, review and approval of accreditation standards for healthcare organizations in Kazakhstan. Moreover, the limitations of the process will be discussed and recommendations will be presented.

Compliance of Monshaat Sultan Family Health Center with the current Egyptian Primary Health Care Accreditation Standards

Objective The aim of the study was to assess degree of compliance of Monshaat Sultan Family Health Center (FHC) with current Egyptian Primary Health Care (PHC) Accreditation Standards. Background Evaluation of healthcare quality is an essential component of health system research; all healthcare-related activities should be evaluated. The main purpose of quality assessment is to improve performance. More accurately, it is to identify points of weakness that call for strengthening and strengths for better use of them. Methods This is a cross-sectional descriptive study conducted on Monshaat Sultan FHC. The study used the PHC Accreditation Program Standards, designed, tested and finalized in February 2001 by the Egyptian Ministry of Health and Population, to assess the compliance rate of Monshaat Sultan FHC with these standards, where all activities were reviewed during the period from May 2014 to August 2014. The quality of performance of these activities was analyzed and the results were reported from September 2014 to April 2015. Results The study revealed that the overall compliance of Monshaat Sultan FHC with current Egyptian PHC Accreditation Standards was 33.64%. Among the eight dimensions of quality, patient care showed the highest compliance (46.65%), and quality improvement program showed the lowest compliance (12.12%). Patient rights compliance was 13.73%, safety was 38.70%, support services was 43.89%, information management was 23.81%, family practice model was 24.07%, and organization management was 12.82%. Conclusion Monshaat Sultan FHC is now only 33.64% compliant with current Egyptian PHC Accreditation Standards, whereas it was 80.18% in the year 2004. Lack of continuous evaluation and training is the leading cause of this low compliance.

A Particle Swarm Algorithm for Solving the Multi-objective Operating Theater Layout Problem

The multi-objective Operating Theater Layout (OTL) problem consists of a given facilities of different areas to be placed in different sections of an operating theater department. The OTL problem seeks to find the layout of facilities in a hospital department in compliance with international health care accreditation standards, and to meet the internal constraints on the organizational layout. The main objectives are to minimize the total traveling costs among facilities and to maximize the desirable adjacencies among them. The paper presents a mathematical formulation to determine the optimal OTL. A Particle Swarm Optimization (PSO) algorithm is also proposed to solve approximately this NP-Hard OTL problem. The PSO algorithm employs a constructive heuristic to generate initial feasible solutions to explore by the PSO search concept to find an effective solution in an efficient computation time. The PSO approach is implemented to solve a real-life OTL instance available at Roanne hospital in France. The obtained solution was validated and approved by a senior official responsible of the OTL at the hospital.

Oncology Patients’ Satisfaction Towards Quality Health Care Services at Accredited University Hospital

Background: Patients’ satisfaction has become an important tool to assess the quality health care services, which is progressively required by accreditation agencies in the checking of quality of hospital care. Aim: evaluate oncology patient satisfaction towards health care services at University Hospital after accreditation. Methods: Quantitative, descriptive study was used. This study was conducted in five units as the medical; surgical (male and female) and gynecology wards at King Abdulaziz University Hospital. It is one of the first Hospitals in the eastern Mediterranean region implement health care accreditation standards. Sample: Total number of non-randomized convenience sample was 123 oncology patients who admitted to the above-mentioned setting. Patients were selected for their oncology diagnosis from each department and who is oriented and conscious included in the study. Data was collected by structured interview questionnaire for measuring patient satisfaction level towards health care services. Results: Studied sample was satisfied by the knowledge and an experience they give about illness; information about medical tests; and information is given about treatment at (mean = 4.67); highly statistically, significant difference's relationship was observed in the total level of patient's satisfaction, and care received from nurses to the oncology patient during his hospital staying and regarding to services care organization at p = .000. Conclusion: there was satisfaction with the information provided by the medical staff about the patient's illness and the course of treatment. This is followed by the time spent with the physician and the interpersonal skills of the physician and nurses. The implication of study: develop the training program for health care providers about effective documentation; guidelines for providers in care for similar patients, and different formal monitoring systems are used by health care providers or regulators.

The standard of healthcare accreditation standards: a review of empirical research underpinning their development and impact

BackgroundHealthcare accreditation standards are advocated as an important means of improving clinical practice and organisational performance. Standard development agencies have documented methodologies to promote open, transparent, inclusive development processes where standards are developed by members. They assert that their methodologies are effective and efficient at producing standards appropriate for the health industry. However, the evidence to support these claims requires scrutiny. The study’s purpose was to examine the empirical research that grounds the development methods and application of healthcare accreditation standards.MethodsA multi-method strategy was employed over the period March 2010 to August 2011. Five academic health research databases (Medline, Psych INFO, Embase, Social work abstracts, and CINAHL) were interrogated, the websites of 36 agencies associated with the study topic were investigated, and a snowball search was undertaken. Search criteria included accreditation research studies, in English, addressing standards and their impact. Searching in stage 1 initially selected 9386 abstracts. In stage 2, this selection was refined against the inclusion criteria; empirical studies (n = 2111) were identified and refined to a selection of 140 papers with the exclusion of clinical or biomedical and commentary pieces. These were independently reviewed by two researchers and reduced to 13 articles that met the study criteria.ResultsThe 13 articles were analysed according to four categories: overall findings; standards development; implementation issues; and impact of standards. Studies have only occurred in the acute care setting, predominately in 2003 (n = 5) and 2009 (n = 4), and in the United States (n = 8). A multidisciplinary focus (n = 9) and mixed method approach (n = 11) are common characteristics. Three interventional studies were identified, with the remaining 10 studies having research designs to investigate clinical or organisational impacts. No study directly examined standards development or other issues associated with their progression. Only one study noted implementation issues, identifying several enablers and barriers. Standards were reported to improve organisational efficiency and staff circumstances. However, the impact on clinical quality was mixed, with both improvements and a lack of measurable effects recorded.ConclusionStandards are ubiquitous within healthcare and are generally considered to be an important means by which to improve clinical practice and organisational performance. However, there is a lack of robust empirical evidence examining the development, writing, implementation and impacts of healthcare accreditation standards.

