The effect of certification and accreditation on quality management in 4 clinical services in 73 European hospitals
Identifieur interne : 003F31 ( Main/Exploration ); précédent : 003F30; suivant : 003F32The effect of certification and accreditation on quality management in 4 clinical services in 73 European hospitals
Auteurs : Charles D. Shaw [Australie] ; Oliver Groene [Royaume-Uni] ; Daan Botje [Pays-Bas] ; Rosa Sunol [Espagne] ; Basia Kutryba [Pologne] ; Niek Klazinga [Pays-Bas] ; Charles Bruneau [France] ; Antje Hammer [Allemagne] ; AOLIN WANG [États-Unis] ; Onyebuchi A. Arah [États-Unis] ; Cordula Wagner [Pays-Bas]Source :
- International journal for quality in health care [ 1353-4505 ] ; 2014.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Santé publique, Hospitalisation.
English descriptors
- KwdEn :
Abstract
Objective. To investigate the relationship between ISO 9001 certification, healthcare accreditation and quality management in European hospitals. Design. A mixed method multi-level cross-sectional design in seven countries. External teams assessed clinical services on the use of quality management systems, illustrated by four clinical pathways. Setting and Participants. Seventy-three acute care hospitals with a total of 291 services managing acute myocardial infarction (AMI), hip fracture, stroke and obstetric deliveries, in Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey. Main Outcome Measure. Four composite measures of quality and safety [specialized expertise and responsibility (SER), evidence-based organization of pathways (EBOP), patient safety strategies (PSS) and clinical review (CR)] applied to four pathways. Results. Accreditation in isolation showed benefits in AMI and stroke more than in deliveries and hip fracture; the greatest significant association was with CR in stroke. Certification in isolation showed little benefit in AMI but had more positive association with the other conditions; greatest significant association was in PSS with stroke. The combination of accreditation and certification showed least benefit in EBOP, but significant benefits in SER (AMI), in PSS (AMI, hip fracture and stroke) and in CR (AMI and stroke). Conclusions. Accreditation and certification are positively associated with clinical leadership, systems for patient safety and clinical review, but not with clinical practice. Both systems promote structures and processes, which support patient safety and clinical organization but have limited effect on the delivery of evidence-based patient care. Further analysis of DUQuE data will explore the association of certification and accreditation with clinical outcomes.
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Affiliations:
- Allemagne, Australie, Espagne, France, Pays-Bas, Pologne, Royaume-Uni, États-Unis
- Angleterre, Catalogne, Grand Londres, Hollande-Septentrionale, Nouvelle-Galles du Sud, Utrecht (province), Île-de-France
- Amsterdam, Barcelone, Londres, Paris, Sydney, Utrecht
- Université d'Amsterdam
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Shaw</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Centre for Clinical Governance Research, University of New South Wales</s1><s2>Sydney</s2><s3>AUS</s3><sZ>1 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Groene, Oliver" sort="Groene, Oliver" uniqKey="Groene O" first="Oliver" last="Groene">Oliver Groene</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>London School of Hygiene and Tropical Medicine</s1><s2>London</s2><s3>GBR</s3><sZ>2 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Botje, Daan" sort="Botje, Daan" uniqKey="Botje D" first="Daan" last="Botje">Daan Botje</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>NIVEL, Netherlands Institute for Health Services Research</s1><s2>Utrecht</s2><s3>NLD</s3><sZ>3 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation></author><author><name sortKey="Sunol, Rosa" sort="Sunol, Rosa" uniqKey="Sunol R" first="Rosa" last="Sunol">Rosa Sunol</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Avedis Donabedian Institute, Universitat Autonoma de Barcelona</s1><s2>Catalonia</s2><s3>ESP</s3><sZ>4 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Catalonia</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>4 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Kutryba, Basia" sort="Kutryba, Basia" uniqKey="Kutryba B" first="Basia" last="Kutryba">Basia Kutryba</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Polish Society for Quality Promotion in Healthcare</s1><s2>Krakow</s2><s3>POL</s3><sZ>5 aut.