International Journal for Quality in Health Care Advance Access originally published online on October 2, 2008
International Journal for Quality in Health Care 2009 21(1):27-28; doi:10.1093/intqhc/mzn045
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Editorial |
Promoting research into healthcare accreditation/external evaluation: advancing an ISQua initiative
In 2005, the Research Working Group of the ISQua Accreditation Council began discussing how to stimulate, promote and share accreditation/external evaluation research and information. What research in this area currently exists? What are the research gaps? What mechanisms might be developed to facilitate the sharing of this research?Healthcare accreditation started in 1918. However, since the 1980s there has been a marked increase in expansion globally, with accreditation organizations now existing in over 70 countries and using a great amount of resources and effort. Questions are being raised about the value of accreditation and whether it makes a verifiable improvement in healthcare delivery and healthcare outcomes [1, 2]. Those directly involved in the accreditation projects strongly believe in its contribution to improving health service and care quality. Others have differing opinions based on their perceptions [3]. Research in the area of accreditation/external evaluation is, for that reason, essential to address those issues. Accreditation/external evaluation must be relevant and measurably contribute to healthcare improvement. Given the escalating uptake of accreditation and the resultant increasing amount of accreditation-related research and data being generated [4], it is increasingly important to enable effective sharing of research ideas and findings. It is important to learn from each other, to share the evidence and, at the same time, to identify the gaps and areas within which more research is required.
One of the first steps undertaken by the ISQua Research Working Group was the creation of a preliminary inventory of the existing accreditation/external evaluation research being undertaken within the ISQua member organizations. We discovered that a significant number of projects were kept as ‘grey literature’. For that reason, it was decided to create a database that would allow trends and gaps in the research to be identified while simultaneously helping researchers avoid redundant projects. Following this step, it was agreed to develop a research website within which accreditation/external evaluation research would be posted including both official and ‘grey literature projects’.
Though we do not have a unique conceptualization for accreditation performance [5], research on accreditation focuses on primarily three areas: the impact of accreditation on the quality and safety of healthcare delivery, the efficiency of accreditation tools and systems for providing feedback with reliable information both to the accreditation organizations as well as all key stakeholders and the impact on the capacity development of systems.
Impact of accreditation/external evaluation research includes topics such as organizational and managerial changes due to accreditation, professional involvement and satisfaction with the process, changes in organizational culture, changes in key processes that are evidence based related to outcomes, changes in outcomes and costs and impact of patients' and other stakeholders involvement in the process. All of these are hot topics that have been insufficiently explored in research projects in past years. One reason for this is that accreditation has been implemented in some countries for many decades and consequently it is difficult to identify ‘control groups’ to compare. In countries starting the process, driving forces of accreditation generally do not consider the need for research in this field.
The new ISQuA Accreditation/external evaluation research website, hosted by Accreditation Canada, formerly the Canadian Council on Health Services Accreditation, www.isquaresearch.com, enables identification of projects and key researchers and supports open dissemination of the data and research to the accreditation community, the public and other stakeholders. Projects are easily searchable based on multiple criteria, and can be browsed for your convenience. Projects may be in the early stage of initiation, ongoing or completed. Each completed project listed includes the project abstract and the results. Contact information for all projects is included.
Readers of the website will note trends in accreditation research topics that can be recognized such as mandatory versus voluntary accreditation, or impact of performance measures within the accreditation process [6]. At the same time, opportunities for international comparative research emerge. Data reported in the website is obtained from researchers and accreditation organizations as well as from literature review. For that reason is important to involve all interested groups involved in this effort.
Your partnership to ensure completeness of the website content is essential. The website is populated by submissions from accreditation/external evaluation researchers and authors. ‘Consequently, in order to populate the website we strongly encourage, invite and welcome new submissions for inclusion’. Criteria have been identified that are applied to screen research projects and related reports. Following acceptance for posting and meeting these criteria, the information will be posted. Please see the website for more information for the submission process.
This initiative will serve researchers worldwide and will prove to be a useful tool for advancing evidence-based knowledge in this field of accreditation/external evaluation. If you have commenced or completed the research in this area or completed a report directly relevant to accreditation/external evaluation, we welcome hearing from you. Please see the website for detailed information regarding the submission process.
Avedis Donabedian Research Institute
CIBER Epidemilogía y Salud Pública - (CIBERESP)
E-mail: rsunol{at}fadq.org
Accreditation Canada
Haute Autorité de Santé
The Council for Health Services Accreditation of Southern Africa (COHSASA)
References
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[Abstract/Free Full Text]
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