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Many organizations are considering or have chosen to seek accreditation from the Community Health Accreditation Program (CHAP). This article presents information about the program and strategies on preparing the organization and staff for accreditation. Look for a follow-up article on preparing for the accreditation site visit.
The Multistate Learning Collaborative on Performance and Capacity Assessment or Accreditation of Public Health Departments (MLC) is an initiative undertaken with the Exploring Accreditation Project (EAP). The EAP is jointly funded by the Robert Wood Johnson Foundation (RWJF) and the Centers for Disease Control and Prevention (CDC), and staffed collaboratively by the Association of State and Territorial Health Officials (ASTHO) and the National Association of County and City Health Officials (NACCHO) to explore the implications and feasibility of a national public health accreditation system. The MLC, also financially supported through grants from RWJF, is designed under the auspices of the National Network of Public Health Institutes (NNPHI) and the Public Health Leadership Society (PHLS) to enhance the accreditation/assessment activities already underway in each of the grantee states; to promote learning among the states participating in the collaborative; to disseminate information to state and local health departments nationally; and to inform the work of the EAP. Five states with mature accreditation or assessment programs were selected from among 18 applicants. This article describes the ongoing work, including breakthroughs and challenges, in these natural "laboratories" so that this information may be a resource for other states as well as nationally.
PURPOSE: The purpose of this paper is to point out the dangers inherent in choosing schools or programs from the internet, particularly in the field of health services, which may not be accredited, and therefore not recognized either by other institutions or by employers. DESIGN/METHODOLOGY/APPROACH: The problem is described and some of the better known American accrediting agencies are listed. PRACTICAL IMPLICATIONS: The paper has practical implications in terms of providing useful steps for anyone interested in exploring a health services career through ongoing education. ORIGINALITY/VALUE: The paper represents a viewpoint from the perspective of an American accreditation consultant who is familiar with the organizational and program accreditation system in the USA.
With the objective of evaluating and accrediting the quality of medical education in the country, the Mexican Association of Medical Schools initiated the National Programme for the Strengthening of the Quality of Medical Education (PNFCE). This programme led to the establishment of the National System of Accreditation. Medical school deans in Mexico determined the criteria for the evaluation of quality and its subsequent standards through a consensus process. The following 10 criteria resulted: general basis and educational objectives; government and institutional orientation; educational programme and academic structure; educational process assessment; students; teaching staff; institutional coherence; resources; clinical sites; and administration. Eighty-eight standards were developed in the instrument designed for the self-evaluation phase. The information resulting from the self-evaluation will be verified by a group of experts during a survey visit, which will be finalized with a report to serve as the basis for the decision to be made by the Accreditation Commission. The self-evaluation phase started in 1994. In 1996 four schools submitted their request for accreditation. As of July 1996, one survey visit has been completed and three more are programmed for the second half of the year.
Subspecialty training accreditation is a way in which the adequacy of postresidency training can be controlled. The development of subspecialty training accreditation is the purview of the Residency Review Committees (RRCs) of the Accreditation Council for Graduate Medical Education (ACGME). An RRC develops the Special Requirements and the Justification/Impact statement for the subspecialty. These documents are reviewed by all other RRCs, the parent organizations of the sponsoring RRC, and the ACGME and other interested groups. When all suggestions from these groups are answered by the RRC, the Committee for Review of Special Requirements of the ACGME must approve the program. The final step is ACGME approval. The program will then go into effect on the date specified in the Justification/Impact statement. The procedure is complex and time-consuming. However, in the final analysis, a subspecialty program accredited in this fashion will be a solid educational experience for the trainee and should have a well-defined role in the parent institution.
Not all sites performing mammography produce optimal images at acceptably low doses. To address this situation, a voluntary accreditation program was instituted through the American College of Radiology. Each site applying for accreditation completes a detailed questionnaire about facilities and equipment, personnel, and quality control. Each unit at each site is evaluated by a medical physicist for clinical and phantom image quality and for average glandular dose. Although a site is accredited for 3 years, the performance of each unit is audited annually. Of 11,162 units for which accreditation was sought, only 5,856 (68%) passed at the first attempt, with another 18% passing after reapplication. The major reason for failure was inadequate clinical images, followed by inadequate phantom images, both inadequate clinical and phantom images, and inadequate quality control records. In a performance audit of 20 new units, an average of 5.8 problems were encountered per unit, the majority of which adversely affected image quality. These results support the requirement of equipment performance audits and raise the question of whether similar problems exist in other areas of medical imaging.