</sZ></inist:fA14><country>Pologne</country><wicri:noRegion>Polish Society for Quality Promotion in Healthcare</wicri:noRegion></affiliation></author><author><name sortKey="Klazinga, Niek" sort="Klazinga, Niek" uniqKey="Klazinga N" first="Niek" last="Klazinga">Niek Klazinga</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>Department of Public Health, Academic Medical Center, University of Amsterdam</s1><s2>Amsterdam</s2><s3>NLD</s3><sZ>6 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region><settlement type="city">Amsterdam</settlement></placeName><orgName type="university">Université d'Amsterdam</orgName></affiliation></author><author><name sortKey="Bruneau, Charles" sort="Bruneau, Charles" uniqKey="Bruneau C" first="Charles" last="Bruneau">Charles Bruneau</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Haut Autorité de Santé</s1><s2>Paris</s2><s3>FRA</s3><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Hammer, Antje" sort="Hammer, Antje" uniqKey="Hammer A" first="Antje" last="Hammer">Antje Hammer</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Science and Faculty of Medicine, University of Cologne</s1><s2>Cologne</s2><s3>DEU</s3><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Cologne</wicri:noRegion><wicri:noRegion>University of Cologne</wicri:noRegion><wicri:noRegion>Cologne</wicri:noRegion></affiliation></author><author><name sortKey="Aolin Wang" sort="Aolin Wang" uniqKey="Aolin Wang" last="Aolin Wang">AOLIN WANG</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA)</s1><s2>Los Angeles, CA</s2><s3>USA</s3><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Los Angeles, CA</wicri:noRegion></affiliation></author><author><name sortKey="Arah, Onyebuchi A" sort="Arah, Onyebuchi A" uniqKey="Arah O" first="Onyebuchi A." last="Arah">Onyebuchi A. Arah</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA)</s1><s2>Los Angeles, CA</s2><s3>USA</s3><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Los Angeles, CA</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>UCLA Center for Health Policy Research</s1><s2>Los Angeles, CA</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>UCLA Center for Health Policy Research</wicri:noRegion></affiliation></author><author><name sortKey="Wagner, Cordula" sort="Wagner, Cordula" uniqKey="Wagner C" first="Cordula" last="Wagner">Cordula Wagner</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>NIVEL, Netherlands Institute for Health Services Research</s1><s2>Utrecht</s2><s3>NLD</s3><sZ>3 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center</s1><s2>Amsterdam</s2><s3>NLD</s3><sZ>11 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author></analytic><series><title level="j" type="main">International journal for quality in health care</title><title level="j" type="abbreviated">Int. j. qual. health care</title><idno type="ISSN">1353-4505</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">International journal for quality in health care</title><title level="j" type="abbreviated">Int. j. qual. health care</title><idno type="ISSN">1353-4505</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Accreditation</term><term>Certification</term><term>Complication</term><term>Europe</term><term>European</term><term>Healthcare quality</term><term>Hospital</term><term>Hospitalization</term><term>Iatrogenic</term><term>Patient</term><term>Patient safety</term><term>Public health</term><term>Quality management</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Iatrogène</term><term>Certification</term><term>Accréditation</term><term>Gestion de la qualité</term><term>Hôpital</term><term>Santé publique</term><term>Hospitalisation</term><term>Europe</term><term>Européen</term><term>Complication</term><term>Malade</term><term>Qualité des soins</term><term>Sécurité du patient</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Santé publique</term><term>Hospitalisation</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective. To investigate the relationship between ISO 9001 certification, healthcare