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General practice accreditation - does time spent on-site matter?

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  • 1<institution content-type="university">School of Psychological Sciences</institution>, <institution content-type="university">Faculty of Medicine, Health and Human Sciences</institution>, <institution content-type="university">Macquarie University</institution>, <addr-line>Balaclava Road, North Ryde</addr-line>, <city>Sydney</city>, <state>NSW</state> <postal-code>2112</postal-code>, <country>Australia</country>.

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Accreditation standards for general practices were assessed. Longer survey visits under the 5th edition identified more non-conformities than shorter visits under the 4th edition, suggesting survey duration impacts results.

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Area of Science:

  • Healthcare Quality and Safety
  • Medical Accreditation Standards
  • General Practice Evaluation

Background:

  • Accreditation by the Royal Australian College of General Practitioners (RACGP) aims to ensure public safety and quality in general practices.
  • Standards have evolved iteratively with limited empirical validation since initial implementation.
  • Previous assessments lacked sufficient data on the impact of survey duration on conformity rates.

Purpose of the Study:

  • To compare non-conformity rates between RACGP 4th and 5th edition standards.
  • To evaluate the effect of survey visit length (half-day vs. full-day) on accreditation outcomes.
  • To determine if changes in standards editions, rather than visit duration, influenced conformity.

Main Methods:

  • A comparative analysis of indicator non-conformity rates was performed.
  • Data from 4th edition (half-day visits) and 5th edition (full-day visits) were analyzed.
  • Statistical tests, including a bootstrapped t-test, were used to compare median conformity percentages.

Main Results:

  • Full-day visits under 5th edition standards identified significantly more non-conformities (median 86% met) compared to half-day visits under 4th edition standards (median 95% met).
  • The difference in conformity was statistically significant (P < 0.0001).
  • Surveyor time on-site emerged as a critical factor influencing assessment outcomes.

Conclusions:

  • The increased non-conformities under the 5th edition appear primarily linked to the extended survey duration, not necessarily stricter standards.
  • Future accreditation assessments should consider the impact of on-site surveyor time.
  • Further research is needed to validate the effectiveness of accreditation standards independent of assessment duration.