This article discusses the background, goals, criteria, current results, impact, and future directions of the American College of Radiology's (ACR's) Mammography Accreditation Program. To date, approximately one half of the mammographic units in the United States have voluntarily applied for accreditation through the ACR program, with approximately one quarter of the units in the United States now accredited. Application rates have increased steadily since the start of the program in August 1987. The equipment performance criteria and professional criteria defined and employed in the ACR Mammography Accreditation Program have been adopted as standards for the performance of screening mammography by the ACR and have served as a basis for quality assurance standards in state and federal legislation on mammography.
Veterinary schools in Australia and New Zealand are assessed for accreditation purposes every six years by the Veterinary Schools Accreditation Advisory Committee (VSAAC), which is a standing committee of the Australasian Veterinary Boards Council (AVBC).1 Prior to undertaking an assessment, VSAAC requests a Self Evaluation Report from the school and subsequently spends a week on site to collect additional information. The committee also takes into consideration other quality assurance procedures within the university and aims for a process that complements other evaluation activities. Internal evaluation procedures within VSAAC are designed to reflect the process and outcomes of each visit and lead to annual revisions of the publication Policies, Procedures and Guidelines publication. The committee has close links with the Royal College of Veterinary Surgeons (RCVS), and there is a routine exchange of observers on all visits in the United Kingdom and Australasia. In recent years VSAAC has become increasingly interested in looking at ways to place greater emphasis on the outcomes of veterinary education and, eventually, to reduce our reliance on input measures. There has been good progress in identifying desirable attributes for veterinary graduates, but further work is needed to establish the reliability of assessment procedures. The Australasian accreditation system is very supportive of recent moves to achieve greater compatibility of veterinary accreditation systems in different parts of the world because we believe it has the potential to assist globalization of animal disease control and veterinary education.
There are 126 medical education programs leading to the MD degree in the United States, and 16 in Canada, that are accredited by the Liaison Committee on Medical Education (LCME). This article summarizes the current policies and procedures used by the LCME and traces their historical development. The external factors that have acted to influence accreditation in the United States, such as recognition of accreditation agencies by the US Department of Education, are then described. Finally, comparisons are drawn between the accreditation systems for medical education and veterinary medical education programs.
Accreditation in nursing continuing education (CNE) is central to professional values such as accountability, competence, and knowledgeable practice. Organizations choosing to participate in the accreditation/approval system make a commitment to quality. This article reviews the history of accreditation, defines the language, describes the system and process, and discusses agency/institution characteristics that should be in place before beginning an accreditation application process. The American Nurses Credentialing Center Commission on Accreditation model is used as the prototype.
PURPOSE: The purpose of this study was to determine characteristics of nursing science and identify expected outcomes from baccalaureate graduates, and to develop accreditation standards and criteria reflecting the characteristics of the nursing profession. METHODS: A methodological research design was utilized in this study. Related literature reviews and the nursing education program goals and objectives of the 99 nursing schools in Korea were analyzed. A cross-sectional survey research design was utilized to test the validity of the developed characteristics of the nursing profession and their accreditation criteria and standards. The face validity was from the advisory committee and public committee hearing. RESULTS: The characteristics of nursing science were defined with five concepts including humanity, scientific knowledge, professionalism, therapeutic relationship, and facilitating well-being. The expected outcomes from graduates were identified as providing holistic nursing, critical thinking, establishing professionalism and leadership, construction of a therapeutic relationship, and skilled nursing practice. Finally 6 standards and 14 criteria reflecting the unique characteristics of the nursing profession were developed for accreditation. These proposed accreditation standards and criteria are a challenge to promote the quality of nursing science.
A renewed emphasis on clinical competence and its assessment has grown out of public concerns about the safety, efficacy, and accountability of health care in the United States. Medical schools and residency training programs are paying increased attention to teaching and evaluating basic clinical skills, stimulated in part by these concerns and the responding initiatives of accrediting, certifying, and licensing bodies. This paper, from the Residency Review Committee for Internal Medicine of the Accreditation Council for Graduate Medical Education, proposes a new outcomes-based accreditation strategy for residency training programs in internal medicine. It shifts residency program accreditation from external audit of educational process to continuous assessment and improvement of trainee clinical competence.
