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PubMed1993

Accreditation of regionalized and comprehensive nurse anesthesia programs.

Regionalized educational systems are becoming more common among nurse anesthesia programs and represented 41 out of 86 programs in a 1992 survey. Surveys were mailed to program directors of all nurse anesthesia programs accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs to determine if the directors perceived a need for three separate categories of accreditation. Responses indicated that, although most directors saw no benefit in applying for separate academic and clinical accreditations for their own programs, they did believe the additional accreditation options should be available to all programs. Most directors also indicated that they preferred the Council to continue offering only one category of accreditation while 33 (38%) indicated they were interested in separate accreditation categories.

Accreditation↗
PubMed1997

Accreditation, core curriculum and allied health education: barriers and opportunities.

There is considerable discussion today about the future directions of accreditation of allied health education. A number of discussions and public debates have taken place in recent years which consider and speculate on appropriate directions, how these might be achieved, and what the ramifications will be for allied health education. Current attention to core curriculum in allied health has implications for accreditation of such curricula. This paper reviews the definition and purpose of accreditation, addresses the current accreditation system in allied health, summarizes multiple perspectives in the current debate over the future of allied health accreditation, and examines how accreditation might help or hinder development of core curricula. A set of accreditation standards for evaluating a core curriculum in allied health is proposed.

Accreditation↗
PubMed2002

Medical laboratory accreditation: a Hong Kong perspective.

This is an account of the accreditation of the Surgical Pathology, Cytopathology, Autopsy Service, Haematology, Blood Bank, Bone Marrow Transplant and Electronmicroscopy Laboratories of the Department of Anatomical and Cellular Pathology, the Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR, China, the first of their category to be accredited in the Special Administrative Region. The Australian-based National Association of Testing Authorities (NATA) used standards formulated by the National Pathology Accreditation Advisory Council (NPAAC) to measure the performance of the laboratory sections and to determine whether the laboratory service was of a sufficient standard to be granted accreditation. Some practices dating back to the colonial period required attention, while eliciting the support of staff at all levels was essential for achieving accreditation. Some cultural factors had to be taken into account when implementing changes. Finally, successful accreditation has provided the impetus for other Hong Kong laboratories to become accredited and this will have a beneficial flow-on effect for the entire region.

Hong Kong↗
PubMed2000

Accreditation and continuous quality improvement in athletic training education.

OBJECTIVE: To apply the continuous quality improvement model commonly associated with the business sector to entrylevel athletic training education program accreditation. DATA SOURCES: We applied athletic training educational program accreditation as a tool for ensuring quality in the entrylevel athletic training education programs accredited by the Commission on the Accreditation of Allied Health Education Programs. Literature from the business, education, and athletic training fields is integrated to support this paradigm shift in athletic training education. DATA SYNTHESIS: The advent of mandated entry-level athletic training educational program accreditation has forced institutions to evaluate their educational programs. Accreditation will promote continuous quality improvement in athletic training education through mechanisms such as control measures and process improvement. CONCLUSIONS/RECOMMENDATIONS: Although accreditation of entry-level athletic training education programs has created some dissonance among athletic training professionals, it will strengthen the profession as a whole. Athletic training educators must capture the synergy generated from this change to ensure quality educational experiences for all our students as we move forward to secure a strong position in the allied health care market.

Journal Article↗
PubMed1995

Recent developments in accreditation.

Within the past five years, accreditation has been adopted in a number of countries. Accreditation, originally perceived as a vehicle to enable organisational development, is found to be increasingly of interest to wider publics including governments in regulating and promoting quality. The newer systems are based upon the experience of the mature accreditation systems of the Joint Commission in the USA, the Canadian Council on Health Facilities Accreditation and the Australian Council on Health Care Standards. The mature accreditation systems have demonstrated their responsiveness to the changing needs of the health care systems in which they operate. In the past decade, these accreditation systems have responded to the decline in the role of the hospital in health care delivery; the demands of governments and the public for greater information about quality of health care. They have also responded to pressure for greater knowledge of clinical effectiveness by introducing indicators of clinical performance and are looking to outcome measures.

Accreditation↗
PubMed1992

Demonstrating excellence in home care through Joint Commission accreditation.

Nurse administrators responsible for developing and managing home care delivery systems need to understand the eligibility criteria for accreditation, key components of the standards, survey, and accreditation decision process, and directions for the future including external recognition of accreditation and the use of an indicator monitoring system. The authors highlight the major components and benefits of the home care accreditation program of the Joint Commission on Accreditation of Healthcare Organizations, as well as how the nurse administrator may use accreditation as a valuable management tool.

