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PubMed1999

A laparoscopic surgical training and accreditation program up and running.

Beginning in March 1997, a training and accreditation program in laparoscopic surgery was established at our hospital according to the training guidelines provided by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) (1, 2). Registrars were accredited upon satisfactory completion of supervised surgery at each training level. Consultants seeking clinical privileges in advanced laparoscopic surgery were asked to submit a formal application. By August 1998, 143 minor laparoscopic procedures had been formally assessed resulting in 8 of 9 registrars successfully completing training to level 2 laparoscopy. Thirty-three of 83 (39.8%) advanced laparoscopic procedures were directly supervised and an experienced laparoscopic surgeon was available, if required, for a further 15 procedures. Two consultants undertook additional supervised training before being granted full accreditation for level 3 laparoscopic procedures. Another 2 consultants have been given provisional accreditation for level 3 procedures. Although challenging, implementation of the RANZCOG guidelines on training and accreditation in laparoscopic surgery is quite possible. Greater efforts should be undertaken to establish these guidelines as the 'gold standard' for hospital accreditation committees.

Accreditation↗
PubMed1996

Accreditation of residency training in the US.

In the US, accreditation and certification of residency training are functions of separate public sector agencies. Accrediting decisions are made directly by 26 Residency Review Committees, which represent the primary medical specialties and function under the authority of the Accreditation Council for Graduate Medical Education. The accrediting bodies may consider only educational issues and are prohibited by the government from controlling physician supply. Only the programme, not the institution in which it is conducted, is accredited. The US residency is a structured educational programme that is expected to provide comparable experience to all enrolled residents. Length of training may vary from two to six years depending on the specialty. Additional training may be obtained in subspecialty programmes, which are subsets of the primary specialty residencies and are also reviewed for accreditation. These have increased in significant number in recent years as subspecialisation has proliferated in the US.

Accreditation↗
PubMed2000

[Outline of the accreditation system for primary units of occupational medicine services].

The development and implementation of the system for the quality assurance of services provided by primary units of Occupational Medicine Service (OMS) is aimed at establishing occupational health care of workers in terms of high quality services. Accreditation is commonly regarded as a useful tool in the quality assurance system. The concept of primary OMS unit accreditation is discussed, and the suggestions for some new, additional parameters to be possibly used in the quality assurance process are presented. It is worth stressing that the system proposed is built on the system of control and professional supervision adopted by OMS. Although it is planned to establish the Centre of OMS Accreditation outside OMS, the observations collected in the course of internal controls may be used effectively in the accreditation process. Once an OHS unit is granted accreditation, both the employer and employees may be sure that it not only satisfies the requirements imposed by law, but also provides services of high quality. Such a unit will be recommended by the Centre of OMS Accreditation. Other units may also operate on the market but without the Centre's recommendation.

Accreditation↗
PubMed2001

Health plans' use of asthma quality improvement projects to meet NCQA accreditation standards.

BACKGROUND: Managed care represents an important system of healthcare delivery in the United States and the primary source of care for many persons with asthma. OBJECTIVE: To characterize how US managed care health plans address the quality of asthma care through the use of disease-specific quality improvement (QI) programs complying with National Committee for Quality Assurance (NCQA) standards. METHODS: This study was a cross-sectional review of reports from all accreditation surveys conducted in 1996 and 1997 by the NCQA. Each accreditation report was reviewed for evidence of whether the health plan explored asthma care as a way to demonstrate compliance with NCQA accreditation standards. Asthma activity was examined with respect to health plan characteristics such as size of plan and Medicaid contracting. Types of asthma QI activity, use of guidelines, and application of different NCQA accreditation standards were also examined. RESULTS: Approximately 90% of 197 health plans undergoing NCQA accreditation surveys in 1996 and 1997 reported some form of asthma QI activity. There were no statistically significant differences in this activity in large vs small plans or in plans with vs without Medicaid members. Approximately two thirds of health plans used asthma QI activities to meet NCQA accreditation standards in health management systems, and three fifths monitored and evaluated important aspects of asthma care and service. CONCLUSIONS: During the study period, many US health plans conducted asthma care QI activities. The recently released NCQA asthma performance measure may provide the next assessment of how well managed care is contributing to improving asthma care in the United States.

