Braithwaite Jeffrey, Westbrook Johanna, Pawsey Marjorie, Greenfield David, Naylor Justine, Iedema Rick, Runciman Bill, Redman Sally, Jorm Christine, Robinson Maureen, Nathan Sally, Gibberd Robert
Centre for Clinical Governance Research, Faculty of Medicine, University of New South Wales, 10 Arthur St., Kensington, NSW 2052, Australia.
BMC Health Serv Res. 2006 Sep 12;6:113. doi: 10.1186/1472-6963-6-113.
Accreditation has become ubiquitous across the international health care landscape. Award of full accreditation status in health care is viewed, as it is in other sectors, as a valid indicator of high quality organisational performance. However, few studies have empirically demonstrated this assertion. The value of accreditation, therefore, 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. Most health care organisations participate in some sort of accreditation process and thus it is not possible to study its merits using a randomised controlled strategy. Further, tools and processes for accreditation and organisational performance are multifaceted.
METHODS/DESIGN: To understand the relationship between them a multi-method research approach is required which incorporates both quantitative and qualitative data. The generic nature of accreditation standard development and inspection within different sectors enhances the extent to which the findings of in-depth study of accreditation process in one industry can be generalised to other industries. This paper presents a research design which comprises a prospective, multi-method, multi-level, multi-disciplinary approach to assess the validity, impact and value of accreditation.
The accreditation program which assesses over 1,000 health services in Australia is used as an exemplar for testing this design. The paper proposes this design as a framework suitable for application to future international research into accreditation. Our aim is to stimulate debate on the role of accreditation and how to research it.
认证在国际医疗保健领域已无处不在。在医疗保健领域授予全面认证地位，如同在其他行业一样，被视为组织高绩效的有效指标。然而，很少有研究能实证证明这一断言。因此，认证的价值仍不确定，这一直是认证机构、政策制定者和研究人员面临的核心合法性问题。问题在于如何最好地研究医疗保健领域认证过程的有效性、影响和价值。大多数医疗保健组织都参与某种认证过程，因此不可能采用随机对照策略来研究其优点。此外，认证和组织绩效的工具及过程是多方面的。
方法/设计：为了解它们之间的关系，需要一种结合定量和定性数据的多方法研究方法。不同行业内认证标准制定和检查的一般性，增强了将一个行业认证过程深入研究的结果推广到其他行业的程度。本文提出一种研究设计，包括一种前瞻性、多方法、多层次、多学科的方法，以评估认证的有效性、影响和价值。
澳大利亚评估1000多家医疗服务机构的认证项目被用作测试此设计的范例。本文提出此设计作为适用于未来认证国际研究的框架。我们的目的是激发关于认证的作用以及如何研究认证的讨论。
