Hospital accreditation has been defined as “A self-assessment and external peer assessment process used by health care organizations to accurately assess their level of performance in relation to established standards and to implement ways to continuously improve”. Critically, accreditation is not just about standard-setting: there are analytical, counseling and self-improvement dimensions to the process. There are parallel issues in evidence-based medicine, quality assurance and medical ethics (see below), and the reduction of medical error is a key role of the accreditation process. Hospital accreditation is therefore one component in the maintenance of patient safety. However, there is limited and contested evidence supporting the effectiveness of accreditation programs.
Background
Hospitals and healthcare services are vital components of any well-ordered and humane society, and will indisputably be the recipients of societal resources. That hospitals should be places of safety, not only for patients but also for the staff and for the general public, is of the greatest importance. Quality of hospitals and healthcare services is also of great interest to many other bodies, including governments, NGOs targeting healthcare and social welfare, professional organisations representing doctors, patient organisations, shareholders of companies providing healthcare services, etc. However, accreditation schemes are not the same thing as government-controlled initiatives set up to assess healthcare providers with only governmental objectives in mind - ideally, the functioning and finance of hospital accreditation schemes should be independent of governmental control.
How quality is maintained and improved in hospitals and healthcare services is the subject of much debate. Hospital surveying and accreditation is one recognised means by which this can be achieved.
It is not just an issue of hospital quality. There are financial factors as well. For example, in the USA, up until recently the Joint Commission exercised a de facto veto over whether or not US hospitals and other health providers were able to participate, and therefore earn from, the Medicare and Medicaid programs. This situation has changed in recent years.
National schemes
Accreditation schemes recognised as providers of national healthcare accreditation services include: Accreditation Association for Ambulatory Health Care (AAAHC) - based in the United States American Accreditation Commission International (AACI) - based in the United States CHKS Ltd is a specialist provider of healthcare accreditation programmes to UK and international healthcare providers, based in the UK and accredited to ISQua and ISO 17021:2015 standards. The Council for Health Service Accreditation of Southern Africa Malaysian Society for Quality in Health, or MSQH - based in Malaysia QHA Trent Accreditation - based in the UK-Europe The National Safety and Quality Health Service Standards (NSQHS Standards) developed by the Australian Commission on Safety and Quality in Health Car] (ACSQHC) Australian Council for Healthcare Standards International, or ACHSI - based in Australia Accreditation Canada, formerly known as Canadian Council on Health Services Accreditation, or CCHSA - based in Canada Healthcare Facilities Accreditation Program (HFAP) -based in the United States The Joint Commission (TJC) - based in the United States Community Health Accreditation Program (CHAP) - based in the United States Accreditation Commission for Health Care Inc. (ACHC) - based in the United States The Compliance Team: "Exemplary Provider Programs" - based in the United States Healthcare Quality Association on Accreditation (HQAA) - based in the United States DNV GL - based in Norway and the United States Thailand Hospital HA - based in Bangkok, Thailand Taiwan Joint Commission on Hospital Accreditation (財團法人醫院評鑑暨醫療品質策進會) - based in Taipei, Taiwan La Haute Autorité de Santé, French National Authority for Health, based in Paris, France A.N.M.C.S., National Authority of Quality Management in Health, based in Bucharest, Romania National Accreditation Board for Hospitals & Healthcare Providers (NABH) based in India Center for Improvement in Healthcare Quality (CIHQ) -based in the United States
The different accreditation schemes vary in quality, size, intent and the skill of their marketing. They also vary considerably in terms of the cost incurred by hospitals and healthcare institutions. They have varying degrees of commitment to assessing medical ethical standards and clinical standards.