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14 Hospital Accreditation KCE reports 70
4 EVIDENCE ON THE EFFECTIVENESS OF
ACCREDITATION
In the study carried out for this project, the question on ‘evidence based outcomes
generated by accreditation’ was explicitly integrated as it seems a logical starting point
for the study as it aims to establish the added value of hospital accreditation and
consequently is one of the keystones to determine whether hospital accreditation
should be pursued.
Based on the lengthy experience of hospital accreditation programmes in the
neighbouring countries one could expect that this would allow Belgium to profit of
evidence of improved healthcare quality as a result of these schemes.
4.1 POTENTIAL IMPACTS OF ACCREDITATION
When referring to ‘evidence based outcomes’ it has to be clear what is meant by
‘outcomes’. In our definition, ‘outcome’ is the ultimate impact of an accreditation
programme, namely the quantity and quality measures, reflecting e.g. the incidence of
infection, number of procedures performed per year of a certain kind, patient
satisfaction and knowledge, continuity of care, accuracy of diagnosis, etc 2 . In that sense,
so called output indicators like waiting times are also considered as outcome.
Apart from ‘outcomes’, one may expect other potential impacts of hospital
accreditation programmes which do contribute directly or indirectly to improved
outcomes in the long run. In the existing literature different opinions exist on what the
benefits or potential impacts of hospital accreditation are and who (which stakeholders)
benefits from them.
In ‘Accreditation and other External Quality Assessment Systems for Healthcare’ the
following overview on positive benefits is presented:
Table 3 : Who benefits from accreditation?
• Who benefits
– Patients
• Benefit from improved quality
– Providers
• Benefit from association with a reputable facility
– Staff
• Benefit from job satisfaction and pride involved in the process
– Organizations
• Quality conscious
Source: Health Systems Resource Centre
A much broader ‘impact range’ is presented in the Journal on Quality and Patient Safety
of May 2006, after the authors have stated that there is much debate about whether
accreditation is effective, and about what evidence there is to support the answer 1 .