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Accreditation and ISO certification: do they explain differences in quality management in European hospitals?
Charles Shaw1, Oliver Groene, Nuria Mora
1European Society for Quality in Healthcare, Limerick, Ireland. cdshaw@btinternet.com
Summary
Hospitals with accreditation or International Standardisation Organisation (ISO) certification show better quality and safety management. While both external assessments improve hospital quality, differences between them were not substantial, though country-specific variations exist.
Area of Science:
- Healthcare Management
- Quality Improvement
- International Healthcare Standards
Background:
- Hospital accreditation and International Standardisation Organisation (ISO) certification are mechanisms for enhancing healthcare quality and safety.
- Limited evidence exists comparing the relative merits of these two quality management systems.
Purpose of the Study:
- To identify systematic differences in quality management between hospitals with accreditation, ISO certification, or neither.
- To assess the impact of external quality assessments on hospital performance.
Main Methods:
- A comparative study assessed compliance with quality and safety measures in 89 hospitals across six countries.
- External auditors used a standardized tool as part of the EC-funded Assessing Response to Quality Improvement Strategies project.
- Hospitals were categorized based on achieving accreditation, ISO certification, or neither.
Main Results:
- Hospitals with accreditation (66.9%) and ISO certification (60.0%) demonstrated higher overall compliance scores compared to those with neither (51.2%).
- Statistically significant differences in mean scores were observed between hospitals with external assessments and those without.
- No substantial differentiation in quality scores was found between hospitals with accreditation only versus ISO certification only.
Conclusions:
- External assessments, such as hospital accreditation and ISO certification, appear to correlate with improved quality and safety structures and procedures.
- While differences exist, the study could not definitively distinguish between the effectiveness of accreditation versus ISO certification.
- Limitations include sample size and confounding factors related to the country-specific implementation of these standards.
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