Three decades of quality improvement in electroconvulsive therapy: exploring the role of accreditation

This study aims to track electroconvulsive therapy (ECT) clinics' compliance with standards for the administration of ECT before and after the introduction of the Electroconvulsive Therapy Accreditation Service (ECTAS) in 2003.

Three audits on the practice of ECT were retrospectively analyzed, and ECTAS data from 2004 to 2011 were prospectively analyzed. Overall compliance with 10 ECT audit standards was presented in 2 ways: annually and for each of the 3 waves of accreditation.

There have been continuing improvements since the introduction of the accreditation service in compliance with all 10 ECT audit standards whether measured annually or by accreditation cycle, although these improvements have not been linked to changes in clinical outcomes.

Although improvements in ECT delivery have coincided with the accreditation service, other factors may have also contributed.