Accreditation

This review of experience in accreditation and external quality assessment systems was produced at the request of the UK Department for International Development in India. The purpose of this review is to describe where External Quality Assessment fits in the broader set of levers that exist for engaging with health care providers and organisations in developing countries in order to improve quality and affordability of care. This information is partially based on theory, but primarily presents lessons learned and experience with accreditation and other assessment methods in both OECD and developing countries.

This report will review the critical elements of quality assessment in Section 1. In the second section it will review the National Health Insurance Fund Act requirements for accreditation and the current means of registering and evaluating health providers. What is needed in accreditation, the options for Tanzania, and the potential problems there may be with accreditation. The final section provides practical guidance for implementing a short-term and longterm strategy for accreditation of NHIF providers and more broadly for all Tanzanian providers. Appendix A provides a practical tool: An Accreditation Survey Instrument for Hospitals.

Credentialing of health care providers, facilities and educational institutions is an integral component in building and sustaining robust human resources for health (HRH) systems. The credentialing mechanisms

This presentation was part of the 2006 Global Health Mini-University. This session highlights the need for greater investments in quality improvement in the private health sector. It also provides an overview of promising approaches and offers a detailed discussion of emerging accreditation models and other recognition systems for the private sector. [publisher’s description]


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This study explores the details of the process leading to the equivalence determination of qualifications and degrees for the education and training of the health professions in Thailand. [from abstract]

QAP implemented the first randomized control trial to measure the impact of accreditation in a developing country setting and reports its findings in this Operations Research Results report. The central issue to the report addresses the extent to which accreditation, known to favorably impact measurable indicators relating to the quality of care, actually improves patient outcomes. While exploring this issue, the report also sheds light on the importance of careful planning and communication in implementing complex research and would serve as a guide to others in undertaking similar efforts. [

This report analytically and comparatively reviews international models and experiences in the development and implementation of health care regulations. The study commences with an introduction to the concept of health care regulations, and then describes the most universally common approaches for putting them into practice: licensing, accreditation, and certification. Depending on the country and its economic and political structures, different governmental and voluntary regulations over health services have evolved. Traditionally, in most countries, official licensure of health personnel has been the favored approach.

This monograph provides a brief overview of several aspects of quality assurance, including its cost-effectiveness and its feasibility in less developed countries. The monograph describes the dimensions of quality, the four principles of quality assurance, the QA process, and key activities in the development of a QA program. Activities/tools: QA cycle (since replaced by the QA triangle); analytical tools, including the cause and effect (fishbone) diagram, flowchart, and systems model; statistical and presentation tools, including the run chart, histogram, check sheets, pareto chart, scattergram, and control chart. [publisher’s description]

This article provides an historical overview of the three major ways that nursing regulates the profession, its members, and their performance, i.e., licensure, certification, and accreditation. Each type of regulation mechanism is described and differences between them are explained. Current issues related to accreditation of schools of nursing are outlined. [abstract]

PROQUALI is a comprehensive, coordinated and innovative reproductive health (RH) service performance and quality improvement accreditation model funded by USAID. PROQUALI was developed to improve performance and quality and increase access to RH services at the primary healthcare level in northeastern Brazil. The training and technical assistance activities of the three previously independent CAs were integrated and applied during PROQUALI to help demonstration sites achieve state-approved RH service quality standards and accreditation. During the pilot demonstration phase, Phase I, the accreditation model was developed and field-tested in five primary health clinics in the states of Bahia and Cear

The value of accreditation remains uncertain, and this persists as a central legitimacy problem for accreditation providers, policymakers and researchers. The question arises as to how best to research the validity, impact and value of accreditation processes in health care. [from abstract]

A global review resulted from a study conducted by the International Society for Quality in Health Care (ISQua) under contract to the World Health Organization. The first of this report’s three parts describes structures and activities at national and international levels around the world to promote quality in health care. The second part catalogues quality concepts and tools in local use in various countries. The third part outlines initiatives in health service accreditation and analyses the operation of functioning national programmes around the world. The appendices include recommendations of major international bodies and meetings on quality assurance.

In addition to QA and performance improvement, this issue focuses on accreditation in South Africa, QI teams in Guatemala, identifying root causes, increasing compliance with standards, and community-based problem solving. [publisher’s description]

The WHO Regional Office for the Eastern Mediterranean held a regional consultation on the accreditation of health professions education. The objectives of the meeting were to enable countries of the Eastern Mediterranean Region to exchange experience in establishing national systems of accreditation, identifying strengths and constraints, and to formulate region- and country-specific plans of action for establishing accreditation of health professions education. [from author]

This presentation discusses quality issues in private practice in developing countries, how the government can make licensing and regulation more effective, shifting the quality distribution and the use of accreditation. [adapted from author]

This brief report describes four different accreditation programs in South Africa: one is nationwide and addresses hospitals; the second accredits privately financed healthcare programs; the third is a provincial program accrediting all public healthcare facilities, and the fourth assesses clinics providing adolescent reproductive health. This operations research study interviewed stakeholders of the South Africa healthcare system to elicit their views of the best possible options for South Africa and of the strengths and weaknesses of the four existing programs. [author’s description]

This report examines whether Zambia’s hospital accreditation program improved health outcomes and other indicators. Performed after an accreditation program had been launched in about 40 hospitals, the evaluation examined eight indicators of healthcare quality at hospitals that had and had not been exposed to the accreditation program. The report is rich in details about what can go right and what can go wrong in such program and concludes that accreditation programs in Africa can have a positive impact on hospital compliance with such programs, especially if the programs provide education, consultation, technical assistance, and a gradual and graduated sequence of steps toward accreditation. [author’s description]

Zambia’s recently developed hospital accreditation program is a major component of ongoing health sector reforms that have taken place in the country during the last decade. Although Zambia previously had several processes in place for evaluating hospital performance, comprehensive performance standards had not been developed and quality measurement was not standardized. Zambia’s hospital accreditation program has focused on developing realistic standards, educating hospitals on their performance vis-à-vis these standards, and making decisions on whether hospitals have achieved accreditation status.