The effect of certification and accreditation on quality management in 4 clinical services in 73 European hospitals.
Int J Qual Health Care
; 26 Suppl 1: 100-7, 2014 Apr.
Article
em En
| MEDLINE
| ID: mdl-24615598
ABSTRACT
OBJECTIVE:
To investigate the relationship between ISO 9001 certification, healthcare accreditation and quality management in European hospitals.DESIGN:
A mixed method multi-level cross-sectional design in seven countries. External teams assessed clinical services on the use of quality management systems, illustrated by four clinical pathways. SETTING ANDPARTICIPANTS:
Seventy-three acute care hospitals with a total of 291 services managing acute myocardial infarction (AMI), hip fracture, stroke and obstetric deliveries, in Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey. MAIN OUTCOMEMEASURE:
Four composite measures of quality and safety [specialized expertise and responsibility (SER), evidence-based organization of pathways (EBOP), patient safety strategies (PSS) and clinical review (CR)] applied to four pathways.RESULTS:
Accreditation in isolation showed benefits in AMI and stroke more than in deliveries and hip fracture; the greatest significant association was with CR in stroke. Certification in isolation showed little benefit in AMI but had more positive association with the other conditions; greatest significant association was in PSS with stroke. The combination of accreditation and certification showed least benefit in EBOP, but significant benefits in SER (AMI), in PSS (AMI, hip fracture and stroke) and in CR (AMI and stroke).CONCLUSIONS:
Accreditation and certification are positively associated with clinical leadership, systems for patient safety and clinical review, but not with clinical practice. Both systems promote structures and processes, which support patient safety and clinical organization but have limited effect on the delivery of evidence-based patient care. Further analysis of DUQuE data will explore the association of certification and accreditation with clinical outcomes.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Garantia da Qualidade dos Cuidados de Saúde
/
Procedimentos Clínicos
/
Acreditação
Tipo de estudo:
Guideline
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
Asia
/
Europa
Idioma:
En
Revista:
Int J Qual Health Care
Assunto da revista:
SERVICOS DE SAUDE
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Austrália