accreditation and quality management in European hospitals. Design. A mixed method multi-level cross-sectional design in seven countries. External teams assessed clinical services on the use of quality management systems, illustrated by four clinical pathways. Setting and Participants. Seventy-three acute care hospitals with a total of 291 services managing acute myocardial infarction (AMI), hip fracture, stroke and obstetric deliveries, in Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey. Main Outcome Measure. Four composite measures of quality and safety [specialized expertise and responsibility (SER), evidence-based organization of pathways (EBOP), patient safety strategies (PSS) and clinical review (CR)] applied to four pathways. Results. Accreditation in isolation showed benefits in AMI and stroke more than in deliveries and hip fracture; the greatest significant association was with CR in stroke. Certification in isolation showed little benefit in AMI but had more positive association with the other conditions; greatest significant association was in PSS with stroke. The combination of accreditation and certification showed least benefit in EBOP, but significant benefits in SER (AMI), in PSS (AMI, hip fracture and stroke) and in CR (AMI and stroke). Conclusions. Accreditation and certification are positively associated with clinical leadership, systems for patient safety and clinical review, but not with clinical practice. Both systems promote structures and processes, which support patient safety and clinical organization but have limited effect on the delivery of evidence-based patient care. Further analysis of DUQuE data will explore the association of certification and accreditation with clinical outcomes.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Espagne</li><li>France</li><li>Pays-Bas</li><li>Pologne</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Catalogne</li><li>Grand Londres</li><li>Hollande-Septentrionale</li><li>Nouvelle-Galles du Sud</li><li>Utrecht (province)</li><li>Île-de-France</li></region><settlement><li>Amsterdam</li><li>Barcelone</li><li>Londres</li><li>Paris</li><li>Sydney</li><li>Utrecht</li></settlement><orgName><li>Université d'Amsterdam</li></orgName></list><tree><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Shaw, Charles D" sort="Shaw, Charles D" uniqKey="Shaw C" first="Charles D." last="Shaw">Charles D. Shaw</name></region></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Groene, Oliver" sort="Groene, Oliver" uniqKey="Groene O" first="Oliver" last="Groene">Oliver Groene</name></region></country><country name="Pays-Bas"><region name="Utrecht (province)"><name sortKey="Botje, Daan" sort="Botje, Daan" uniqKey="Botje D" first="Daan" last="Botje">Daan Botje</name></region><name sortKey="Klazinga, Niek" sort="Klazinga, Niek" uniqKey="Klazinga N" first="Niek" last="Klazinga">Niek Klazinga</name><name sortKey="Wagner, Cordula" sort="Wagner, Cordula" uniqKey="Wagner C" first="Cordula" last="Wagner">Cordula Wagner</name><name sortKey="Wagner, Cordula" sort="Wagner, Cordula" uniqKey="Wagner C" first="Cordula" last="Wagner">Cordula Wagner</name></country><country name="Espagne"><noRegion><name sortKey="Sunol, Rosa" sort="Sunol, Rosa" uniqKey="Sunol R" first="Rosa" last="Sunol">Rosa Sunol</name></noRegion><name sortKey="Sunol, Rosa" sort="Sunol, Rosa" uniqKey="Sunol R" first="Rosa" last="Sunol">Rosa Sunol</name></country><country name="Pologne"><noRegion><name sortKey="Kutryba, Basia" sort="Kutryba, Basia" uniqKey="Kutryba B" first="Basia" last="Kutryba">Basia Kutryba</name></noRegion></country><country name="France"><region name="Île-de-France"><name sortKey="Bruneau, Charles" sort="Bruneau, Charles" uniqKey="Bruneau C" first="Charles" last="Bruneau">Charles Bruneau</name></region></country><country name="Allemagne"><noRegion><name sortKey="Hammer, Antje" sort="Hammer, Antje" uniqKey="Hammer A" first="Antje" last="Hammer">Antje Hammer</name></noRegion></country><country name="États-Unis"><noRegion><name sortKey="Aolin Wang" sort="Aolin Wang" uniqKey="Aolin Wang" last="Aolin Wang">AOLIN WANG</name></noRegion><name sortKey="Arah, Onyebuchi A" sort="Arah, Onyebuchi A" uniqKey="Arah O" first="Onyebuchi A." last="Arah">Onyebuchi A. 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