[The integrated approach between Health Organisation accreditation and professional excellence accreditation]

Later than in other industrialized areas, Health Organisation accreditation has become popular in our country during the last few years as a result of legislation requiring accreditation for healthcare providers of the National Health Service. Out of the two accreditation models, for regulation and public accountability (institutional) and professional, voluntary self-developed (for excellence), Institutional accreditation process has been slowly growing with the adoption of generic structural and organisational standards, which have been set up and managed directly by government. The recently undertaken second model is a peer review assessment activity that originates from a comparison with explicit standards during reciprocal visits carried out by professional organisations. The basis for the assessment is primarily clinical and patient oriented. The healthcare quality of Institutional accreditation is guaranteed mainly through the achievement of predetermined standards for risk management and organisation. On the other hand, the excellence accreditation, whose aim is to implement the continuous improvement of quality, depends on the context and the changes that result from new knowledge and scientific progress. The model operates according to values, which can change in the long run. It measures the effort to improve performances while special care is required to define standards through peer consensus. Once the prescribed model of accreditation is adopted, as is the case for Health Organisation accreditation, it is essential to have flexible patient-oriented tools ensuring that new knowledge and scientific progress complete the assessment and audit.