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6 Hospital Accreditation KCE reports 70
Table 1 : Philosophy of Accreditation
• Mandated Voluntary
• Punitive Improvement oriented
• Cyclical Continuous
• Prescriptive Non-prescriptive
• Confidential Publicly disclosed
• Minimum requirements Cutting edge requirements
• Reactive Proactive
• Announced Unannounced
• Retrospective Prospective
• Standards based Performance measured based
• Process oriented Outcomes oriented
• Absolute measurement Comparative measurement
• One-level award Multi-level award
Source: Joint Commission International
Another example is the classification used by the International Society for Quality in
Health Care (ISQua), in their ‘Toolkit for Accreditation Programs’, as developed for the
World Bank in 2004 4 . This classification groups the different variables that determine
the potential effectiveness, affordability and sustainability in 4 main categories:
Table 2 : Variable factors determining the potential effectiveness,
affordability and sustainability of a programme
Policy:
• What is the purpose of the proposed program?
• How might it complement or replace alternative mechanisms, such as licensing and certification?
• How would it match the culture of the population and professions concerned?
• What incentives would encourage participation?
Organisation:
• How would the people most likely to be affected (“stakeholders”) be identified and involved?
• How would the program be governed?
• How would it ensure compatibility with associated regulatory and independent agencies?
Methods:
• How will standards be made valid?
• How will assessments be made reliable?
• How will assessors be trained and re-validated?
• How will procedures and results be made transparent and fair?
Resources:
• What are the implications for data, information and training?
• What are the costs to participating institutions?
• How long does it take to set up a sustainable program?
• What does it cost to set it up?
For the purpose of this report, a framework to analyse accreditation was developed in
function of the 2 research questions defined (1, the Inventory and Comparative Analysis
of Hospital Accreditation Programmes in Europe; 2, the Exploration of Accreditation
Opportunities for Belgian Hospitals), of the literature search strategies applied and of
the (International and national) surveys conducted. To some extent the proposed
framework combines certain elements already applied in other reports as this will allow
to point out trends and tendencies (see 5.1.3., 5.1.4. and 5.2.4).