Accreditation↗
PubMed2001

[Accreditation of medical schools. Purpose, development and projections of a process (corrected)].

Important advances in the accreditation of higher education institutions and programs have occurred in Chile. A definite step forward had been the accreditation of three of the six Medical Schools, considered in the agreement subscribed between the Chilean Medical Faculties Association and the National Committee for Undergraduate Program Accreditation (CNAP). According to this understanding, educational quality was evaluated using international standards and its improvement was encouraged. The accreditation procedure carried out at the University of Chile Medical School is described. Its observation has revealed the difficulties of accreditation procedures and the early benefits obtained after they have been completed. The careful observation of the evaluation procedure will help to improve the used model and to design an effective accreditation instrument that will ultimately improve undergraduate teaching programs.

Accreditation↗
PubMedDate not supplied

Accreditation at the US EPA-NEIC. National Enforcement Investigations Center.

The US Environmental Protection Agency-National Enforcement Investigations Center (NEIC) of Denver, Colorado is the specialty technical arm of the Office of Enforcement and Compliance Assurance (OECA) within the US EPA. NEIC is a center for technical support nationwide to state, local, tribal, and federal environmental enforcement and compliance assurance programs. NEIC is a source of expertise for technical analysis, compliance monitoring, engineering evaluations, forensic laboratory activities, information management, computer forensics, and witness testimony. Effective 1 February 2001, NEIC was granted accreditation for overall environmental measurement activities that include field sampling, field measurements and monitoring, and laboratory measurements. NEIC became the first and only environmental forensic center in the United States to be granted this type of accreditation. The accreditation criteria incorporates nationally and internationally accepted forensic and quality management standards. Awarded by the National Forensic Science Technology Center (NFSTC), the NEIC Accreditation Standard was developed for conducting environmental measurements while adhering to forensic requirements in specific areas. The NEIC Accreditation Standard is based on ISO/IEC Guide 25 and ANSI/ASQC E4-1994, and it references specific aspects of the American Society of Crime Laboratory Directors/Laboratory Accreditation Board (ASCLD/LAB) Manual.

Accreditation↗
PubMedDate not supplied

Nursing accreditation: what's a librarian got to do with it?

Nursing education accreditation visits are similar to JCAHO accreditation visits. Both types of accreditation are offered to ensure quality programs and services. The author, a librarian, describes the role of the nursing library in helping the Hampton University School of Nursing to achieve full accreditation from the two national nursing accreditation bodies. This article describes the process and outcomes of accreditation visits.

Accreditation↗
PubMed2002

Selected determinants of the quality of hospital care. I. Accreditation and effectiveness of managing a therapeutic team.

In order to provide a higher level of the quality of medical services an external process of evaluation of health care units called accreditation has been implemented. Obtaining the Quality Certificate by a hospital greatly depends on knowledge and engagement of the staff in the accreditation process as well as on the effective managing of therapeutic teams by ward head/managers of clinics. Therefore, studies were undertaken to discover the knowledge of requirements concerning the possession of the Quality Certificate and how managing therapeutic teams is evaluated by physicians and nurses from hospitals with and without accreditation. The study covered 560 physicians and nurses from 4 hospitals with accreditation and 17 hospitals which did not possess the Quality Certificate. The research method was a diagnostic survey, and the technique--a questionnaire form. The material was subject to statistical analysis. Significant differences were observed in the knowledge of requirements concerning the possessing of the Quality Certificate between the staff of hospitals with accreditation, compared to the respondents from health units without the Quality Certificate. Respondents from hospitals without accreditation evaluated the effectiveness of managing therapeutic teams by ward head/managers of clinics in more negative terms, compared to the staff of hospitals which possessed the Quality Certificate.

Accreditation↗
PubMed2003

Accreditation of veterinary inspection systems.

Accreditation of Veterinary Services could be a key factor in facilitating international recognition of certificates. For this to occur, accreditation must be conducted within the international normative framework on compliance evaluation. The EN 45004 standard for inspection bodies is the most appropriate organisational reference. It makes a clear distinction between the technical activity of inspection, and decisions which fall within the competence of public authorities. However, there are few international normative texts describing inspection methods, which is a major obstacle to the development of a widely recognised accreditation system. Organisations that accredit inspection bodies exist in many countries, but there are no agreements on multilateral recognition. This paper describes the accreditation cycle and outlines the possibilities for accrediting networks or individual sites.