Accreditation↗
PubMed1988

Accreditation, certification, and the quality of care in state hospitals.

Data on 216 state psychiatric hospitals were analyzed to determine whether accreditation by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) or certification by the Health Care Financing Administration (HCFA) were related to seven hospital characteristics generally accepted as reflecting quality of care. The characteristics were average cost per patient, per diem bed cost, total staff hours per patient, clinical staff hours per patient, percent of staff hours provided by medical staff, bed turnover, and percent of beds occupied. While a majority of the hospitals had either JCAHO accreditation, HCFA certification, or both, analysis revealed a weak relationship between accreditation or certification status and the indicators of quality of care. Accredited or certified hospitals were, however, more likely to have higher values on specific indicators than hospitals without accreditation.

Accreditation↗
PubMedDate not supplied

Achieving JCAHO accreditation in a university student health center.

Of the approximately 1,500 colleges and universities in the United States, only approximately 100 university student health centers are accredited by either of the two major ambulatory healthcare accreditation agencies. The accreditation process can be daunting. We found few examples in the accreditation literature that assisted us in our endeavor. This article is designed as a primer to assist college health center administrators in achieving accreditation by the Joint Commission on Accreditation of Healthcare Organizations.

Accreditation↗
PubMed2005

Hospital oversight in Medicare: accreditation and deeming authority.

To be eligible to receive payment from Medicare, hospitals must be certified to meet certain conditions. Hospitals may gain such credentials by choosing to be reviewed by a state certification agency under contract to the Centers for Medicare & Medicaid Services or to be accredited by either the Joint Commission on Accreditation of Healthcare Organizations or the American Osteopathic Association. This issue brief looks at how accreditation of hospitals developed and how it continues to change. It considers the legal and practical reasons that a majority of hospitals choose accreditation and why some hospitals do not, along with broader consideration of the extent to which accreditation may be judged of value to Medicare beneficiaries. The intersection of state and federal oversight responsibilities and the role of accrediting organizations in hospital quality improvement also are examined.

Accreditation↗
PubMed1998

Accreditation in managed behavioral health care: an interview with Mary Cesare-Murphy and Claire Sharda. Interview by Gary J. Mihalik.

Accreditation of managed behavioral health care organizations is being driven by the demands of multiple stakeholders in the health care industry. Accreditation is expensive-both in terms of the direct and indirect costs of preparation and survey but also in terms of the consequences of failure. Though accreditation is a new expectation for the managed behavioral health care field, it is unlikely that the major organizations in the industry will have the years to achieve accreditation that the nonbehavioral managed care field enjoyed. This article explores, in an interview format, the managed behavioral health care accreditation programs of the Joint Commission on Accreditation of Healthcare Organizations and the National Committee for Quality Assurance.

Accreditation↗
PubMed1982

Relationship between accreditation status and hourly wages of medical record technicians.

Using data from a 1975 hospital wage survey conducted by the Industry Wage Division of the U.S. Bureau of Labor Statistics, the relationship between accreditation status and hourly wages of 590 female full-time medical record technicians (MRTs) in four metropolitan areas was examined. Through multiple regression analysis, the hourly wages of Accredited Record Technicians were found to be $0.62 greater than those not accredited. Job location and hospital funding source also were related strongly to MRT hourly wages. Only 35 percent of the MRT's studied were accredited. These data reveal the willingness of employers to hire MRT's not accredited, while being willing to pay a premium for accreditation.

Accreditation↗
PubMed1999

Mobilizing toward regional accreditation.

In January 1999, the Eastern Regional Health Board began planning for a Regional Accreditation scheduled in November 1999. This would be the first time that our two programs (Addiction Services and Public Health), and two of the nine acute care facilities in our Region would be accredited. This article describes a regional accreditation planning process. It suggests the resources required for such a project, suggests a workable time line, and indicates a communication strategy. Mobilizing over 1000 staff, physicians, and the communities toward Regional accreditation was a challenge for the Steering Team. Defining a plan of action with defined time lines proved helpful; defining team chairs who were flexible and positive was vital, and engaging the communities in our review was rewarding. Informing the public was completed using strategies borrowed from our Newfoundland counterparts (an accreditation mural and a regular newsletter), and our own creative strategies such as "Sharing Day" and engaging community health board involvement on accreditation teams. The project development was initiated by a steering committee, and spanned 21 teams. Both a communication and education plan were important in keeping the board, staff, physicians and residents of the Region informed.

