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Hospital accreditation: an umbrella review.

Katherine Lewis1,2, Reece Hinchcliff1,3

  • 1School of Public Health & Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia.

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
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Hospital accreditation

Keywords:
accreditationexternal evaluationpatient safetyquality assessmentquality improvementquality standards

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Area of Science:

  • Healthcare Management
  • Quality Improvement
  • Health Services Research

Background:

  • Hospital accreditation is a widely adopted quality improvement strategy.
  • Existing research on its effectiveness is contested, necessitating a comprehensive synthesis.
  • Understanding the impact of accreditation on healthcare quality is crucial for optimizing health systems.

Purpose of the Study:

  • To synthesize existing reviews on the impacts of hospital accreditation on healthcare quality.
  • To identify research trends, knowledge gaps, and the theoretical underpinnings of accreditation's effects.
  • To provide evidence-based recommendations for future research and accreditation program development.

Main Methods:

  • An umbrella review methodology was employed.
  • Searches were conducted across seven major databases (CINAHL, Embase, Medline, PubMed, Scopus, Cochrane, JBI).
  • 33 systematic reviews were included after rigorous screening, quality assessment, and data extraction.

Main Results:

  • Hospital accreditation shows associations with various health system and organizational outcomes.
  • Effectiveness, efficiency, patient-centeredness, and safety were the most frequently studied quality dimensions.
  • Access, equity, and timeliness received limited research attention, and conclusive evidence remains impeded by methodological barriers.

Conclusions:

  • The precise impact and mechanisms of hospital accreditation on quality improvement remain poorly understood.
  • The current body of research is largely atheoretical, lacking robust explanations for how accreditation influences quality.
  • Future research should integrate implementation and behavioral science, control for variables, and investigate underlying mechanisms.