The 1992 AMH is a key step in what will be major ongoing changes in the JCAHO's approach to accreditation. After January 1992, hospital administrators and medical staff leadership should expect that JCAHO surveyors will be looking for indications of a diligent effort to interpret and apply the continuous quality improvement requirements. Meeting the new and revised standards will require rapid implementation of the continuous quality improvement approach. The JCAHO has provided two resources to assist hospitals in this process. The first is a description of the continuous quality improvement process, in both the Introduction and in the Quality Assessment and Improvement chapter of the 1992 AMH. Also, the JCAHO has published a booklet entitled "Transitions from Quality Assurance to Continuous Quality Improvement," which is available from the JCAHO Customer Service Department. It is important that hospital administrators and medical staff leadership review the 1992 AMH promptly and make any changes necessary to comply with the new standards. Despite the fact that JCAHO has been criticized in recent years, accreditation remains important to the viability of the vast majority of hospitals, primarily because of its importance to licensing agencies and third party payors. As accreditation standards become more comparable to the Medicare Conditions of Participation, hospital accreditation will become even more closely linked to a facility's ability to receive or maintain Medicare provider status.
This final notice recognizes accreditation by the Community Health Accreditation Program (CHAP), a subsidiary of the National League for Nursing (NLN), for home health agencies (HHAs) that wish to participate in the Medicare Program. As a result of this recognition, HHAs accredited by CHAP are deemed to meet the Medicare conditions of participation for HHAs to the extent described in this notice. This final notice sets forth certain specific requirements with which CHAP must comply to maintain Medicare recognition of its HHA accreditation program.
The relationship of accreditation to the public interest has been a topic of discussion in the media as well as in higher education circles as the topic has been politicized. This article examines the historical evolution of public involvement in the accreditation process as well as the reasons for public representation on accreditation bodies and in decision making. The links between accreditation and quality control are discussed and assessed.
Health service accreditation systems have explicit standards for organisation against which the participating hospital assesses itself before a structured visit by outside "surveyors". They submit a written report back to the hospital with commendations and recommendations for development prior to a follow-up survey. Accreditation may be awarded for a fixed term or may be with held by an independent assessment Board if the hospital does not meet a defined threshold of standards. In Europe, some government and medical organisations initially distanced themselves from the pilot hospital wide programmes, arguing that they would cost too much and undermine management, or that they were irrelevant to clinical practice. But gradually it became obvious that accreditation worked for hospitals; purchasers and insurers saw its potential for quality and resource management; and professional bodies recognised the links between clinical training, practice and outcome and the environment in which health care is provided. If nothing else, it offered a multi-professional bridge between the existing numerous fragmented systems such as inspecting (statutory safety), visiting (professional training), and monitoring (service contracts). The introduction of accreditation appears to benefit hospitals in many different countries and health systems and provides a vehicle for integrated quality management which is visible to funding agencies, government and the public. Interest is growing within Europe.
Meeting expectations of high quality health care, the safe and secure operation of medical information systems is a "must". However for healthcare software nationwide quality control systems are not widely used. A quality control project of health care applications in Hungary has been launched in 1996 by the Hungarian Society of Healthcare Informatics (MEIT) and Medico-Biological Section of Johann Neumann Society of Computing (NJSZT) by establishing a joint Healthcare Informatics Applications Accreditation Board (Board ESAB). The Board developed an evaluation methodology and a legal procedure to test health care software application modules. The evaluation method is based on international standards as ISO-9126 and on emerging European standards of CEN/TC 251. First rounds of accreditation already proved that there is a need among providers and users for the accreditation process. The authors hope that establishing an accreditation system will lead to a more balanced health care software market where users have an opportunity to inform themselves by the opinion of independent experts on the product they intend to purchase.
Management of quality assurance protocols in a radiology department can be done by using several tools or models. Some are specific like accreditation manuals issued by some organizations, others like the ISO 9000 certification and the Total Quality management are more general and already well known by manufacturers. In order to implement a process of quality improvement, we have reviewed three models of quality assurance: evaluation in total quality based on the European model "EFQM", accreditation based on booklets from French cancer centers and Canadian radiology centers and, finally, accreditation based on the ISO 9002 certification model. Based on results of our comparative study, these three tools of quality management are not contradictory and may be complementary. However, they can be compared in terms of constraints they impose, of their historical background, of the criteria evaluated as well as the role of different teams. In conclusion, we suggest that directors of radiology department interested in implementing a quality assurance program first evaluate their department using the Canadian accreditation model issued in 1993 which is useful to become familiar with this new concept of quality. In a second step, a self assessment using the EFQM has to be done in collaboration with all members of the administration board in order to integrate all parameters and to share this protocol with all decision makers. The last step is to consolidate the organization of the quality assurance protocols by means of the ISO 9002 certification.