Accreditation↗
PubMed2001

A stakeholder approach towards hospital accreditation in India.

Accreditation has been recommended as a mechanism for assuring the quality of private sector health services in low-income countries, especially where regulatory systems are weak. A survey was conducted in Mumbai, India, in 1997-98 to elicit the views of the principal stakeholders on the introduction of accreditation and what form it should take. There was a high level of support for the classical features: voluntary participation, a standards-based approach to assessing hospital performance, periodic external assessment by health professionals, and the introduction of quality assurance measures to assist hospitals in meeting these standards. Hospital owners, professional bodies and government officials all saw potential - though different - advantages in accreditation: for owners and professionals it could give them a competitive edge in a crowded market, while government officials reckoned it could increase their influence over an unregulated private market. Areas of disagreement emerged; for example, hospital owners were opposed to government or third party payment bodies having a dominant role in running an accreditation system. The growing strength of a health service user representative lobby in Mumbai is an additional reason why this would be a suitable place for piloting such a system. The biggest obstacle to introducing accreditation in poorly resourced settings, such as India, is in how to finance it. The provisional support of the principal stakeholders for such a development, demonstrated in this study, will require a commitment from government and policymakers if the potential benefits of accreditation to the health of the population are to be realised.

Accreditation↗
PubMed2000

Joint Commission International accreditation: relationship to four models of evaluation.

OBJECTIVE: To describe the components of the new Joint Commission International (JCI) accreditation program for hospitals, and compare this program with the four quality evaluation models described under the ExPeRT project (visitatie, ISO, EFQM, organizational accreditation). RESULTS: All the models have in common with the JCI program the use of explicit criteria or standards, and the use of external reviewers. The JCI program is clearly an organizational accreditation approach with evaluation of all the 'systems' of a health care organization. The JCI model evaluates the ability of an organization to assess and monitor its professional staff through internal mechanisms, in contrast with the external peer assessment used by the visitatie model. The JCI program provides a comprehensive framework for quality management in an organization, expanding the boundaries of the quality leadership and management found in the EFQM model, and beyond the quality control of the ISO model. The JCI organizational accreditation program was designed to permit international comparisons, difficult under the other models due to country specific variation. CONCLUSION: We believe that the organizational accreditation model, such as the international accreditation program, provides a framework for the convergence and integration of the strengths of all the models into a common health care quality evaluation model.

European Union↗
PubMed1997

The meaning and application of medical accreditation standards.

The authors examined the operational meaning of the 48 items that state the accreditation standards for teaching, learning, and evaluation in medical school, and determined the extent to which these standards were applied by schools and by on-site evaluators for 59 programs surveyed by the Liaison Committee on Medical Education (LCME) in 1994-1996. In this study, "application" meant that evidence was offered, not necessarily that it proved compliance with the standard. The data sources employed were the medical education databases and self-studies prepared by schools undergoing accreditation surveys, and the reports prepared by ad hoc teams of surveyors. The frequency with which evidence of compliance was offered by the schools and cited by evaluators was determined for each of the 48 accreditation requirements. In addition, the authors compared the patterns of surveyors' concerns about noncompliance at schools surveyed during 1984-1986 and at those visited during 1994-1996. In 1994-1996, schools addressed 42 of the 48 accreditation requirements in 90% of instances of more. The areas of particularly low attention dealt with the definition and communication of educational objectives (47% of schools provided evidence); faculty authority and control of academic programs in clinical affiliates (12%); and the faculty's commitment to being effective teachers and their understanding of pedagogy, curricular design, and methods of evaluation (8%). Survey teams, in contrast, accounted in their reports for only 26 (55%) of the standards during the same time period. Among those least frequently addressed were the definition and communication of educational objectives by schools (accounted for in 59% of the reports); assessment of students' problem-solving ability (51%); comparability of educational experiences and student evaluation across dispersed teaching sites (49%); faculty understanding of pedagogy, curriculum construction, and the evaluation of students (8%); faculty authority and control of academic programs in clinical affiliates (7%); and knowledge of the administration and faculty about methods for measuring student performance (2%). Over the past decade, surveyors' most frequently cited concerns about schools' noncompliance with accreditation standards dealt with student counseling and health services, institutional financial and space/facilities resources, faculty issues, and vacant decanal and department chair positions. Next in order were concerns about various aspects of the educational program leading to the MD degree. Among the high-profile concerns about the educational program that increased significantly over the decade were those about curriculum design, management, and evaluation; primary/ambulatory care experiences; and student advancement policies and due-process issues. Schools paid high attention to most of the 48 standards, in large part because they were prompted by the formatting of the medical education database and self-study guidelines. In those instances of lesser attention, the fault lies as much or more with ambiguities in the construction and meaning of the standards as with institutional laxity. The surveyors' inattention to accreditation standards is more troubling. In some cases it can be attributed to uncertainties about the meaning of the requirements and the quantities that need to be audited; or surveyors may be comfortable reaching a "substantial compliance" threshold without adducing all the evidence. The authors argue that many of the standards given scant attention on surveys are important to educational program development and quality control. The LCME will need to consider whether more prominent definition and highlighting should be given to neglected standards, or whether some of the requirements are at the margin as quality indicators. A planned survey of communities of interest-educators, practitioners, students, graduates, and residency program directors, among others-may help confirm