Quality of care in accredited and nonaccredited hospitals

Although Saudi Arabia is one of the first countries in the Eastern Mediterranean Region to implement healthcare accreditation standards, little is known about its impact on nurse assessment of the provision of healthcare. The main objectives of this study were to determine the quality of healthcare services provided by accredited and nonaccredited hospitals on the basis of the views of nurses. In addition, this study aimed to explore the potential contributing factors affecting the quality of care. A cross-sectional study was carried out at one accredited and another nonaccredited hospital at Al-Khobar city, Saudi Arabia. A questionnaire was used to assess nurses' perceptions of the quality of healthcare provided in the target hospitals on a five-point Likert scale tool. A total of 164 nurses were surveyed. Quality of healthcare services and the potential contributing factors affecting the quality of care. The most highly rated scales by nurses were 'education & training' (mean=4.09), followed by 'quality management' (mean=3.96) at the accredited hospital compared with 'use of data' (mean=3.56) and 'strategic quality planning' (mean=3.56) at the nonaccredited hospital. For both hospitals, the lowest scores were assigned to the 'reward' (mean=2.78 and 3.06 by nurses at accredited and nonaccredited hospitals, respectively). Nurses' rating for all scales was higher in the accredited compared with the nonaccredited hospital, except for the reward scale. The difference was statistically significant for all scales, except human resource utilization (P≤0.02). In accredited hospitals and for different scales, nurses with 4-6 years of experience, Saudi nurses, and those aged 30-35 years had significantly higher agreement scores than their counterparts. For the accredited hospitals, the predictors of good-quality results were leadership, commitment and support (P=0.019), and strategic quality planning (P=0.007). For nonaccredited hospitals, predictors of good quality results were leadership, commitment, and support (P=0.001). As perceived by nurses in study hospitals, accredited hospitals perform favorably compared with nonaccredited hospitals in almost all quality scales. Thus, accreditation can be considered a tool for improving hospital quality. The most important determinants of quality in healthcare were leadership, commitment and support, and strategic quality planning.

Managing emergency department overload

Patient flow is a critical issue in many hospitals and health care institutions across the country. Nowhere are the problems of patient overcrowding, lack of coordination of care, and inefficient utilization of resources more apparent than in an overcrowded, overutilized, and inappropriately staffed emergency department (ED). The challenges of overcrowded EDs and an archaic patient flow and admission processes result in excessively long waits for all patients, including both those treated and released and admitted. Such problems lead to increased costs and lost revenue. They also increase the risk of unsafe care and poor quality of services, especially in relation to the patient experience that in itself jeopardizes compliance with health care accreditation standards. Patient flow is a critical issue in many hospitals and health care institutions across the country. Nowhere are the problems of patient overcrowding, lack of coordination of care, and inefficient utilization of resources more apparent than in an overcrowded, overutilized, and inappropriately staffed emergency department (ED). The challenges of overcrowded EDs and an archaic patient flow and admission processes result in excessively long waits for all patients, including both those treated and released and admitted. Such problems lead to increased costs and lost revenue. They also increase the risk of unsafe care and poor quality of services, especially in relation to the patient experience that in itself jeopardizes compliance with health care accreditation standards.

A 10-year review of quality improvement monitoring in pain management: Recommendations for standardized outcome measures

Quality measurement in health care is complex and in a constant state of evolution. Different approaches are necessary depending on the purpose of the measurement (e.g., accountability, research, improvement). Recent changes in health care accreditation standards are driving increased attention to measurement of the quality of pain management for improvement purposes. The purpose of this article is to determine what indicators are being used for pain quality improvement, compare results across studies, and provide specific recommendations to simplify and standardize future measurement of quality for hospital-based pain management initiatives. Pain management quality improvement monitoring experience and data from 1992 to 2001 were analyzed from 20 studies performed at eight large hospitals in the United States. Hospitals included: the University of Wisconsin Hospital and Clinics, Madison; Texas Medical Center, Houston; McAllen Medical Center, McAllen, TX; San Francisco General Hospital, San Francisco; Rush-Presbyterian-St. Luke's Medical Center and Northwestern Memorial Hospital, Chicago, IL; Memorial Sloan Kettering Cancer Center, New York; and Kaiser Sunnyside Medical Center of Kaiser Permanente Northwest, Clackamas, OR. Analyses of data led to consensus on six quality indicators for hospital-based pain management. These indicators include: the intensity of pain is documented with a numeric or descriptive rating scale; pain intensity is documented at frequent intervals; pain is treated by a route other than intramuscular; pain is treated with regularly administered analgesics, and when possible, a multimodal approach is used; pain is prevented and controlled to a degree that facilitates function and quality of life; and patients are adequately informed and knowledgeable about pain management. Although there are no perfect measures of quality, longitudinal data support the validity of a core set of indicators that could be used to obtain benchmark data for quality improvement in pain management in the hospital setting. © 2002 by the American Society of Pain Management Nurses