Accreditation↗
PubMed2005

The role of accreditation in an era of market-driven accountability.

Accreditation has been widely used to promote accountability in healthcare. However, with the rise of both purchaser and consumer demand for broader and more detailed information on performance beyond licensure and professional self-regulation, especially at the provider level, the role of accreditation is less clear. We hypothesize that for accreditation to be a critical part of a market-driven, consumer-focused healthcare system, accrediting bodies must enlarge their scope of assessment with an emphasis on clinical performance of providers, revise and expand their level of reporting and transparency of assessment, and broaden the base of their governance. A new approach to accreditation could enhance accountability by (1) building on an existing framework and data-collection structure that are proven elements of quality assurance in multiple healthcare sectors; (2) expanding existing involvement of both public and private entities in the process; (3) building on existing linkages to professional and regulatory bodies; (4) providing greater flexibility, compared with regulation, in responding to change; and (5) having a defined source of funding. By these means, accrediting bodies will both improve accountability and successfully drive quality improvement.

Accreditation↗
PubMed2006

[Clinical leaders' and staff's assessment of the current quality related to the patient pathways and expectations of and knowledge about accreditation--a baseline evaluation in Copenhagen County].

INTRODUCTION: In the preparation for accreditation in Copenhagen County the commitment of clinical leaders and staff members is crucial. The objectives of these surveys are to examine the leaders' and the staff's assessment of quality improvement and their expectations and knowledge about accreditation, as well as the staff's advice concerning the further planning. MATERIALS AND METHODS: Two surveys among clinical leaders and staff members were carried out. RESULTS: Statistically, significant differences between staff and leaders were found in many areas concerning quality improvement and knowledge about accreditation. Leaders and staff both had high expectations of the use of accreditation as a tool for quality improvement, thus no statistically significant difference between expectations were found. CONCLUSION: The overall positive expectation for accreditation as a tool for quality improvement is an excellent basis for the accreditation process. The different assessments in quality among leaders/staff and positions show the need to involve all personnel in the organization. A survey about patient experiences includes the same subjects as the survey among staff and leaders. A striking discrepancy between the evaluation of quality by patients and by the leaders and staff in specific areas was found; therefore further investigations will be carried out.

Accreditation↗
PubMedDate not supplied

Accreditation of mammography facilities by the American College of Radiology: results of a national survey.

Mammographic screening for the early detection of breast cancer is rapidly becoming an increasingly common practice in the United States. With more than 20 million mammograms estimated to be performed annually by more than 11,000 units, ongoing quality assurance and evaluative programs have gained importance. Recent federal legislative and regulatory efforts augment a patchwork of state mandates establishing or encouraging specific quality control requirements for mammography facilities, personnel, equipment, and radiation exposure. Many of these requirements are based on the American College of Radiology's (ACR) voluntary accreditation program that has been offering facility certification since 1987. The ACR collects and maintains detailed data on the characteristics of accredited facilities; however, little is known about facilities not participating in the ACR program. This article describes national results from the 1992 National Mammography Facilities Survey, a representative sample of 1,057 mammography facilities. We found statistically significant (P < .05) differences between accredited and nonaccredited facilities in type of mammography practices, cost, personnel standards, variables linked to accessibility, and corollary screening practices (availability of breast self-examination instruction and breast physical examination). Other variables showed minor or little variation between accredited and nonaccredited facilities. The results of this study suggest that, although all facilities engage in various components of "good" quality assurance practices, ACR-accredited facilities reported conducting these programs more frequently. Further, despite the substantially increased costs associated with these programs, ACR-accredited facilities reported lower average charges for screening mammograms and were more likely to participate in reduced fee programs.

Accreditation↗
PubMed1993

The nemesis of allied health accreditation: the emperor needs new clothes.

Allied health programs need a new approach and direction to accreditation. The author proposes that individual program accreditation be abolished and accreditation of allied health programs, by regional bodies, become part of institutional accreditation. The allied health accreditation process would thus change from the traditional self-study to an outcome assessment with an emphasis on monitoring change and innovation. Data bases on allied health, established by regional accrediting agencies, would become part of a national data base, which would facilitate the assessment of manpower needs, the equitable distribution of manpower, and the establishment of new educational programs. The competencies and change strategies of the Pew Health Professions Commission are used to specify the outcomes of educating allied health practitioners for the year 2005.