Accreditation↗
PubMed1997

The influence of accreditation on educational change in U.S. medical schools.

The authors examined the influence of accreditation on educational change and reform in U.S. medical schools in the past decade, by reviewing the survey databases and site visit reports of 90 schools that had comprehensive accreditation surveys by the Liaison Committee on Medical Education (LCME) between July 1992 and June 1997. In this study, substantive change was defined as centralizing the design and management of the curriculum, as well as one or more of the following reforms: integrating basic and clinical science instruction and/or conversion to interdisciplinary courses; implementing methods of active, small-group, independent, and hypothesis-based learning; and substantially increasing students' exposure to ambulatory and primary care. Accreditation reports were reviewed to determine the extent to which the LCME previously had admonished schools for shortcomings in their educational programs and advised curricular changes. Notice was taken of grant support by national foundations promoting educational reform, in relation both to the correction of accreditation deficiencies and to curricular reform undertaken by schools on their own initiative. The study also scrutinized the evolution of accreditation standards promoting educational reform, and the LCME's support of initiatives for shortening the period of medical education and promoting performance-based teaching and the assessment of clinical skills. On entering the 1990s, the LCME toughened the standards for design and management of the medical curriculum and for the evaluation of educational program effectiveness that schools must conduct. The greater assessment rigor identified educational shortcomings in 61 of 90 medical schools coming up for accreditation surveys during 1992-1997. On those occasions, 34 of the 61 schools had instituted reforms or were on the verge of doing so. Twenty-five of the schools carrying out reforms (73%) had received major foundation grants, compared with ten of the 27 schools (37%) that had accomplished little. Fifteen schools that had not been reproached earlier were found on the 1992-1997 surveys to have undertaken substantial innovation on their own initiative, five with the help of major foundation awards. The study also shows that a number of schools implemented parts of more sweeping reforms with the help of smaller foundation grants for more discrete purposes. In some instances, it has not been possible to differentiate the influence of the LCME as a force for educational reform from the incentives for change created by national foundations. Overall, the LCME, through its standards and assessment practices, and in synergy with schools and kindred agencies promoting change, is now on the leading edge of improved education and evaluation in the nation's medical schools.

Accreditation↗
PubMed1993

Accreditation policies in occupational health care.

Occupational health practitioners have striven for 60 years to develop and implement appropriate accreditation policies and procedures to promote quality assurance of occupational health practice. In 1987 the American Occupational Medical Association affiliated with the Accreditation Association for Ambulatory Health Care, an independent ambulatory health care accreditation organization, to advance this movement. This paper explores the history of occupational health care accreditation and identifies potential incentives needed to encourage accreditation of occupational health care. The Occupational Safety and Health Administration, industry, labor, insurance carriers, and professional organizations collectively must develop strategies to promote accreditation and ensure that workers receive the maximum standard of occupational health care.

Accreditation↗
PubMed1997

The nature and value of small and community hospital accreditation.

Discusses the characteristics of health care accreditation schemes, especially the implications of their voluntary status. Singles out the Trent small hospital accreditation scheme (TSHAS) for detailed and systematic evaluation. Describes the quantitative and qualitative evaluation methods, which involved a meta-analysis of the literature, interviews with key staff and questionnaires completed by other participants in TSHAS. The main findings, divided into ten themes, confirm much of the published work on accreditation. The findings also provide new insights into the nature and value of health care accreditation, notably about the direction in which accreditation needs to go if both community and larger hospital accreditation is to survive.

Accreditation↗