Accreditation↗
PubMed1993

New directions for allied health education accreditation.

The American Medical Association's (AMA's) proposal in October 1992 for a new freestanding agency to replace the Committee on Allied Health Education and Accreditation (CAHEA) energized review committees and their sponsoring organizations, educational institutions, and communities of interest to examine the current accreditation system. It also prompted the design of an independent allied health education accrediting body responsive to the needs of allied health professions, educational institutions, students enrolled in allied health educational programs, and the public. The result of a task force and input by many communities of interest, CAHEA's proposed successor agency, the Commission on Accreditation of Allied Health Education Programs (CAAHEP), will be operational in mid-1994 to provide accreditation and related coordination services. It is committed to simplify the existing accrediting process, be more inclusive of allied health professions that provide entry-level education, and serve as a steppingstone for future more far-reaching developments.

Accreditation↗
PubMed1998

Medicare and Medicaid programs; recognition of the Commission for Accreditation of Rehabilitation Facilities--HCFA. Notice with comment period.

This notice announces and invites comments on the receipt of an application from the Commission for Accreditation of Rehabilitation Facilities for recognition as a national accreditation organization with deemed status authority. The Social Security Act requires us to publish this notice in which we identify the national accreditation body making the application, describe the nature of the request, and provide a 30-day public comment period. The intent of this notice is to solicit public comment as to the advisability of recognizing the Commission for Accreditation of Rehabilitation Facilities as a national accreditation organization with deeming authority to survey and accredit comprehensive outpatient rehabilitation facilities for participation in the Medicare or Medicaid programs.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1998

Measuring and improving the performance of health care providers: accreditation in the 21st century.

Outcomes data will become part of the Joint Commission on Accreditation of Healthcare Organizations' accreditation process. Accredited organizations will select a measurement system that they will use to submit data to the Commission. Data trends will be reviewed to determine response by the accreditor. The Joint Commission will work with organizations to assist with improvement opportunities. Accreditation decisions will continue to be based on standards. The Joint Commission's system, the IMSystem, is one of several systems available for use in accreditation activities.

Accreditation↗
PubMed1999

Joint Commission World Symposium on Improving Health Care Through Accreditation.

BACKGROUND: Throughout the world, in developed and developing countries alike, governments, payers, employers, and consumers desire means of holding providers accountable for the quality of care purchased and delivered. To explore the relevance and value of accreditation systems for meeting these various needs, the Joint Commission on Accreditation of Healthcare Organizations (Oakbrook Terrace, III) cosponsored a "World Symposium on Improving Health Care Through Accreditation," in Barcelona, Spain, July 8-10, 1999. To sharpen the issues involved in improving health care worldwide, the program was organized around debates focusing on four provocative propositions. Each pair of keynote debaters was followed by a reactor panel, audience discussion, and balloting. PROPOSITIONS: 1. No single set of quality standards is appropriate for universal use in health care organizations; 2. Health care financing mechanisms provide the primary incentives and disincentives to deliver high-quality health care; 3. Effective health system reform must be legislated and encompass reliance on the private sector; and 4. An accreditation system that includes professional credentialing and evidence-based practice will improve health care outcomes. SUMMARY: There was much agreement that emphasis on accountability has stimulated dramatic growth in internal (organizational) quality management programs, external (cross-organizational) benchmarking with comparative data, and accreditation or certification.

Accreditation↗
PubMedDate not supplied

JCAHO accreditation and quality of care for acute myocardial infarction.

We examined the association between JCAHO accreditation of hospitals, those hospitals' quality of care, and survival among Medicare patients hospitalized for acute myocardial infarction. Hospitals not surveyed by JCAHO had, on average, lower quality (less likely to use aspirin, beta-blockers, and reperfusion therapy) and higher thirty-day mortality rates than did surveyed hospitals. However, there was considerable variation within accreditation categories in quality of care and mortality among surveyed hospitals, which indicates that JCAHO accreditation levels have limited usefulness in distinguishing individual performance among accredited hospitals. These findings support current efforts to incorporate quality of care in accreditation decisions.

Accreditation↗